Canadian Underwriter

How COVID-19 is changing virtual medical assessments

March 16, 2020   by Adam Malik

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Virtual medical assessments could play a significant role in keeping the insurance industry moving along during the COVID-19 pandemic. But conducting such procedures will be changing as people are urged to stay home.

“COVID-19 has brought this up to the surface in terms of how technology can be used for convenience, and for ensuring the insurance industry and claimants are getting the benefits they deserve,” said Gloria Rajkumar, CEO of SIMAC Medical Assessment Centre in Richmond Hill, Ont. “We’re living in a time of technology. We should be utilizing technology to the best of our advantages and for less exposure.”

Until recent events related to COVID-19 came to light, an assessment would involve a client going to a medical facility equipped with the technology capable to conduct the procedure remotely with the assessing doctor. That means having a webcam, internet connection, and the space to do it. The examination would be done through a secure platform developed specifically for this purpose. Additionally, another doctor — a chiropractor, for example — would be present to help the claimant understand what the assessing doctor was asking of them.

In today’s new reality, such assessments would be done through the same platform but from home. An assistant would be with the assessing doctor demonstrating what is being asked of the claimant.

“So we’re trying to do these assessments in a different type of way just to ensure [proper protections are being taken],” Rajkumar said, adding that claimants can still visit a clinic if a client doesn’t have a webcam or adequate internet connection at home.

This isn’t the first time Rajkumar has had to work through a pandemic. But even though SARS raised a level of concern in 2003, it wasn’t as severe as what’s happening with COVID-19.

“While there was an associated level of anxiety with SARS, the disease spread itself was much more contained,” she said. “There weren’t any shutdowns or any pending shutdowns and there weren’t any of these legislative guidelines. [Dealing with issues back then] wasn’t as hard as it’s going to be now in terms of staff, in terms of hours, remotely working from home — all of these things that the industry hasn’t really planned for.”

What Rajkumar wants to see is more people in the insurance space move towards virtual medical assessments so that claimants don’t have to wait. “I want the public, the insurance industry, the lawyers, and the claimants to know that there are alternatives to the normal way we conduct assessments. You don’t have to feel that everything has to shut down.”

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3 Comments » for How COVID-19 is changing virtual medical assessments
  1. Donald says:

    While the use of virtual medical assessments, for certain types of assessments, primarily psychological or psychiatric evaluations, may one day be considered a highly effective tool for both assessors and insurers to integrate into the disability claims process, the industry is currently not properly prepared to use such technology, at least with any real efficacy. While there has been a significant uptake in the use of virtual technology for the provision of various types of treatment or care required by individuals living in remote regions or those unable to get into a physician’s office, this virtual care model is nowhere near the same type of application of the virtual technology as would be that utilized in a benefit entitlement, claim assessment process.

    Undoubtedly the strong desire by many to integrate the mainstream use of virtual medical assessments has been around for decades and while the technological platforms that can support such an initiative have indeed advanced immensely over the years, the collective acceptance of tools like voice recording or video recording during an insurer’s examination has remained stagnant and is often challenged by various parties in the assessment process. There have been a few exceptions to the rule that have involved court ordered video recording of assessments but these have been for very extenuating circumstances and have been few and far between. Thus if we cannot get agreement on the acceptance of these much older types of technologies within the claims process, how does anyone think we would gain unchallenged stakeholder adoption of virtual medical assessments at this point in time.

    As technologies advance in support of the areas of disability assessment and claims management, there is most definitely a place for virtual assessments. But I would suggest that in order for this type of assessment tool to be most effective and well relied upon, as well as worth the money spent to have it completed, it needs to be introduced to the claims world in a fully transparent and fulsome way, after months of piloted trials. And importantly virtual medical assessments in their current form are not likely the best type of stop-gap measure at a time of crisis, like the one we are currently challenged with overcoming right now.

    Without question, all key stakeholders need to buy into what the standardization protocols of virtual medical assessments would ultimately be and to get meaningful consensus would require open dialogue with groups like the IBC, OTLA, OMA and other regulatory colleges, as well as injured victims advocate groups. That said, if there may be one small silver lining to this Covid 19 crisis, within the disability claims world, it may be that our awareness to the need to expeditiously develop an industry-wide, agreed upon standardization, for the practicable application of virtual assessments, has never been greater!

  2. Gloria says:

    Donald, While I agree with most of what you wrote above, at some point we have to take bold steps and there is no time like the present. To wait for the industry – consisting of Insurers, Lawyers, Legislators etc, and most importantly the claimant to get on board is at least months if not years away. The OMA, the CMPA and respective colleges are all on board with Virtual Assessments. Telehealth is being utilized (for years) and yet we cannot seem to get on board with IMEs. My firm has successfully complete Virtual Assessment over the past two years and no one has:
    1. complained about the process
    2. challenge the process
    3. reverse opinion as a result of the process

    At the end of the day, reports will be challenged no matter what – its the name of the game, but as long as the quality output is not compromised, we should all take a deep breath and allow this process to unfold.

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