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Insurers are developing new rules in the context of medical expertise - Companies

Insurers are developing new rules in the context of medical expertise – Companies

Being the subject of medical expertise after a traffic accident or assault, for example, is a source of anxiety for many patients. The insurance sector has therefore set up a clear and transparent framework with doctors’ associations to make medical expertise less stressful. An explanatory brochure will also be made available to patients.

Medical expertise is important for the execution of an insurance contract, for example after an accident at work. This, carried out by an independent medical consultant, allows the insurer to objectively assess the medical situation of a patient and compensate him correctly. Each year, at least 25,000 people are called to carry out a medical expertise.

Assuralia, the professional union of insurers, has drawn up, for the first time, guidelines in this area in collaboration with the professional associations of medical advisers (Abefradoc and Benevermedex). “The aim is to guarantee a transparent process and an empathetic follow-up of the medical expertise in the interest of each patient who visits a medical advisor.“, explains Assuralia. The emphasis is on the well-being of the patient, the doctor’s duty to inform and a transparent medical process.

The guidelines to follow before, during and after the exam have been sent to all members of professional associations.

During the expertise, the patient can thus be assisted by a trusted person or a doctor of his choice. The medical advisor undertakes to take the time to answer questions and to express himself clearly. Insurers undertake for their part to clearly explain the reimbursement procedure.

After the exam, patients can always obtain a copy of the medical report and those who wish can also challenge the expertise with the competent bodies. The new brochure gives more information on this subject.

Medical expertise is important for the execution of an insurance contract, for example after an accident at work. This, carried out by an independent medical consultant, allows the insurer to objectively assess the medical situation of a patient and compensate him correctly. Every year, at least 25,000 people are called in for medical expertise. Assuralia, the professional union of insurers, has drawn up, for the first time, guidelines in this area in collaboration with the professional associations of medical advisors (Abefradoc and Benevermedex). “The aim is to guarantee a transparent process and an empathetic follow-up of the medical expertise in the interest of each patient who goes to a medical advisor”, explains Assuralia. The emphasis is on the well-being of the patient, the doctor’s duty to inform and a transparent medical process. The guidelines to follow before, during and after the exam have been sent to all members of professional associations. During the expertise, the patient can thus be assisted by a trusted person or a doctor of his choice. The medical advisor undertakes to take the time to answer questions and to express himself clearly. Insurers undertake for their part to clearly explain the reimbursement procedure. After the examination, patients can always obtain a copy of the medical report and those who wish can also contest the expert’s report with the competent bodies. The new brochure gives more information on this subject.

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