Sequoia Visions 

  There is a trend by the insurance industry to rely on computerized programs in the determination of reasonable and necessary duration, type, frequency and cost of medical treatment provided for injuries sustained in accidents.  

   These computer programs remove the human element and human intelligence previously associated with the handling of medical claims. This trend also has allowed the insurance industry to reduce their claim personnel.

     Now, more claims can be handled by fewer people. The claims no longer involve the process of intelligence or decision-making. Also, the claims no longer require that experience of the claims handler be a factor. This has allowed the insurance industry to replace many seasoned and experienced claim handlers with computer data processors.

  The insurance industry is realizing additional savings by centralizing the handling of medical claims, increasing inventory levels of processors and eliminating the need for higher salaried employees.

   The future will be dictated by the adaptation of the computer programs and electronic services available to the insurance industry. Many treating physicians will be offered immediate payment in exchange for a 20% discount. This discount will increase each continuing year so as to represent another considerable savings for the insurance industry. The treating physician will be tempted to accept this offer in lieu of realizing months of delay, or even eventual denial, if they don’t.