Doctor accused of altering medical reports for insurance claims

GP’s libel claim is denied by a Toronto judge

Insurance News

By Lucy Hook

A Toronto doctor has been denied a libel claim after he was accused of having altered medical reports on victims of car accidents to affect their insurance claims.

Dr. Howard Platnick was named in an email sent by the former president of the Ontario Trial Lawyers Association (OTLA), Maia Bent, which was later leaked.

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In the email, sent in November 2014, Bent warned 670 other OTLA lawyers about his practices.

Now, a libel suit brought by Platnick has been dismissed in court, with Justice Sean Dunphy finding that Bent’s concerns had merit, and there is also a “public interest” in not concealing them, Toronto Star reports.

Bent, then the president-elect of the OTLA, had been representing a client whose claim for catastrophic injury following a car accident had initially been denied by TD Insurance.

As part of TD’s assessment of the claim, Platnick had been asked to sum up the specialists’ opinions in an executive summary report, via independent medical assessment firm Sibley SLR.

In the report, Platnick wrote that the “consensus conclusion” of specialists was that the accident claim was not serious enough to warrant a catastrophic impairment rating.

However, a neurologist who had assessed the victim said at an arbitration hearing that important sections of the report he had prepared for Sibley had been removed without his knowledge, and he never signed off on the final report, Bent wrote in her email to colleagues.

After initially denying the claim – a decision based partly on Platnick’s report – TD then changed its mind following the neurologist’s account, and offered an “obscene amount of money to settle”, which her client accepted, Bent wrote.

“(TD’s lawyer) must have received instructions from the insurance company to shut (the case) down at all costs,” she said.

In the judgement, Dunphy said that Bent’s comments appear to have been “substantially true and correct or are fair and reasonable comment upon those facts,” and were reasonably likely to succeed due to “credible and
compelling evidence.”

Over the last decade, family physician Platnick worked almost exclusively as a “medical expert” for insurance companies or assessment companies hired by insurers to evaluate claims, the report said.

Platnick’s lawyer, Tim Danson, said he and his client are disappointed by the decision and plan to appeal.

Bent’s lawyer, Howard Winkler, said the case represents an important opportunity to reconsider the role of executive summary reports commissioned by insurers in the determination of catastrophic injury claims in Ontario.

“In my view, it is a practice that should be immediately abandoned.”


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