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Workers Compensation Division-
          Claim# 028-CB-AFU3616-J
“Is It Better Under the Umbrella?”
                          Part 1




           7/20/12            1
I need your help to address the barbaric, inhumane treatment Travelers
Insurance Group imposes on injured workers within the Workers’
Compensation System! The “umbrella of coverage” folds as the State of
IL allows Travelers Insurance Group to deny legitimate wc claims.




                                              7/20/12                     2
Immediate and necessary medical care, to resolve all the medical issues which
were a direct result of his work-related accident that occurred on April 10,
2004. The injured worker learns employer-chosen doctors will increase
disputes over appropriate medical care as cost-containment is Travelers’ top
priority!




                                                  7/20/12                       3
1.   Practiced deception to secure      unfair or
     unlawful gain.


2.   Any act, expression,   omission or concealment

     that deceives another to their disadvantage.


3.   Intent to deceive another; a trick.
                              7/20/12         4
   Several medical documents state,
    “Right shoulder injury is due to
    improper positioning on the surgical
    table.”

   The surgeon and other professionals
    state, “The right shoulder injury is
    part of the work-related accident
    that occurred on April 10,2004.”

   Patient’s first report of right shoulder
    pain was Sept 6th, 2005, per wc
    physician’s chart note.


                               7/20/12         5
7/20/12   6
7/20/12   7
   Denies legitimate claims—Insurance is a
    business for profit.

   Morals, ethics, and adhering to the law
    become secondary considerations. The
    injured workers’ quality-of-life is
    meaningless.

   Treats injured workers like statistics…Your
    never respected as an individual or human
    being.

                    7/20/12

                                              8
Heterosexual, bisexual/gay, transgender,
          Catholic, Baptist, or Jewish: Healthcare,
          something we all need, irrespective of race,
          religion, creed or sexual orientation. The
          silence has to be broken. Travelers Insurance
          Group literally destroyed a human life. Injured
          workers should not have to endure such
          inhumane treatment. He trusted the
          professionals…the professionals trust the dollar
          bill! First lie: the right shoulder injury is a result
          of the work-related accident on April 10, 2004.




7/20/12                        9
   1) A doctor who submits a falsified medical
    report to hide the true injuries of an injured
    worker and allow an insurer to deny benefits
    to an injured worker is guilty of Workers’
    Compensation fraud.
   2) A doctor who falsifies medical records to
    indicate that a worker has an occupational
    injury when he does not, is committing
    Workers’ Compensation fraud.



                            7/20/12         10
IL Bureau of Disability Determination   Travelers’ Second Opinion-Independent
      Services-Medical Report                     Medical Evaluation


                                        7/20/12                    11
Thus, claims for the right shoulder impingement should be paid by
Travelers, not Medicare. It’s time for the patient’s suffering to end…
The truth according to the documentation will be told.




                                                7/20/12                  12
7/20/12   13
for claimant’s wheelchairs was not
          completed by the prescribing physician.
          The State of Il Insurance Commission fails
          to address the issue…They uphold the
          rights of the insurance carrier, Travelers!!




7/20/12                   14
7/20/12   15
Their loss ratio is 30%--For every dollar in premium collected from
employers, only 30 cents were paid out in benefits. Injured workers
innocently pay the price for Travelers’ financial success!!




                                              10%




                                                        20%




                               70%




                                              7/20/12                 16
Senator Dick Durbin was notified of the
          loans originated with an interest rate--
          45%--typical of a “loan shark” and
          Congressman Joe Walsh was apprised of
          Travelers unjust denial of legitimate
          workers’ compensation claims. Although
          it’s the job of state government to look-
          out for injured workers, they chose to
          simply “look the other way or pass-the-
          buck!”




7/20/12                  17
7/20/12   18
7/20/12   19
7/20/12   20
7/20/12   21

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Travelers Is It Better Under The Umbrella

  • 1. Workers Compensation Division- Claim# 028-CB-AFU3616-J “Is It Better Under the Umbrella?” Part 1 7/20/12 1
  • 2. I need your help to address the barbaric, inhumane treatment Travelers Insurance Group imposes on injured workers within the Workers’ Compensation System! The “umbrella of coverage” folds as the State of IL allows Travelers Insurance Group to deny legitimate wc claims. 7/20/12 2
  • 3. Immediate and necessary medical care, to resolve all the medical issues which were a direct result of his work-related accident that occurred on April 10, 2004. The injured worker learns employer-chosen doctors will increase disputes over appropriate medical care as cost-containment is Travelers’ top priority! 7/20/12 3
  • 4. 1. Practiced deception to secure unfair or unlawful gain. 2. Any act, expression, omission or concealment that deceives another to their disadvantage. 3. Intent to deceive another; a trick. 7/20/12 4
  • 5. Several medical documents state, “Right shoulder injury is due to improper positioning on the surgical table.”  The surgeon and other professionals state, “The right shoulder injury is part of the work-related accident that occurred on April 10,2004.”  Patient’s first report of right shoulder pain was Sept 6th, 2005, per wc physician’s chart note. 7/20/12 5
  • 8. Denies legitimate claims—Insurance is a business for profit.  Morals, ethics, and adhering to the law become secondary considerations. The injured workers’ quality-of-life is meaningless.  Treats injured workers like statistics…Your never respected as an individual or human being. 7/20/12 8
  • 9. Heterosexual, bisexual/gay, transgender, Catholic, Baptist, or Jewish: Healthcare, something we all need, irrespective of race, religion, creed or sexual orientation. The silence has to be broken. Travelers Insurance Group literally destroyed a human life. Injured workers should not have to endure such inhumane treatment. He trusted the professionals…the professionals trust the dollar bill! First lie: the right shoulder injury is a result of the work-related accident on April 10, 2004. 7/20/12 9
  • 10. 1) A doctor who submits a falsified medical report to hide the true injuries of an injured worker and allow an insurer to deny benefits to an injured worker is guilty of Workers’ Compensation fraud.  2) A doctor who falsifies medical records to indicate that a worker has an occupational injury when he does not, is committing Workers’ Compensation fraud. 7/20/12 10
  • 11. IL Bureau of Disability Determination Travelers’ Second Opinion-Independent Services-Medical Report Medical Evaluation 7/20/12 11
  • 12. Thus, claims for the right shoulder impingement should be paid by Travelers, not Medicare. It’s time for the patient’s suffering to end… The truth according to the documentation will be told. 7/20/12 12
  • 13. 7/20/12 13
  • 14. for claimant’s wheelchairs was not completed by the prescribing physician. The State of Il Insurance Commission fails to address the issue…They uphold the rights of the insurance carrier, Travelers!! 7/20/12 14
  • 15. 7/20/12 15
  • 16. Their loss ratio is 30%--For every dollar in premium collected from employers, only 30 cents were paid out in benefits. Injured workers innocently pay the price for Travelers’ financial success!! 10% 20% 70% 7/20/12 16
  • 17. Senator Dick Durbin was notified of the loans originated with an interest rate-- 45%--typical of a “loan shark” and Congressman Joe Walsh was apprised of Travelers unjust denial of legitimate workers’ compensation claims. Although it’s the job of state government to look- out for injured workers, they chose to simply “look the other way or pass-the- buck!” 7/20/12 17
  • 18. 7/20/12 18
  • 19. 7/20/12 19
  • 20. 7/20/12 20
  • 21. 7/20/12 21