Technology: Insurer withheld payments for this 92-year-old Toronto van attack survivor’s medical care. Now its own doctors say her injuries are catastrophic - PressFrom - Canada
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TechnologyInsurer withheld payments for this 92-year-old Toronto van attack survivor’s medical care. Now its own doctors say her injuries are catastrophic

15:36  31 march  2019
15:36  31 march  2019 Source:   thestar.com

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Lawyers and support workers say 91- year - old Aleksandra Kozhevnikova is still waiting for The attack left Kozhevnikova in a wheelchair and requiring physical and psychological care that Asked why she has continued to supply care without payment , Ginzburg said , “What would you suggest I do?

Lawyers and support workers say 91- year - old Aleksandra Kozhevnikova is still waiting for payment of almost AIG has now arranged for new assessments of Kozhevnikova this month, using its own medical assessors in order to determine future payments . “ Doctors told me I have to walk more.

Insurer withheld payments for this 92-year-old Toronto van attack survivor’s medical care. Now its own doctors say her injuries are catastrophic© Cole Burston Alesandra Kozhevinkova, a survivor of last summer’s deadly Yonge St. van attack, is photographed in her North York home in December.

The 92-year-old mowed down on a Yonge Street sidewalk during last year’s van attack has now been declared “catastrophically” injured by medical experts hired by the insurance company that has been withholding benefit payments for her care.

That “catastrophic” designation — declared by four medical professionals who assessed her in January on behalf of AIG Insurance — should pave the way for dramatically better coverage for Aleksandra Kozhevnikova, the retired widow and grandmother whose story touched the city following a January Toronto Star investigation into allegations that tens of thousands of dollars worth of care wasn’t being paid.

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The Toronto van attack was a vehicle-ramming attack that occurred on April 23, 2018, in Toronto , Ontario, Canada. A man, alleged to be Alek Minassian

A catastrophic injury is a severe injury to the spine, spinal cord, or brain, and may also include skull or spinal fractures. This is a subset of the definition for the legal term catastrophic injury , which is based on the definition used by the American Medical Association.

A neurologist, orthopedic surgeon, occupational therapist and neuropsychologist — all acting for AIG — concluded Kozhevnikova’s combined physical and non-physical injuries place her at “75 per cent whole person impairment.”

That conclusion means Kozhevnikova could now be eligible for up to $1 million in coverage for attendant care and rehabilitation — a huge spike from her existing coverage which is capped at $65,000 for both.

“I have a feeling of gratitude toward everyone,” she said in Russian through a translator this week.

Before being hit during the April 23, 2018 terrorist attack in which a van, allegedly driven by Alek Minassian, plowed down pedestrians on Yonge Street, Kozhenvnikova was a “relatively healthy individual,” the medical assessment reads. Today, she suffers from a neck fracture, spinal strains, post-traumatic stress disorder, despression, cognitive disorder and pain, it concludes.

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One of the medical assessors, orthopaedic surgeon Dr. Cameron Paitich, concluded Kozhevnikova has “a significant disability in ambulatory function necessitating the use of a walker and a wheelchair. This is permanent in nature.”

Michael Taylor, a partner with Toronto law firm Taylor, Baber and Mergui, which is representing Kozhevnikova, said the catastrophic designation still needs to be accepted by AIG — a step that should be a mere formality.

“It’s their own doctors who determined my client is catastrophically impaired. I’m waiting for them to act on the submitted invoices but now I’m comfortable that all of her expenses will be paid going forward. I want this woman to feel relaxed and comfortable.”

An AIG spokesperson in New York declined comment.

The January story about Kozhevnikova triggered outrage across the city, generating dozens of emails and calls from readers offering to help care for her, clean her apartment or donate money.

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Health insurance is an insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons.

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The story reported that AIG had withheld payment for attendant care and rehabilitation that added up to more than $40,000, according to invoices and correspondence between the company and Taylor’s firm.

The seriousness of her injuries was disputed.

While assessments by a psychologist and orthopaedic surgeon hired by Taylor’s firm found she was catastrophically injured, the insurer did not accept the findings.

An August letter to Taylor from Faber Insurance Adjusters Ltd., acting on behalf of AIG, said the medical information and documentation on Kozhevnikova’s injuries provided “insufficient evidence” of catastrophic impairment.

That matter has now been settled, says Taylor.

“On behalf of my client and her family, I’d like to thank all Torontonians for their support. It meant a lot to my client and helped her during the difficult recovery.”

Taylor says Kozhevnikova’s much improved prospects were largely inspired by public scrutiny after nearly a year of unpaid bills.

“I thank (the Star) for this. If not for the story, she wouldn’t have been labelled catastrophic. They (the doctors) wrote a real report with a real determination and not adjusted for AIG needs or wants. Usually doctors paid by insurance companies dance to the music.”

Robert Cribb is an investigative reporter. Reach him via email: [email protected]

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This is interesting!