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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Insurer withheld payments for this 92 - year - old Toronto van attack survivor ’ s medical care . Now its own doctors say her injuries are catastrophic . AIG has now arranged for new assessments of Kozhevnikova this month, using its own medical assessors in order to determine future payments .

Now its own doctors say her injuries are catastrophic . AIG Insurance initially disputed the severity of this 92 - year - old ’ s van And doctors say hospital administrators were told about the risks years ago. → Read More. Toronto van attack : Insurer withholds payment to cover care for victim, 91.

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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Insurer withheld payments for this 92 - year - old Toronto van attack survivor ’ s medical care . Now its own doctors say her injuries are catastrophic . Insurer withholds payment to cover care for Toronto van attack victim. Lawyers and support workers say 91- year - old Aleksandra Kozhevnikova

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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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They rushed to help after the Toronto van attack . A year later, they're still haunted. Opinion | I was friends with Alek Minassian in high school. We were both outcasts. Insurer withheld payments for this 92 - year - old Toronto van attack survivor ’ s medical care . Now its own doctors say her injuries

Lawyers and support workers say 91- year - old Aleksandra Kozhevnikova is still waiting for payment AIG has now arranged for new assessments of Kozhevnikova this month, using its own medical She’ s not going to get the help she needs otherwise.” Kozhevnikova says she was more mobile when

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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Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. Catastrophic plans are designed to protect you in a worst-case scenario; for example, if you get into a medical emergency and your medical costs total thousands of dollars.

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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