The Real Cost of Opioid Addiction for Insurers

The opioid crisis continues to rage. However, it doesn’t take a seasoned claim professional to understand that its not the adjuster’s role to tell a claimant, who has just sustained a severe injury or undergone an invasive surgery, what an adequate amount or how long pain medication is appropriate.

Taking the position of, “They are adults and can make their own decisions” is a complicated approach; Opioid addition overall decreases quality of life at the very least and is fatal at the very worst. In addition, its expensive for insurers and employers – Once addiction is diagnosed, the costs for detox treatment becomes another claim exposure. Detox often requires multiple rounds. Another cost to consider is, once opioids become part of the treatment regimen, they will become part of the MSA evaluation. Generic opioids may seem like a minor expense until you consider their cost over decades of use, as well as the cost to treat the gastric upset caused by decades of opioid use.

A better approach may be to consider an early IME once one or more risk factors for opioid addiction are identified. A social media investigation can help identify these factors early in a claim and also give insight into how the claimant recovery is progressing in the early stages. The information developed by this investigation will help your IME doc provide the medical basis to take the steps necessary to limit opioids from becoming an addition. This not only saves the claimant from months of agony but limits your exposure as well.

Fraudsniffr can help with the Social Media Investigation – learn more here:

Hydrocodone Pills and Prescription Bottle with Non Proprietary Label. No model release required – contains fictitious information.