Pitards and Hoisting Come to Mind

Insurance companies often use service deadlines to avoid responsibility when plaintiffs have trouble with service of process. I don’t remember seeing an insurance company’s lawyers have the same problem. An insurance company that wanted to avoid defending a company that inspected and certified an amusement park drop tower ride that fatally ejected a 14-year-old boy […]

United Health Is Using AI to Deny Insurance Claims

Insurance carriers have already begun using artificial intelligence to deny health insurance claims. A new lawsuit in Minnesota identifies United Health as using algorithms to deny the health insurance claims of elderly and disabled insureds, When claims are denied, necessary treatment is delayed – increasing the likelihood of serious injuries and death. The lawsuit, filed […]

When A Settlement Isn’t Final?

Holding the carrier liable post-settlement for continuing care and expenses under Medicare rules is an uncommon and aggressive approach. In most cases, settlements result in a release that relieves the paying party from any ongoing financial responsibility. This argument – to hold the carrier for that at-fault responsible for expenses going forward –  bears watching, […]

Med Mal Presuit Rules Can Be A Trap

Many states, like Florida, have presuit rules for medical malpractice cases, passed at the urging of lobbies that represent insurance companies and hospital systems. These rules differ from state to state but generally make filing suit more difficult by setting up a series of procedures your lawyer has to follow. Unsurprisingly, almost every case involves […]

Pay No Attention to the Man Behind the Curtain

I’ve been around the block long enough to know that in personal injury cases – particularly serious ones – there are frequently issues “behind the curtain”. The other side will often conceal these issues but they can affect everything from trial scheduling to negotiations. Sometimes, the defense counsel will be upfront but more often your […]

Insurance Coverage

Legal advice and strategy in your personal injury case require a detailed understanding of the various responsible parties and their insurance. Your lawyer should anticipate coverage issues in advance and address them with you so that you can make informed decisions about pursuing your case and a recovery with meaning. The Eighth Circuit agreed with […]

The Endless Courthouse Drama When Hospitals Are Determined To Hide Their Policies And Procedures

I posted recently about frivolous defenses and appeals raised by defendants, often because their insurance carriers have the resources to waste time and the incentive to hold on to the money that will eventually be paid to satisfy the claim. When we hear about frivolous claims, it is usually from insurance interests complaining that non-meritorious […]

Quality Fraud and Patient Safety

Doctors who prescribe to people they’ve never met and care they never give. These claims go back to a Civil War era law designed to prevent the Government from being overcharged for military supplies. Now, the DOJ brings in billions of dollars every year for healthcare fraud. Here’s the link Physicians facing prison, fines, for […]

Quality Fraud: The Insurance Industry Gets It All Wrong

After lobbying legislatures for “tort reform” for decades, the number of medical malpractice claims – especially what they used to call “frivolous” claims – has gone down. Has that lowered rates for physicians? Of course not. But instead of accepting responsibility, the insurance industry now blames “nuclear claims” and other imaginary foes to explain their […]