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 […]

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 […]

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

Like the insured persons in the story below, follow your instincts when it comes to insurance claims you think have been improperly denied. If you suspect something, they probably are improperly denied. The rejection of van Terheyden’s claim was typical for Cigna, one of the country’s largest insurers. The company has built a system that […]

Researching The Quality of Your Medical Care

“The AMA strongly believes patients should have access to reliable information about physicians, and state regulatory agencies are best positioned to offer well-balanced information to help patients make informed decisions about physicians,” an AMA spokesperson said in a statement. Trial lawyers shouldn’t be the only ones with access to relevant information about the background of […]

The Battle of Evermore: How the Insurance Lobby Rules Florida

The end of the year brings legislative sessions to a close, setting up final face-offs between special interests affected by pending legislation. Back in the Spring, I wrote in separate posts about a long hoped-for consumer win in Florida to change unfair wrongful death laws: Turns out, politics isn’t the only place where misinformation is […]

Victims of Malpractice Don’t Lose Their Patient Rights.

I know – for a fact – that this happens waaay too often. Sometimes, the physicians and trial lawyers share an interest in patient safety that is contrary to the interests of the doctor’s insurance carrier. “Protecting patient and physician confidentiality must be a paramount concern of medical malpractice carriers. What Coverys has done in […]

“CVS Health intentionally prevented certain Medicare beneficiaries from accessing less expensive, generic prescriptions…”

The Forbes report is here: Report: Whistleblower accuses CVS of “calculated and widespread” drug pricing scheme targeting elderly patients

Disinformation: How To Manufacture A “Crisis” & Tort Reform To Solve It

Turns out, politics isn’t the only place where misinformation is used to ply the soil that grows bad ideas. In the 1980’s, health care providers and insurance carriers deliberately and falsely yelled that the sky was falling due to negligence claims and payouts. Their solution? Caps on damages in the most righteous and significant cases. […]

On Top Of Locking Many Brain Damaged Children Out Of Court, Florida Begins Gaslighting Them

In the late 1980s, the Florida legislature set up a regulatory scheme to immunize doctors and hospitals by locking Florida courthouse doors to the families of some children who suffer severe brain damage during birth. All government programs get an acronym and the acronym for this burden-shifting agency is NICA (The Florida Birth-Related Neurological Injury […]

What To Expect When You Come Between The Fortune 500 and Their Bottom Line

Marketing can cover a lot of warts. Meanwhile, in the real world, people behave in line with our experience and the incentives put in front of them, even where it conflicts with what we know to be right and wrong. From the NYT, Mr. Williams said a State Farm claims adjuster told him that she […]