Ramblings of an Emergency Physician in Texas
Going after Las Vegas’ medical mafia – Aug. 19, 2009
Wow. Read it all. Greedy bastards…
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My car was rear-ended this summer in Florida. The tow company hired by the city where the accident happened bullied me something fierce to try and get me to take the insurance check and scrap the car (turns out they’d have been 1st in line at the auction; my car is worth >$10k in parts but only $3k bluebook). I called another tow company to go get my car out of their lot and made a fast friend over the phone.
Roland called me every day for 3 weeks–sometimes 3 or 4 times–to get me to visit with his lawyer friend. “You need a doctor? I know doctors. Just call me. Anything you need. Whenever you’re ready to get started.” The same message, again and again. And again. Voicemail, text messages, repeating himself over the phone with me. “When are you going to call (lawyer’s name)? You should go see my doctor friend.”
The at-fault driver’s insurance company was so nervous I’d play ball that they decided to fix my car. (They didn’t know I hate chiropractors.)
This machine operates all over the country. And it goes both ways–I’m sure you know better than me about how insurance adjusters collude to deny care to patients who desperately need it….
This story just shows how broken our system is when the incentive to commit fraud is bigger for the ambulance chasers than it is for the injured(?) parties, themselves.
As an ex-insurance field employee, this just turns my stomach. Of course I know this sort of thing happens but it still sux. The Claims Manager with whom I worked was a very upright and honest man – if it qualified as a claim, he approved it; if it didn’t, then no amount of bending the rules would turn him. I’m so grateful I worked with a man such as this rather than those mentioned. But, sadly, I still wouldn’t trust one as far as I can toss a cabre. I am also immensely grateful that I live in England so medical insurance is not a hoo-ha I have to get into. So far the NHS has done me proud.
I had the same thing happen after I was rear-ended by a girl at a stop-light. My bronco was completely undamaged, except for some paint on my heavy tow bumper. The girl who hit me practically totaled the front end of her 240SX. My car was still good enough that I gave the girl a ride home after the police cleared the scene.
My insurance company called me over and over and over to make sure I was OK, and to make SURE there was no problem, and to make sure I didn’t want to file a claim. I got letters from attorneys, and “clinics” offering to help me. I was perfectly fine, and completely NOT interested in any of the “services” they’d offered me. I eventually became angry and told them to stop calling. I was fine, wasn’t going to file a claim, and that was that!
But I can easily see where the auto accident thing is big business. These people clearly had a serious financial motive to keep calling with the “hard sell.”
From the article: ” She went to her regular doctor but was told that she’d have to pay all her treatment costs upfront, since a car accident could result in lawsuits and her health insurance might not cover her. ”
That doesn’t make much sense. Her health insurance would have been subrogated to whatever she received from the other party anyway. What I see a lot, and is much more likely, is that her medical provider didn’t want to submit to insurance because they knew there would potentially be a third party provider who would pay more than the negotiated health insurance rate. I see this all the time with Medicaid recipients who are in car wrecks. If they tell the physician or hospital accounts person they were in a car wreck, the person won’t submit to Medicaid.
New Guy is right about one thing – the auto accident claims business is big business. Whenever physicians talk about the incentive to file frivolous lawsuits in med mal, it never makes sense. Too much up front cost, too many top lawyers in med mal defense, and too many tough insurers because of the size of the typical claim, simply due to the bills alone. Auto accidents though, that’s another story. Cheap to file, for the most part cheap to try if you have to. And, in a recession, insurers are lowballing because they know people need the money and will settle quickly. If you’re a plaintiff’s lawyer doing a lot of car wrecks, you can make a lot on volume on small damage cases. Much more money and much less financial risk if you want to file BS claims, too.
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