How To Avoid No-Fault Nightmares: Review Your Car Insurance Today

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Karen Wheadon, a paralegal who works with Ziff Law Managing Partner Jim Reed, has written the following blog post about no-fault insurance coverage.

Many of our clients are victims of car crashes, and therefore, subject to the rules and regulations of no-fault insurance. Unfortunately, many of our clients struggle financially because they have inadequate no-fault coverage.

Karen Wheadon.

Karen Wheadon.

Briefly, state-required minimum no-fault insurance consists of $50,000 in coverage for the following:

  1. All necessary doctor and hospital bills and other health service expenses, payable in accordance with fee schedules established or adopted by the New York State Insurance Department.
  2. Eighty percent of lost earnings up to a maximum monthly payment of $2,000 for up to three years following the date of the crash.
  3. Up to $25 a day for a period of one year from the date of the accident for other reasonable and necessary expenses the injured person may have incurred because of an injury resulting from the accident, such as the cost of hiring a housekeeper or necessary transportation expenses to and from a health-service provider.
  4. A$2,000 death benefit, payable to the estate of a covered person, in addition to the $50,000 coverage for economic loss described above.

When shopping for car insurance, many people don’t think to invest in anything other than that basic coverage. However, additional coverage can be purchased … and can make a huge difference to someone’s life and financial stability. When we consider the growing costs of health care, $50,000 does not last long.

Here are some examples of crash victims and their no-fault insurance coverage,

Mike

Mike, like many of our clients, receives Medicare benefits. He had a serious car crash and exhausted his basic no-fault coverage. His medical bills were then submitted to Medicare for coverage and he was personally responsible for co-pays. On top of that, under federal law, Medicare (and Medicaid) are allowed to assert a lien against any third-party recovery.

What that means for Mike is that the personal injury claim/lawsuit we filed against the person responsible for causing the crash and Mike’s injuries now has a lien against it. At the time of the settlement, Mike has to pay Medicare back from his settlement. Had Mike had additional no-fault coverage, he could have avoided his bills going to Medicare and kept more of his settlement for himself.

Michelle

Michelle, injured in a car crash in 2016, had basic no-fault coverage that was paying her medical bills and was also reimbursing her for lost wages because she is unable to work. Like so many of our clients, Michelle relied on her monthly wage loss checks to pay for her basic necessities (mortgage, groceries, etc.).

Michele’s no-fault benefits were exhausted in May, leaving her with NO income at all. She has an application pending with Social Security Disability, but applicants often wait a year to hear if they are accepted or denied. If denied, the appeal process is even longer.

On top of that, Michelle’s private health insurance is through the Affordable Care Act. She has catastrophic coverage only with a $6,000 deductible. The neck surgery that was being scheduled is now on hold because she cannot afford to pay a $6,000 deductible without any income.

Obviously, Michelle would have benefited greatly from additional no-fault coverage. Her story is a great argument for universal health care because her health insurance plan is abysmal. She is a hard-working, taxpaying citizen who found herself with a disability and unable to work after a car crash. She should not have to put off medical treatment because she can’t afford her co-pay.

Opponents of universal health care argue that they don’t want the government making their medical decisions, but insurance companies already do that all the time. They arbitrarily decide a patient only needs 10 physical therapy sessions, or that they can’t have a drug prescribed by their doctor because it is too costly, or that surgery is not necessary because they have not exhausted conservative treatment options. Insurance companies base these decisions on money – their money that they would rather not pay out!

Justin

My stepson, Justin, was involved in a near-fatal car crash in 2015. He was taken from the scene of the crash by ambulance to Arnot Ogden Medical Center in Elmira, and then quickly transferred to Robert Packer Hospital in Sayre, Pa. From there, he was life-flighted to Geisinger Medical Center in Danville, Pa., where he was admitted for more than a month and underwent numerous surgeries to repair his fractured neck and re-attach a shoulder and arm.

There are a lot of miracles associated with Justin’s crash – too many to recount here. The fact that he is alive and well and now a father of two beautiful little children is sometimes more than I can believe. We are very, very blessed. But as you can imagine, the medical bills were astounding. The life-flight bill alone was $54,999, which was paid in full by his primary no-fault coverage.

Luckily, in addition to the basic no-fault coverage of $50,000, Justin had $10,000 of med-pay, $25,000 of OBEL (Optional Basic Economic Loss), and $150,000 of APIP (Additional Personal Injury Protection). He had such incredible coverage because he was the passenger of a vehicle that had more than basic coverage and he was also covered under his own policy which had even better coverage. This is far from the norm.

But even all of that coverage was very quickly exhausted, leaving a balance due to Geisinger Medical Center in excess of $1 million. This was turned over to his health insurance.

Justin was 23 years old at the time of his crash, but thankfully he was still covered by his father’s health insurance plan as a result of the Affordable Care Act, which extended medical coverage for children up to age 26. Donations from friends and family through a gofundme campaign covered the deductible, so Justin did not have to file bankruptcy because of insurmountable medical debt, as so many Americans do.

Justin’s example shows that even incredible no-fault coverage cannot adequately cover you from a catastrophic injury. But catastrophic injuries are, thankfully, rare.

The vast majority of our clients are like Michelle and Mike. They have broken bones that may or may not need surgery. Most of our clients seek medical treatment locally and don’t have multiple ambulance and life-flight bills. However, even routine injuries that require fairly routine medical treatment will quickly exhaust a basic no-fault policy.

So make the wise choice and protect yourself by asking your insurance agent about increasing your no-fault coverage. Had Michele or Mike had Justin’s maximum no-fault coverage, they would not be facing hard financial and medical decisions. We hope you won’t have to, either.

Therefore, we recommend adding Additional Personal Injury Protection (APIP) of at least $75,000 and Supplementary Underinsured (SUM) Coverage of at least $250,000. The good news is that adding this additional protection does not cost much more but will give you much better protection.

If you have questions, or would like us to review your insurance policy for free, please email me at [email protected] or Jim Reed at [email protected].

Thank you for reading,

Karen Wheadon
Paralegal
Ziff Law Firm
[email protected]


Top NY Court Questions Privacy On Facebook Posts, So Think Before You Post

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If you think your private Facebook account and its personal photos will never be exposed publicly, think again.

The top court in New York State recently ruled that parts of Facebook users’ private profiles are fair game to opponents in a lawsuit and can’t be shielded by privacy settings.

 

According to news reports, the Court of Appeals case in question involved a woman’s serious fall from a horse in a Long Island park in 2011. Kelly Forman sued the horse’s owner, claiming a strap attaching the stirrup to the saddle broke, leading her to fall. She said she suffered traumatic brain damage that has caused memory loss and difficulty communicating, among other problems.

 

Attorneys for Mark Henkin, the horse’s owner, wanted access to Forman’s Facebook account, saying they needed that to evaluate her credibility and injuries. A trial court granted access to private sections of her Facebook account, but an Appellate Division decision said Forman only had to show photos and messages she planned to reveal at her trial.

 

The Court of Appeals decision basically said Forman can’t decide what Facebook information can be revealed in her trial.

 

The case returns to the trial court now, where the horse owner’s attorneys can pursue Forman’s Facebook information.

 

The Court of Appeals, in the 7-0 opinion, compared social media material like Facebook photos to information kept in a file cabinet and said it should be available in a lawsuit if relevant.

 

NY Court of Appeals Chief Judge Janet DiFiore.

NY Court of Appeals Chief Judge Janet DiFiore.

Chief Judge Janet DiFiore compared Facebook information and medical records in writing for the court. If a patient commences a lawsuit, the patient may have to release private files if they pertain to the lawsuit, she wrote.

 

For example, if a person brings a lawsuit, the other side – the insurance company and their lawyers – often ask the person suing to see their Facebook postings, including photos. In some cases, they want to see why you are not able to do something now that you were able to do before.

 

Previously, NY courts have been specific that a defendant and their insurance company and their lawyers didn’t have a right to look beyond a person’s public settings in Facebook. If you permit everyone to see everything on Facebook, then defense lawyers and their insurance companies can see everything, too. But if you lock down your settings to friends only, posts were off-limits to the other side.

 

With the new ruling, the courts are not going to automatically allow access beyond a privacy setting. Trial judges will decide on a case-by-case basis if it’s appropriate for a defendant and their insurance company to see what was posted privately.

 

There is a very good reason for that decision: what the court is saying is just because you label something as “private” doesn’t necessarily mean that information is not relevant for the other side to be able to see. People often have to disclose private information in a lawsuit because the courts consider it relevant.

 

Here is the bottom line to remember from this case: there is no such thing as 100 percent privacy once you post something online.

 

Think before you post.

Thanks for reading,

Jim

___________________________________

James B. Reed
Best Lawyers’ “2015 & 2017 Lawyer of the Year”
NY & PA Injury & Malpractice Lawyer
Ziff Law Firm, LLP
Office: (607)733-8866
Toll-Free: 800-ZIFFLAW (943-3529)
Blogs: NYInjuryLawBlog.com and
            NYBikeAccidentBlog.com

Feds Put Pressure On Doctors, Hospitals To Make It Easier For Patients To Receive Their Medical Records

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The Obama administration is knocking down the obstacles that Americans face when requesting their own medical records, which will be a big boost in prosecuting medical malpractice cases.

The federal government told doctors and hospitals that in most cases they must provide copies of these records within 30 days of receiving a request. Patients have been able to obtain copies of their records for a long time, but millions of people have complained to federal officials that they were thwarted in trying to exercise that right.

doctor-with-clipboardIn the new guidelines, which were announced recently, patients will not be required to state a reason for requesting their records, and doctors and hospitals cannot deny access out of concern that patients might be upset by the information.

“Based on recent studies and our own enforcement experience, far too often individuals face obstacles to accessing their health information,” said Jocelyn Samuels, the director of the Office for Civil Rights at the Department of Health and Human Services, which enforces federal health privacy standards, in The New York Times. “This must change.”

According to the Times, under the new guidelines, a health care provider cannot require patients to pick up their records in person if they ask that the records be sent by mail or email. A health care provider cannot deny a request for access to health information because a patient has failed to pay medical bills. A doctor or a hospital may charge a fee to cover the cost of copying, but cannot charge for the cost of searching for data and retrieving it.

The rules were issued under the Health Insurance Portability and Accountability Act of 1996. Doctors and hospitals are supposed to provide consumers with access to personal health information within 30 days and, in some cases, can extend the deadline by 30 days. But most requests should be fulfilled in fewer than 30 days, the government said.

Unfortunately, I see this issue firsthand far too often. Many times, people attempt to get their medical records before calling a lawyer. Although this should be a good way to see what the records say quickly, they are often faced with delays of weeks — or even months — before their requests are honored.

Hopefully, these new guidelines will help, though time will only tell whether they can begin to remedy what appears to be a deep and systemic problem.

 

To read more about your rights, click here.

 

A summary of important changes:

Some of the ways in which the new guidance should make it easier for patients include:

  • Doctors and hospitals are not allowed to ask you why you want your records. If you happen to volunteer your reason for requesting your records, they cannot deny you access to your records based on your reason for wanting them.
  • Your doctor or hospital cannot require you to go to the office of facility in person if you request that they mail your records to you.
  • Nor can they require you to use a web portal to request access to your records, because there are still people who do not have internet access.
  • They must provide your records within 30 days. That’s calendar days, not business days. Under certain circumstances, that time limit can be extended by up to 30 days, but you must be notified of the extension within the first 30-day time period.
  • You can be charged a fee for the cost of making paper or electronic copies and postage, but not fees for searching for your records, storage, or retrieval. This applies even if your state laws allow the extra charges.

 

Thanks for reading,

Christina Sonsire

[email protected]

 


Defective Hip Prostheses Cause Pain And Suffering For Patients, Says NY and PA Injury Lawyer

Hip failures caused by faulty medical implants will cost taxpayers, employers, insurers and others billions in the coming years, experts say.

A recent News York Times article discussed the very high costs associated with victims of failing artificial hip prostheses. The story is particularly compelling for me because I represent a number of local people who are suffering horribly with medical complications caused by defective hip prostheses:

  • A Hammondsport, N.Y.,  man who had the misfortune to receive the DePuy A.S.R. hip prosthesis that was recalled last year by its manufacturer, Johnson & Johnson. This poor fellow has already suffered through several surgeries in an unsuccessful attempt to replace the defective hip prosthesis but he continues to suffer significant ongoing complications.
  • A Bath, N.Y., woman who also had the DePuy A.S.R. hip prosthesis and who is suffering dramatically elevated chromium and cobalt levels in her blood.
  • Two women, from Corning, N.Y., and Big Flats, N.Y.

Although prosthetic devices can fail for a number of reasons (poor design, improper materials, improper installation, etc.), these particular cases involve hip prostheses that failed because of their metal-on-metal design.  Metal wear due to metal grinding on metal causes small flakes of metal debris to contaminate both the artificial joint and the patient’s bloodstream. This metal wear causes premature failure of the hip joint itself and has the nasty effect of causing all sorts of medical complications due to the metal contamination.

It is important to note that in our cases we are NOT claiming that the doctors who performed the surgery to implant the prosthesis were negligent. Our claims are against the manufacturers like Johnson & Johnson, who released a defectively designed product without performing appropriate long-term testing or otherwise confirming that the prosthesis as designed was safe.

The New York Times story points out a staggering toll from this failure:

  • “Until a recent sharp decline, all-metal implants accounted for nearly one-third of the estimated 250,000 hip replacements performed each year in the U.S.
  • Some 500,000 people have received an all-metal replacement hip!
  • “Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in the coming years.”
  • Lawsuits and complaints against the makers of all-metal hip replacements have passed the 5,000 mark.
  • Private insurers are warning patients that they plan to recover their expenses from any settlement money the patients receive, and Medicare expects to try to recover its costs, too.

The New York Times reporter also answers readers’ questions about the story here. And there is also a graphic here that explains why the implaints fail.

If you or someone you love in Elmira, Corning and the Twin Tiers has an artificial hip, be sure they are checked by their medical doctor to see whether they have an all-metal implant that could cause them major medical complications.

Thanks for reading.

Thanks, Jim

_________________________________

James B. Reed
NY & PA Injury & Malpractice Lawyer
Ziff Law Firm, LLP
Mailto: [email protected]
Office: (607)733-8866
Toll-Free: 800-ZIFFLAW (943-3529)
Web: www.zifflaw.com
Blogs: NYInjuryLawBlog.com and
NYBikeAccidentBlog.com


With Rise In Accidents, NY Woodworking Lawyer Urges Table Saw Safety

Woodwworkers should look into investing in a table saw from SawStop.

As an avid woodworker (my wife says too avid!) and injury lawyer who has seen way too many people hurt in way too many ways, I am always concerned about woodworking safety.

I have an uncle who is a constant reminder of what can easily happen when working in the workshop. My uncle is a good, safe, competent woodworker who is missing a good portion of a finger because of a woodworking accident that happened literally in the blink of an eye. He wasn’t doing anything unsafe and was doing what he had done hundreds of times before, but nonetheless he lost a big chunk of a finger.

In my quest for greater safety, I recently purchased a new table saw featuring a finger-saving technology called SawStop.  Essentially, this is a saw that has an incredible technology built into it that causes the whirring saw blade to be stopped in milliseconds if there is any contact between the blade and skin.

Sure, the SawStop saw costs a little bit more than other comparable table saws, but when you consider the pain, disability and whopping medical bills that result from a table saw accident, that small additional expense is chump change.

I bought my SawStop from Brian Kita of Hermance Machine Co. in Williamsport, PA. Brian was awesome to deal with and he had this to say about the SawStop saw:

We handle a lot of manufacturer’s products here, and I have to tell you, this is the only product line we carry that makes such a difference in our customers’ lives. They sell through recessions and they sell when schools have no budget money. People have come to us straight from the emergency room with bloody bandages covering what’s left of their fingers to write me a check for a SawStop. I’ve taken calls from pros angry that they need a cartridge that seemingly blew for no reason, only to have them call back and excitedly tell me that as they wrote out the purchase order, they found a small smear of blood from where they contacted the blade but never even felt it. Yeah, SawStop has something unique, and they could probably charge a whole lot more for it, but I’m grateful that they don’t.

Having now assembled my SawStop saw, I am pleased to report that not only does it feature incredible safety technology, it is also, by far, the most precision-machined, well-engineered piece of power woodworking equipment I have ever owned.

My point of this post isn’t intended to serve as an advertisement for SawStop — it is intended to reach out to my woodworking friends to encourage them to very carefully consider ALL aspects of safety, which would include consideration of the latest, greatest safety technology.

The alternative — doing nothing, using an old, unsafe table saw — is not wise. According to an October story by The Associated Press, the U.S. government says about 10 people EACH DAY lose a finger or get their hand mangled by unsafe table saws! That is remarkable!

The Consumer Product Safety Commission has started looking for ways to reduce injuries. The agency estimated there were more than 67,000 blade-contact medical injuries in 2007 and 2008, costing more than $2 billion.

Table saw makers say those numbers don’t reflect the new products like SafeSaw. So we’ll keep track of this story and watch for newer figures from the government!

In the meantime, be safe out there!

Thanks for reading.

Thanks, Jim

_________________________________

James B. Reed

NY & PA Injury & Malpractice Lawyer

Ziff Law Firm, LLP

Mailto: [email protected]

Office: (607)733-8866

Toll-Free: 800-ZIFFLAW (943-3529)

Web: www.zifflaw.com

Blogs: NYInjuryLawBlog.com and

NYBikeAccidentBlog.com


NY Malpractice Lawyer Discusses “Wrong-Site” Surgery Cases: Did We Operate on the WRONG Leg?

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It's up to you to be vigilant when you or someone you love faces surgery!

As a New York medical malpractice lawyer who has handled “wrong-site” surgery cases, I wasn’t too surprised to see the news report that estimates that 40 times a week (that’s more than 2,000 times a year!), doctors mistakenly operate on the wrong site.

Huh, the wrong site? Yup, that happens when a doctor is supposed to operate on a RIGHT knee and he operates on the LEFT knee. Or the doctor was supposed to operate on the left eye and he operates on the right. Can you say “Ooooooppppsss”?

But this is NOT funny. The victims of wrong-site surgery suffer all the dangers of surgery (bleeding, infection, scarring, disability, etc.) with none of the benefits of the surgery they were supposed to receive. In fact, many times, the patient is so weakened by the wrong-site surgery that they don’t have the strength to undergo the surgery they were supposed to have.

The Washington Post reported this week that seven years after the Joint Commission, the group that accredits our nation’s hospitals, unveiled mandatory rules to prevent surgery errors, the problem may actually be getting worse!

The good news is that progressive hospitals and doctors are implementing strategies to combat wrong-site surgery, according to the report. Some strategies are simple: require the doctor to physically mark the site of the surgery during the pre-operative preparation; make both doctors and nurses double-check one another as to the proper site of the surgery, and so on.

Medicare is also creating a very strong incentive for doctors and hospitals to ensure that they do not perform surgery at the wrong site by refusing to pay any of the expenses associated with the incorrect surgery. Nothing like hitting someone in the pocketbook to make them pay attention!

And finally, the prospect of an expensive medical malpractice lawsuit is also a strong deterrent to this sloppy mistake that simply shouldn’t occur. In NY and PA, where I routinely practice, it is medical malpractice for a doctor to perform surgery at the wrong site because the standard of care for proper surgical practice always requires the surgeon to confirm the proper site for surgery BEFORE operating.

According to the Washington Post report, based on state data, Joint Commission officials estimate that wrong-site surgery occurs 40 times a week in U.S. hospitals and clinics. In 2010 alone, 93 cases were reported to the accrediting organization, compared with 49 in 2004.

“Attention to the problem comes at a time of increased focus on the broader issue of medical errors, which a recent study found affected one-third of hospital patients,” the report said.

The federal government recently introduced a program aimed at reducing medical mistakes, the Post reported. Medicare requires reporting and does not pay for wrong-site surgery, and many insurers have followed suit, the Post added. Next year, Medicaid will begin a similar policy.

Wrong-site mistakes have multiple causes, experts told the Post: mixing up the left and right sides; operating on a patient who was accidentally given test results belonging to someone else; marking the incorrect vertebrae in spinal surgery; neglecting to mark the site at all. Some occur even though a member of the surgical team thinks something might be wrong but fails to speak up, fearful of slowing the process or challenging the surgeon in charge.

Please remember when you or someone you love is facing surgery – be watchful and ask questions!

Thanks, Jim

_________________________________
James B. Reed
NY & PA Injury & Malpractice Lawyer
Ziff Law Firm, LLP
Office: (607)733-8866
Toll-Free: 800-ZIFFLAW (943-3529)

 

 

 


Wall Street Journal Reports: Malpractice Claims Push Physicians to Make More Accurate Diagnoses

I just came across a very interesting article in the Wall Street Journal about medical malpractice.

This article discloses an important truth about the medical malpractice system, which allows patients to seek redress after health care mistakes. The money that is paid out in medical malpractice claims is a very, very strong incentive for doctors and hospitals to improve their methods. Medical malpractice claims aren’t just reactive – they have a proactive effect on health care.

The Wall Street Journal article, “What the Doctor Missed: Using Malpractice Claims to Help Physicians Avoid Diagnostic Mistakes, Delays” by Laura Landro, looks specifically at diagnostic errors. We have all heard horror stories about doctors who have fallen asleep while performing surgery or been under the influence of drugs or alcohol while practicing. Diagnostic errors may be more subtle, but the results can be just as devastating. Think of the breast cancer victim who believes a lump is just a cyst, or the person with a rare blood disorder that dies with it undiagnosed because specialists didn’t share information. These aren’t cases of bad or evil doctors. They’ve probably saved the lives of many other patients. The problem is, when these doctors do slip up, there’s lives at stake.

Let me outline some of the key points of the article:

  1. Diagnostic errors are rampant and costly. Landro’s article reports that, according to studies of resolved claims, diagnostic errors make up 40 percent of malpractice cases, and cost an average of $300,000 to settle.
  2. Malpractice claims are a driving force behind the development of new diagnostic methods, equipment and tracking systems. Doctors are looking into any effective means for identifying potential problems and carefully following up with patients. Some are trying electronic alerts, while others are using checklists to follow tried and true methodology.
  3. Mistakes in diagnosis are far too frequent, and reflect core problems in our health-care system. Primary-care doctors are overloaded with patients and paperwork. Test results are lost. Follow-up exams aren’t ordered. It’s discouraging, but Landro points out that hospitals and insurance companies are pressing for improvements because they don’t want to face frequent claims.

When you hear someone complain or theorize that malpractice claims are driving up the cost of health care, think about the efficiencies and improvements our system has brought about.

Medical malpractice claims can be good for medicine, good for the patients that rely and trust in their physicians, and good for the doctors who need reliable systems of managing and tracking an unbelievable amount of patient information.

Thanks for reading,

Christina Sonsire

NY & PA Injury & Malpractice Lawyer
Ziff Law Firm, LLP
303 William Street
Elmira, New York 14902-1338
[email protected]
Office: 607.733.8866
Toll-Free: 800.ZIFFLAW (943.3529)
Web: zifflaw.com
Blog: NYInjuryLawBlog.com


NY & PA Malpractice Attorney Shares Surprising Truth about Tort Reform

Medical-malpracticeThe Elmira Star-Gazette recently published a letter written by my cousin Pat O’Donnell. Although I agree with my cousin on many matters, there are a few on which we differ. One subject on which our opinions vary is tort reform and the cost of health care in America. First, let me share my cousin’s letter, then I’ll explain why I feel I must dispute his argument.

From the Elmira Star-Gazette, Feb. 19, 2010:

“Most Americans agree we need health care reform. What we do not want is for the government to take over the industry. Start with tort reform. Doctors are paying six-figure checks for malpractice insurance a year, and these figures increase yearly, as do all our premiums. The reason Washington does not want to address this problem is most of them are lawyers (with friends who are lawyers) getting rich on malpractice law suits.

The second problem to tackle is the sale of insurance across state lines (you can buy insurance only from a company within your own state). Open up the lines – its called competition – which in turn make you sharpen your pencil when you quote your goods.

Next – jobs. Unemployment’s hovering around 10 percent; we tried to spend our way out time and time again, but it does not work. Cut taxes across the board. If we Americans have more, we spend more. Consumer spending creates jobs. It’s time we stand up to the corruption once and for all. Maybe its time we elected some people that actually live the life the people now in Washington so want to control.”

– Pat O’Donnell

To counter Mr. O’Donnell assertions, I can begin with the results of a comprehensive study published by University of Connecticut Law Professor Tom Baker.  He revealed that the cost of all malpractice claims in the United States – including legal fees, insurance costs, and payouts – amounts to less than one-half of 1 percent of all U.S. health care spending.

I’d also like to share this CNN clip of Senator Richard J. Durbin making a strong, compelling argument against the Republican push for malpractice reform:

Simply put, lawsuits are not to blame for our health care system’s deficiencies – they are simply political scapegoats.

Malpractice claims actually decrease spending by encouraging doctors to perform properly, avoiding costs associated with caring for people injured by their mistakes.

Moreover, tort reformists want to shift responsibility from private insurance companies to taxpayers.

According to the Institute of Medicine, 98,000 people die from malpractice each year.  Currently, victims are compensated by negligent doctors’ insurance companies.  By limiting doctors’ exposure to lawsuits, victims will have to look to public entities to cover future medical treatment, lost wages and physical and occupational rehabilitation.

Yes, that’s right– if you limit recoveries in lawsuits, the medical costs will be borne by YOU the taxpayer rather than the medical malpractice insurance carrier!

Although tort reform has the potential to save money – by allowing doctors to save negligible amounts of money in insurance premiums – it is much more likely to lead to increased costs for the rest of us.

As I mentioned, my cousin and I have many opinions in common, but this is a subject on which we diverge. I’m sure Mr. O’Connell will agree with me in an appreciation of a healthy debate!

Thank you,

Christina
________________________________
Christina Bruner Sonsire, Esq.
NY & PA Injury & Malpractice Lawyer
Ziff Law Firm, LLP
303 William Street
Elmira, New York 14902-1338
[email protected]
Office: 607.733.8866
Toll-Free: 800.ZIFFLAW (943.3529)
Web: zifflaw.com
Blog: NYInjuryLawBlog.com





New Anti-Subrogation Law for New York State Could Curb Insurance Companies’ Greedy Practices

Anti-subrogation bill in works for New York StateLast week, the New York State Legislature passed an anti-subrogation bill. To the general reader, I realize this news needs some explanation, but believe me, this is VITAL information for anyone who lives in New York State and it is GREAT NEWS for NY consumers!

Roy A. Mura, posted about the new law on his excellent blog, Coverage Counsel.

Roy gives a very technical explanation, but the real gist of it is that this new law will prevent health insurance carriers in N.Y. from getting away with their historic practice of “double dipping.”

You can check out Roy’s detailed analysis of the new bill in his post “New York State Legislature Passes New Anti-Subrogation Law.”

Below is my less technical explanation of what this new law means to the average person.

What is subrogation – and what’s so bad about it?

As a concept, think of subrogation as you paying someone else’s debt and then your attempting to collect from the person that originally owed the debt. No problem if you do it fairly, but insurance companies have been adding their own twist to the idea.

An example would be: You know Jim owes Mary $40. You run into Mary, she mentions your friend Jim’s debt and you pay it. Then you ask Jim for the money. Fair enough. But what if Mary also asked Jim for the money again? And he paid it again? If he paid you back too, he’d be out $80. Mary would end up with $80 – twice the amount she risked!

The analogy is close to what the insurance companies have been doing for years. First, they charge you HUGE premiums for your health coverage. Then, if you get hurt, and you successfully pursue a personal injury case, they tell you you have to pay them back for the health bills they paid on your behalf!

So essentially, you pay for coverage and then when you use the coverage that you paid for, they say they should get reimbursed IN FULL from YOUR money!

Thankfully, this law will stop this horrible double dipping. I am just glad that the whole health care debate is finally shining a spotlight on some of the egregious past practices of health insurance companies!

Thanks again to Roy A. Mura for his detailed posting about the anti-subrogation bill and his permission to link to it from the NY Injury Law Blog.

Thanks for reading,

Jim
_________________________________________
James B. Reed, Esq.
Personal Injury & Malpractice Lawyer
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel. (607) 733-8866 Fax. (607) 732-6062
Toll Free 1-800-943-3529
mailto:[email protected] http://www.zifflaw.com

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The Big Risk: Lack of Health Insurance Can Cause Financial Ruin FAST

medical-billI recently received a question from a NY Injury Law Blog reader about a vital concern for many Americans: What are the consequences of ENORMOUS medical bills for families or individuals unable to afford health insurance?

I believe the question, and my reply, will resonate with many readers – especially during this time of high unemployment in New York and Pennsylvania. With the e-mail writer’s permission, I have put together this post in the hope that it will inform readers with the same worries.

Hi Jim,

I was reading your article online and was wondering if you might be able to point me in the right direction here, or advise on what kind of lawyer I need to find (there are so many different kinds!) …

If a couple has no health insurance and they get into a catastrophic health issue, like a major disease or accident, what happens financially? Would they be forced to liquidate their house and/or retirement accounts, and other savings?

Could someone’s entire wealth be wiped out? Or would there be reasonable payment plans or other recourse?

Who could “force” them to liquidate anyway? If they owed the doctors and hospitals six figures, could they just pay what they can each month? Can the hospital/doctors “force” them to liquidate their life savings? Does that happen often?

Thanks,

Rick

Dear Rick:

You ask a truly great question. To answer your question bluntly: Yes, uninsured folks can be financially devastated by the staggering costs of medical treatments.

The bottom line is that my law partner, who is a bankruptcy lawyer, tells me that approximately 75% of all the bankruptcy cases he handles are because of HUGE uninsured medical expenses.

Contrary to conventional wisdom, these folks filing for bankruptcy are good, hard-working folks who merely had the misfortune of getting sick.

Medical providers, just like any other creditor, can pursue a judgment against you for their unpaid bills and once they get that judgment they can collect by all the typical collection methods – wage garnishment, liens against your home, etc.

I am sorry to be the bearer of such bad news, but your question brings in to sharp focus just how important it is for people to have health insurance.

Thanks,

Jim

Even though our exchange may not have offered the answer my reader hoped for, I was glad to share the response, and I hope it gives him something to work with.

I feel that it is important to share what I have gleaned from 20-plus years as a personal injury and medical malpractice attorney in New York and Pennsylvania, so I encourage readers of this blog to e-mail me with questions. I may not always be able offer good news, but forewarned is forearmed.

Thanks for reading,

Jim
_________________________________________
James B. Reed, Esq.
Personal Injury & Malpractice Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel. (607) 733-8866 Fax. (607) 732-6062
Toll Free 1-800-943-3529
mailto:[email protected] http://www.zifflaw.com

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