Dr. Lewkovich: Using the Proper Prognoses will help your bills get paid
Lewkovich makes clear that a great physical examination, quality care and diagnosis are notenough.
Usually missing from most PI reports is the prognoses.
The prognosis is the doctor’s opinion of the likelihood of the patient reaching a resolved status. The sooner the patient recovers, the less the insurance must pay.
Lazy or missing prognoses will make the case much less valuable and cause a great disservice to the patient.
It is that simple -- and it is rational.
For example: Patient is 65 years old, suffers years of DJD, has a “moderate” impact rear-ender yet there is NO prognosis written by the doctor. Auto Club will pay $500 each month while the patient is treating for pain and suffering. However, if the patient has NO prognoses, Auto Club can argue the patient is pain free.
How many 65-year-olds -- DJD patients no less -- are “pain free” from a moderate to serious impact? It is lifetime for many cases.
Lewkovich offers a neat formula for rendering a clear and concise Prognoses for most of your PI patients. Use his form. To get your copy contact firstname.lastname@example.org.
Insurance companies warned against COVID MVA Fraud
"Really, if it sounds too good to be true, it probably is," says James Schweitzer, COO for the National Insurance Crime Bureau (NICB).
The NICB is a secretive agency for casualty insurance companies designed to detect and prosecute auto fraud cases.
Most fraud cases you read about are usually investigated and "packaged" by the NICB for local prosecutors.
The three biggest fraud areas where the NICB spends hundreds of millions of dollars investigating include:
An event where one purposely causes an accident in order to make a claim. Intentionally rear-ending or sideswiping another car are common schemes and such accidents are often committed by organized fraud rings.
This occurs when people who were not in the car at the time of the accident file injury claims. The jump-in spin is similar to the staged accident spin. Scammers might take advantage of another's anxiety and suggest a limited exchange of information, such as passenger names. With no police report and no witnesses, they have an opportunity to make a false injury claim.
During the months of COVID some doctors or patients were tempted to "add" visits when patients were reluctant to go to the clinic. The NICB set up a special task force examining unusual treatment patterns during the lockdown.
ACE's Lit Tip:
Are Lawyers Who Pocket Med Pay Committing Fraud?
The following is a controversial statement: Attorneys who collect and keep your MedPay might be committing insurance fraud.