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Monday, November 15, 2021

BREAKING NEWS

How to 'Beat Up' Mercury in a UIM Case

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Ryan M. was broadsided on Sunset Blvd. in West Hollywood and suffered injuries to his low back.


The defendant who hit Ryan only had $15,000 insurance and promptly paid the policy limits.


Ryan filed an Underinsured Motorist (UIM) claim against his own insurance company Mercury. Mercury rejected the claim stating they believed Ryan received sufficient compensation from defendant’s insurance company. Mercury had a $100,000 UIM policy; Ryan required extensive chiropractic care, PRP injections, and epidurals were suggested by a pain management doctor. There was also testimony that Ryan may require future surgery. 


In arbitration, the judge awarded $146,000 to Ryan, well over the policy limits. 


Ryan M. vs. Mercury Insurance, March 15, 2021. 


Pro Tips:


1) Insurance always try to pay the minimum.

2) Mercury’s failure to analyze this case cost them a lot and probably the adjuster’s job.

3) Ryan and his doctor’s testimonies were compelling. 

FEATURED ARTICLES

Who is Auditing Your PI Practice -- & Why?

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This is important!


There is an explosion of insurance audits on PI cases. Often, audits take place years after the case closes. Insurance companies are looking for substantial reimbursement for “billing errors” by the doctor.

 

Each “error“ is considered fraud by insurance companies and each “error” is a separate cause of action.

 

This explosive report by PI Guru Dr. Gary Lewkovich offers a comprehensive form of what insurance is seeking in their audits.

 

Lewkovich argues why audits are skyrocketing:

 

  1. Most doctors believe they are billing properly.
  2. Doctors are easy targets.
  3. Insurance is collecting untold millions from doctors through intimidation and the suggestion that the doctor might be doing something criminal.

 

To get the Solutions Form contact johntawlian@shawnsteel.com.


How to Lose a Rear-End Collision

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Antonio M. was rear-ended on Perris Blvd in Moreno Valley. The police did not come to the accident scene and no ambulance was called. Antonio did not complain of injuries at the scene. Both cars were drivable and no tow trucks were called. 


Antonio admitted his body did not move inside the car during the collision, nor did he strike anything inside his car. 


He sought care from a local chiropractor two weeks following the accident. The defendant hired an orthopedic doctor and a biomechanical engineer, to testify at a cost of over $15,000. 


Antonio demanded $75,000. Defendant offered zero. The Jury deliberated 3 hours and awarded zero dollars. 


Antonio will have to pay the Defendant’s cost for expert. 


Antonio Martinez vs Bautista Riverside Superior Court, Judge Harold Hopp, August 10, 2021.


Pro Tips:


1) Greed and foolishness are not virtues – demanding too much money will turn off most juries. 

2) MIST [minor impact soft tissue] cases are hated by juries.


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Contact John Tawlin with any questions at johntawlian@shawnsteel.com.

UPCOMING EVENT

NOVEMBER 24, 2021 @ 1 PM

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🔥 ACE'S LIT TIPS 🔥

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I recently heard from another client (in their deposition, under oath, on the record) that their chiropractor told them, “Not to worry too much” about the bill because he will “work with her” once the case resolves. I understand the temptation to assuage your patients’ worry about rising medical costs during their PI case but there are two very important things to remember:


1) THIS IS FRAUD! If you are billing one price but understand and expect to be paid a lesser amount you are committing fraud. Telling your client you intend to commit fraud and having them repeat it to a defense attorney in a deposition, under oath, on the record is about the worst thing that I can think of. Don’t let that happen to you!


2) In all honesty, you shouldn’t bill an amount you don’t expect to be paid. You should stand behind your bill in all cases and expect to be paid that amount. If, AT THE END of a PI case, you determine that it makes sense to take a reduction due to some unforeseen circumstances, that is your prerogative, but you should start and work up every case as though you intend to be paid in full (and only work with attorneys who strive to pay you in full every time).


Feel free to contact me at alexandereisner@shawnsteel.com.

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TIP 9: BEWARE OF OUT OF STATE DOCS

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