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Nursing Home Bedsore Lawsuits

Nursing home bedsores are also known as pressure sores or decubitus ulcers.  These sores are caused by a lack of blood flow to an area of the skin resulting from prolonged pressure on one area of the body.  Bed sores commonly develop on areas with prominent bones beneath thin layers of skin, such as the tailbone, heels, elbows and shoulder blades.
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Insurance Medical Examinations

Whenever the physical or mental condition of an insured person covered by No-Fault Insurance is “material” to any claim for benefits, the insurance company can require the patient to submit to an insurance medical examination (IME). Read more

Denial Based on Medical Review Companies

More and more insurance companies are submitting their insured's medical bills to a medical review company to determine whether the charges are reasonable and necessary.

Unfortunately, insurance companies continue to unilaterally reduce properly submitted medical claims based on medical review company’s opinion. Some of these companies software programs do not take into account the experience of the board certified medical providers, specialties of medical providers, severity of injury and other factors in determining a reasonable fee to charge a patient. Read more

The Insurance Medical Examination Cut-Off

An insurance company cannot deny payment to a treating physician, unless the insurance company first obtains a report by a physician stating that treatment was not reasonable, related, or necessary. Without such a report, the insurance company who discontinues payment is in violation of the No-Fault laws and a lawsuit is appropriate. Read more

Insurance Industry Oversight/Inefficiency

The no-fault insurance company has 30 days to make payment on a properly submitted claim. Their failure to do so will result in interest penalties. There is no excuse for late payment by the insurance company. Everybody has deadlines to which they must adhere when paying their obligations. Insurance companies should not be treated any differently. Read more

Securing Payment of Unpaid No-Fault Benefits

Oftentimes, a no-fault insurance company fails to pay benefits within the 30 day time period prescribed by law. In some instances, it is simply oversight or inefficiency. However, on too many occasions, insurance carriers wrongfully withhold payment, despite the fact that their insured paid pricey premiums for no-fault benefits. Read more

“Reimbursement For Travel” Form

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If your client has been injured in a motor vehicle accident, s/he is entitled to be reimbursed for the mileage to/from home to the health care provider. Proof of the expenses and demand for mileage reimbursement must be sent to the carrier within 45 days of the date of treatment. Once submitted, the carrier must pay or deny the claim within 30 days. For your convenience, a no-fault mileage reimbursement log can be downloaded in .pdf format free of charge by clicking the picture to the right. Read more

10 Mistakes Dealing with Doctors

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When a victim of negligence suffers an injury, the victim often does not realize that how they deal with their treating physicians will impact the outcome of their case. Here are 10 Mistakes for injured negligence victims to avoid when dealing with doctors: Read more