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Doctors Sue to Stop Health Insurers’ Usual and Customary Fraud

Posted by Andrew J. Barovick | Feb 10, 2009 | 0 Comments

We consumers of medical care aren't the only ones who have been short changed by major U.S. health insurers.  According to an AP story in today's NY Times , physicians have been cheated out of fees they earned for treating patients insured through such companies, which include  Cigna and Aetna.

This has prompted the American Medical Association to join several other state medical associations in suing the health insureres “over a database…that was rigged to underpay doctors on out-of-network claims for more than a decade,” according to the AP.

The report notes that UnitedHealth has already paid $350 million in a separate suit involving the A.M.A. 

So, let's recap.  Major U.S. health insurance companies cheat the people they insure, and cheat the physicians they employ to treat their insureds.  Is there anyone left for them to swindle?  Could this have contributed to the healthcare “crisis” in our country?  Will the Obama team scrutinize this sleazy industry to the same degree they are scrutinizing Wall Street?  At this time when the new administration is evaluating how to improve and reform healthcare, let's hope that the health insurers' fraudulent practices, which hurt both the consumers of healthcare  and the providers of it,  receive a prompt and careful look.

About the Author

Andrew J. Barovick

Mr. Barovick is a graduate of Columbia College and Cardozo School of Law. He began his legal career at the Queens District Attorney’s Office, where he tried over 20 felonies to verdict, and argued an equal number of appeals before the Appellate Division, Second Department, the New York Court of Appeals and the United States Court of Appeals for the Second Circuit.

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REPRESENTATIVE VERDICTS & SETTLEMENTS:

$7.9 million dollars for infant client who suffered severe brain injuries due to post- delivery medical malpractice.

$500,000 wrongful death/medical malpractice settlement on behalf of patient brought to hospital emergency room with serious injuries who suffered complications while unmonitored and died.

$425,000 wrongful death/medical malpractice settlement during trial on behalf of senior hospital patient whose surgeon failed to timely address her worsening symptoms, resulting in her death.

$250,000 to young man whose physician failed to diagnose an impending torsion testicle, causing the loss of the affected testicle.

$200,000 to young mother whose OB/GYN failed to timely diagnose and treat her ectopic pregnancy, resulting in excruciating, long-term pain and the need for surgery to address the ectopic pregnancy once it was diagnosed.

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