Steven Plitt, Expert Witness Steven Plitt, Expert Witness
Insurance Bad Faith Claim Handling Expert Serving Clients Nationwide

Medical Malpractice Archives

COMPUTERIZED MEDICAL BILLING REVIEWS COMES UNDER SCRUTINY IN WASHINGTON

Recently, in Folweiler Chiropractic, PS v. American Family Ins. Co., 2018 WL 5729873 (Wash. App. 2018), the Washington Court of Appeals reinstated a class action lawsuit against American Family where the suit accused American Family of unfairly discounting medical payments based upon computerized databases which were used to determine the reasonable cost of medical services. It was alleged that American Family, based upon the computerized databases that were utilized, automatically disallowed medical bill charges that exceeded the 80th percentile amount for the relevant zip code. The suit alleged that this practice violated Washington's Consumer Protection Act (CPA), RCW 19.8.020. The medical provider, Folweiler Chiropractic, filed the putative class action lawsuit, contending that the automatic deductions were a violation of Washington's PIP statute, the Unfair Claims Settlement Practices Regulations, and the CPA. The case was initially dismissed, but the Court of Appeals reversed and reinstated the case.

OHIO COURT FINDS THAT PHYSICIAN'S SEXUAL RELATIONSHIP WITH A PATIENT DID NOT CONSTITUTE MEDICAL MALPRACTICE

In Beattie v. McCoy, 2018-Ohio-2535, 115 N.E.3d 867, the Court held that professional liability policies did not cover medical malpractice actions arising from a physician's sexual relationship with a patient. The policy in question provided coverage for defined "professional services." The policy defined "professional services" as "medical, surgical, dental, imaging, mental or other healthcare professional service or treatments . . . [and the] provision of drugs, healthcare supplies or appliances." Under the facts presented there was no obligation to provide coverage.

Contact Steven Plitt

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

Phone: 602-322-4038