FRAUD ALERT: INSURER CLAIMS REPS NEED TO BE TAKING A CLOSE LOOK AT MEDICAL BILLS SUBMITTED PRESUIT BY CLAIMANTS’ ATTORNEYS
We have received reliable reports that some plaintiffs’ firms may be sending insurance companies altered and redacted billing records with pre-suit demand letters. The alterations are not always plainly obvious, and may consist of whited-out amounts for adjustments and write-offs. A cursory review of the altered bills would lead one to believe that the claimant has paid or owes more than they actually do. If taken at face value, payment of these bills would result in a windfall for the claimant and his attorney – a windfall gained through fraud, criminal acts and unethical behavior.
We recently confirmed that an altered medical bill was sent to one of our clients with a demand package, pre-suit. We were able to determine that the Plaintiff was trying to hide a $2,300 adjustment from the insurance company.
We highly recommend that all medical records and bills be ordered directly from the medical providers, whether by authorization or by subpoena. Not only will payments and write-offs be easily confirmed, but these records may contain useful information regarding pre-existing conditions, unrelated injuries and conditions, unrevealed medical liens and subrogation interests (which you may remain directly liable for if you pay the claimant), and payment to providers by medical factoring companies.
Our firm can aid in bill review and bill ordering from providers, and you should contact us.
Chamberlain♦McHaney, with offices in Austin and San Antonio, handles all types of civil litigation throughout the state. The firm is A-V (highest peer review) rated by Martindale-Hubbell (Bar Registry of Preeminent Lawyers) and is listed in A.M. Best’s Directory of Recommended Attorneys. For information regarding our areas of practice and a list of representative clients, please visit:www.chmc-law.com.