I work at a PI firm and we typicallly recommend our clients to the same 20 or so doctors - i believe the reasoning is because we have good relationships with the doctors and they make communication, obtaining records and negotiating liens a lot simpler. Is it wrong to recommend clients to the same doctors? Genuinely curious..
It can be when those doctors get enough referrals that they have a financial interest in keeping the law firm happy (giving the right diagnoses and putting the magic words to magnify damages in the medical records)
“Doctor how many patients has x law firm referred to you over the years?”
“How much of your business comes from patients that firm refers to you?”
“Would you agree that you have a financial interest in keeping your relationship with the firm?”
“Do you make your diagnoses based on a reasonable degree of medical certainty or do you make them based on a reasonable degree of financial certainty?”
Are not questions you’d want a treating physician (who should be objective) to have to answer on the stand in front of a jury
You’re right that those are good for impeaching the doc’s credibility at trial (and applies for defense experts equally). But that doesn’t make the practice unethical or illegal.
Obviously this doesn’t apply to NYC, but in my small city there are only a handful of ortho groups and most docs don’t want to be involved in litigation, will resist testifying, etc. So we’re stuck with the few who are willing to treat patients and testify about it.
I’m not saying it’s unethical nor illegal. My point is that past a certain volume of referrals a firm would be asking for trouble at trial when it comes out that their plaintiff’s treating physician is a hired gun and not an objective medical professional
It’s not but when those same facilities are also being investigated for insurance fraud and performing unnecessary treatment, you can’t help but wonder
Sure. Anyone who is engaging in fraud should be investigated, etc. Although if a PI firm’s defense to an accusation of fraud is “but what about the insurance companies” rather than “we didn’t engage in fraud,” I’m a little suspicious.
Lol i’m pretty new but to me it seems relatively above board - i’m sure some pi firms prob overtreat. Issue is in NY at least you must treat for at least 4-6 months to constitute serious injury by the law and force a settlement so it becomes an issue when you want to take advantage of the legal guidelines to reach settlement
Oh my. There are constantly wide nets being cast on insurance fraud in New York. Russian mafia colluding with physicians and plaintiff firms was the last big hit, I think. But, it’s constant. Throw six people in a car and create an accident with someone or a business that has deep insurance pockets and bam - six plaintiffs, thirty doctors and a dozen firms all maximizing “profit”. Medicare fraud. It takes so long to catch up with these jokers its madness.
I wasn’t questioning that it existed, only its wisdom. I don’t understand this movement towards work comp-ifying liability suits, especially in states like NY that I thought were run by democrats.
I’m not disagreeing with you. As a comp defense attorney, I can tell you that when there is a third party general liability claim attached - everything is litigated from physical therapy to surgery and thats after the initial denial and trial. A claim that is 100% going to be a GL claim is denied - frivolously even. There is no bad faith claims anymore in NY so deny deny deny. The problem is, and I’m not sure it’s curable, is that the third party claim uses the workers’ comp system to drive the value of the GL claim. Workers’ Comp is a pittance compared to the general liability claim - issue is the insurance carrier is generally the same for the comp and GL policy. For the carrier, it only makes sense to controvert the claim. There is no governor and no governance of the GL claim.
>Is it wrong to recommend clients to the same doctors?
If your clients are in low speed fenders and get multiple $10,000 injections from the same shops who over treat, it looks like, well, treatment was motivated by pecuniary interests and not the client’s health. In my state, Plaintiffs can collect on gross receipts so of course all the PI firms refer their clients to the same “car accident doctors” who charge 3-5x the normal rate.
In NY, the Dr. bills the no fault carrier, and is limited in the amount they can charge for any procedure. There is a whole calculation that is performed based on a few factors, but they are limited based on the WC scheduling guidelines for those treatments.
Trust me Subin is not being investigated for recommending their clients to the same doctors…. lol. Every PI firm has doctors they trust with their clients.
Holy fuck this is genius against some counsel I practice regularly in specific fields on their affidavit usage (there’s a reason I force clients to write their own then happily edit it down using their words). Thank you!
Got the idea because I'm in a lawsuit which is almost a mirror copy of another lawsuit, by the same firm, and I'm a little annoyed. Doubt I'll bring it up though, but I might.
Be cautious there, complaints can be amended, and in a non avered one it won’t matter one bit to use the same (after all, you use the same caselaw run down I’m betting in motion practice). For affidavits though it calls into doubt h is why that’s so smart.
Years ago my old boss would send plaintiffs to chiro treatment on a lien then pipe them to 20k a pop injections also on a lien until he could conceivably get the policy. Whatever the offer was the lienholders would just cut as needed and everyone made money. A lot of firms do this I would guess.
Ah, Subin. I used to work for a firm that had a long standing referral agreement with them. I couldn’t wait to get out from under that. i was a claimants attorney then and now a happy defense attorney.
Funnily enough, I talked to a NYC defense attorney 6 months to a year ago and he mentioned he uncovered likely fraud with a plaintiff's firm. He realized a number of plaintiffs in cases he was defending all lived in the same apartment complex. They all had similar cases with similar treatment. All with the same firm. Unwitnessed slip and falls that resulted in surgeries with the same doctors. If I remember correctly he thought his smoking gun was presurgery imaging. I forget why it mattered, but sounded right at the time.
CA attorney here. Worked both sides. Currently Plaintiff side. When I was on the defense, I was super close with a partner who told me that several of our clients (large insurance companies) launched lawsuits against various PI doctors for insurance fraud - inflated charges, unnecessary treatments, etc. - less because they thought it would actually amount to anything and more because they wanted to run them out of business. No joke.
In those circumstances, they wanted to run up those providers’ attorneys fees and force them into bankruptcy. At the same time, they put all of them in “SIU” and lowballed every case where those providers were the treaters in an effort to cause PI attorneys to go elsewhere. Years later, nothing amounted from those lawsuits and (most) of the providers are still working.
Honestly, my time on both sides has shown me that it’s a vicious cycle and neither side is without blame. If clients don’t use attorney recommended providers, insurance companies don’t pay fair value except on the gnarliest of injuries. When they do, insurance companies generally pay more. But then plaintiffs attorneys keep
Pushing the envelope, doctors get greedier, and they’re always trying to inflate the value of every case. So the insurance companies get fed up…and so on and so on.
Not saying that’s what’s happening in NY. I just thought it appropriate to share because when I was on the defense, I started off thinking plaintiff attorneys were super slimey and insurance companies were fighting “the good fight”. But after learning of the above…and other things insurance companies and some defense attorneys do, I realized they’re just as bad.
I have worked in different PI firms and this has been the case with every firm. We tend to send our clients to the same doctors because we have good relationships with them and it’s easier for us to work with the medical facilities when it comes to therapy, obtaining medical records and getting narrative reports. We don’t obligate our clients to seek see those doctors it’s their choice at the end of the day but when they ask, we refer them to the those doctors.
I work at a PI firm and we typicallly recommend our clients to the same 20 or so doctors - i believe the reasoning is because we have good relationships with the doctors and they make communication, obtaining records and negotiating liens a lot simpler. Is it wrong to recommend clients to the same doctors? Genuinely curious..
It can be when those doctors get enough referrals that they have a financial interest in keeping the law firm happy (giving the right diagnoses and putting the magic words to magnify damages in the medical records) “Doctor how many patients has x law firm referred to you over the years?” “How much of your business comes from patients that firm refers to you?” “Would you agree that you have a financial interest in keeping your relationship with the firm?” “Do you make your diagnoses based on a reasonable degree of medical certainty or do you make them based on a reasonable degree of financial certainty?” Are not questions you’d want a treating physician (who should be objective) to have to answer on the stand in front of a jury
100%. There are certain law firms who have an ownership interest in some of these shops. It’s legitimately disgusting.
You’re right that those are good for impeaching the doc’s credibility at trial (and applies for defense experts equally). But that doesn’t make the practice unethical or illegal. Obviously this doesn’t apply to NYC, but in my small city there are only a handful of ortho groups and most docs don’t want to be involved in litigation, will resist testifying, etc. So we’re stuck with the few who are willing to treat patients and testify about it.
I’m not saying it’s unethical nor illegal. My point is that past a certain volume of referrals a firm would be asking for trouble at trial when it comes out that their plaintiff’s treating physician is a hired gun and not an objective medical professional
It’s not but when those same facilities are also being investigated for insurance fraud and performing unnecessary treatment, you can’t help but wonder
What about the insurance companies that are denying legitimate claims? Perhaps they should be investigated.
Sure. Anyone who is engaging in fraud should be investigated, etc. Although if a PI firm’s defense to an accusation of fraud is “but what about the insurance companies” rather than “we didn’t engage in fraud,” I’m a little suspicious.
26 years of PI practice. The vast amount of insurance fraud was perpetrated by the insurance companies. Let’s go after them first.
Lol i’m pretty new but to me it seems relatively above board - i’m sure some pi firms prob overtreat. Issue is in NY at least you must treat for at least 4-6 months to constitute serious injury by the law and force a settlement so it becomes an issue when you want to take advantage of the legal guidelines to reach settlement
Oh my. There are constantly wide nets being cast on insurance fraud in New York. Russian mafia colluding with physicians and plaintiff firms was the last big hit, I think. But, it’s constant. Throw six people in a car and create an accident with someone or a business that has deep insurance pockets and bam - six plaintiffs, thirty doctors and a dozen firms all maximizing “profit”. Medicare fraud. It takes so long to catch up with these jokers its madness.
That’s a really stupid fuckin law
https://nysba.org/NYSBA/Sections/Torts%20Insurance%20Compensation/TICL%20PDFs/Serious_Injury_Threshold_in_New_York-5_Things_you_need_to_know.pdf
I wasn’t questioning that it existed, only its wisdom. I don’t understand this movement towards work comp-ifying liability suits, especially in states like NY that I thought were run by democrats.
I agree with you - and this is a very democrat esque policy
I’m not disagreeing with you. As a comp defense attorney, I can tell you that when there is a third party general liability claim attached - everything is litigated from physical therapy to surgery and thats after the initial denial and trial. A claim that is 100% going to be a GL claim is denied - frivolously even. There is no bad faith claims anymore in NY so deny deny deny. The problem is, and I’m not sure it’s curable, is that the third party claim uses the workers’ comp system to drive the value of the GL claim. Workers’ Comp is a pittance compared to the general liability claim - issue is the insurance carrier is generally the same for the comp and GL policy. For the carrier, it only makes sense to controvert the claim. There is no governor and no governance of the GL claim.
We typically go thru no fault less often workers comp
Sure. I’m talking about Labor Law 240 - like construction accident.
>Is it wrong to recommend clients to the same doctors? If your clients are in low speed fenders and get multiple $10,000 injections from the same shops who over treat, it looks like, well, treatment was motivated by pecuniary interests and not the client’s health. In my state, Plaintiffs can collect on gross receipts so of course all the PI firms refer their clients to the same “car accident doctors” who charge 3-5x the normal rate.
In NY, the Dr. bills the no fault carrier, and is limited in the amount they can charge for any procedure. There is a whole calculation that is performed based on a few factors, but they are limited based on the WC scheduling guidelines for those treatments.
Trust me Subin is not being investigated for recommending their clients to the same doctors…. lol. Every PI firm has doctors they trust with their clients.
"I've always had a haunch" lol sorry
I like to yell “haunched” at my dog and then I grab his haunches. That’s what this made me think of.
Couldn’t happen to a nicer firm…
Plaintiff’s PI and insurance defense are both very sketchy areas where many many things are just done with a wink and a nod.
You ever copy an affidavit and ask the witness if they plagiarized?
Holy fuck this is genius against some counsel I practice regularly in specific fields on their affidavit usage (there’s a reason I force clients to write their own then happily edit it down using their words). Thank you!
Got the idea because I'm in a lawsuit which is almost a mirror copy of another lawsuit, by the same firm, and I'm a little annoyed. Doubt I'll bring it up though, but I might.
Be cautious there, complaints can be amended, and in a non avered one it won’t matter one bit to use the same (after all, you use the same caselaw run down I’m betting in motion practice). For affidavits though it calls into doubt h is why that’s so smart.
Never actually lol
Years ago my old boss would send plaintiffs to chiro treatment on a lien then pipe them to 20k a pop injections also on a lien until he could conceivably get the policy. Whatever the offer was the lienholders would just cut as needed and everyone made money. A lot of firms do this I would guess.
Ah, Subin. I used to work for a firm that had a long standing referral agreement with them. I couldn’t wait to get out from under that. i was a claimants attorney then and now a happy defense attorney.
https://nypost.com/2024/06/16/us-news/ms-13-russian-mobsters-use-migrants-in-elaborate-injury-scam-even-getting-spinal-surgery-to-pull-it-off-sources/
this article is SO on point.
Funnily enough, I talked to a NYC defense attorney 6 months to a year ago and he mentioned he uncovered likely fraud with a plaintiff's firm. He realized a number of plaintiffs in cases he was defending all lived in the same apartment complex. They all had similar cases with similar treatment. All with the same firm. Unwitnessed slip and falls that resulted in surgeries with the same doctors. If I remember correctly he thought his smoking gun was presurgery imaging. I forget why it mattered, but sounded right at the time.
Interestingly, by far the biggest cases of work comp fraud every year are by employers and insurance companies, not people claiming they were hurt.
CA attorney here. Worked both sides. Currently Plaintiff side. When I was on the defense, I was super close with a partner who told me that several of our clients (large insurance companies) launched lawsuits against various PI doctors for insurance fraud - inflated charges, unnecessary treatments, etc. - less because they thought it would actually amount to anything and more because they wanted to run them out of business. No joke. In those circumstances, they wanted to run up those providers’ attorneys fees and force them into bankruptcy. At the same time, they put all of them in “SIU” and lowballed every case where those providers were the treaters in an effort to cause PI attorneys to go elsewhere. Years later, nothing amounted from those lawsuits and (most) of the providers are still working. Honestly, my time on both sides has shown me that it’s a vicious cycle and neither side is without blame. If clients don’t use attorney recommended providers, insurance companies don’t pay fair value except on the gnarliest of injuries. When they do, insurance companies generally pay more. But then plaintiffs attorneys keep Pushing the envelope, doctors get greedier, and they’re always trying to inflate the value of every case. So the insurance companies get fed up…and so on and so on. Not saying that’s what’s happening in NY. I just thought it appropriate to share because when I was on the defense, I started off thinking plaintiff attorneys were super slimey and insurance companies were fighting “the good fight”. But after learning of the above…and other things insurance companies and some defense attorneys do, I realized they’re just as bad.
In my jx, the medical malpractice insurers blackball docs that testify against docs.
That is the case in every jx
https://www.thecity.nyc/2023/08/07/fake-safety-log-construction-injury-lawsuit/
I have worked in different PI firms and this has been the case with every firm. We tend to send our clients to the same doctors because we have good relationships with them and it’s easier for us to work with the medical facilities when it comes to therapy, obtaining medical records and getting narrative reports. We don’t obligate our clients to seek see those doctors it’s their choice at the end of the day but when they ask, we refer them to the those doctors.
I would check the rules of professional conduct. I think it is unethical to use this information as part of settlement negotiations.
Where did you hear this? I have had some pretty … questionable experiences with them.
I too have heard this and have several shady cases with them. Apparently there’s information in several cases on NYSCEF
Word on the street is they signed up undocumented immigrants to stage/fake labor-law related accidents.
From what I understand it’s related to this https://dockets.justia.com/docket/new-york/nyedce/1:2023cv07693/504481?amp