Learn about Insurance Frauds

Interviewer: I have had situations where I have had patients come to me, the first examination, they had an accident last week. They come to my office, they are still suffering so we examine them, we treat them and then they come back the next day and they tell me that somebody from the insurance company knocked on their door with a checkbook and a piece of paper saying please sign this form. You promise not to see us, we would not pay for any medical bills here is a $3,000 check go away. It almost gets criminal, it is corporate theft. Interviewee: Since you opened that door, I tell you that there are companies that have programs in effect and people who are trained to reach accident victim before those victims get the lawyers. It is no secret that Allstate was fined by the attorney general’s office years ago for that program. I mean they were sending letters to accident victims. People who had accidents with their insureds and they would send a letter saying you had an accident with our insured so you are now a customer of ours and we are here for you and this is our customer service pledge. Interviewer: They hide under that umbrella of customer service. They always use that line. We want this information, what is your doctor, we want to help you. Interviewee: And then they would also attach page that basically listed reasons why they did not need to consult with an attorney. I made the recommendation that you do consult with an attorney, let us first make an offer to you so this way, if you decide to hire an attorney and decide to give a fee to an attorney, let that fee be based on whatever the attorney can get above and beyond what we are offering you and what is amazing to me is how can an insurance company have an accident victim’s best interest at heart and make an offer right up front without even knowing the extent of the injury. Interviewer: It is a conflict of interest back to the anticonsumer point. Interviewee: Obviously, if you have an accident with an insurance company’s insured, you are not the insurance company’s customer, your interests are adverse to theirs. You want their money. They want to protect their insured so anyway that program stopped, there was a fine that was paid but there are other companies that are still doing it in their own way. Interviewer: Now, there are even lawsuits-- Interviewee: It poisons the relationship that we have with our clients because when a client comes in and I have had it happen and they want our representation to be based on anything that happens subsequent to their own efforts to deal with the insurance company. We have already been poisoned, the whole process because from day one, I do not even want insurance an company to speak to my client, know my client. I want it all to come through us, we can protect their interests, the lawsuits. Interviewer: The IMEs have gotten so bad that there are actually doctors unifying and starting to sue the insurance companies and go after them. Interviewee: State Farm is one that is being sued—It is legal action is it not? Interviewer: Saying that is a legal action against the State Farm saying that it is collusion and then they are all trying to cut all these benefits off on purpose for the sake of their own business. Interviewee: There a couple of them out there, here and they are all over the country. There are a couple of them that sprung up here. Interviewer: They are starting in Long Island and hopefully it will change the nature of the business a little bit. Hopefully, it will clean up the insurance companies. They are not consumer friends, they are just not the consumers--they do not care about them, they do not care about the injured party take care about the business and saving money. That is it and it is amazing how much money they spend on commercials? Interviewee: You are in good hands. Interviewer: You are in good hands— Interviewee: Like a good neighbor. Like 15 minutes and-- Interviewer: If that money was spent on injured patients, people really need care, they are down and out, they have families. Interview