In a recent eye-opening report by Patrick Rucker of The Capitol Forum and Doris Burke and David Armstrong of ProPublica titled “Doctors With Histories of Big Malpractice Settlements Work for Insurers, Deciding If They’ll Pay for Care,” a disconcerting practice within the healthcare insurance industry has been brought to light. The investigation reveals that medical malpractice consequences for doctors in some cases are nil—and, perhaps, to a dangerous extent. Doctors with histories of significant malpractice settlements or disciplinary actions are often employed by major health insurance companies as medical directors.

This revelation is cause for concern. As medical malpractice attorneys committed to upholding the rights of our clients and neighbors, Colling Gilbert Wright is outraged, and we think you should be too.

The Murphy Family Tragedy

This in-depth report begins with the tragic case of Shawn Murphy, whose wife died due to a botched gallbladder surgery performed by Dr. Pachavit Kasemsap. Despite Kasemsap’s involvement in multiple malpractice cases amounting to $3 million in settlements, including $1 million to the Murphy family, he was welcomed into the health insurance industry as a medical director. This position empowers him to make critical decisions affecting the healthcare of thousands of patients, often without direct patient interaction.

Decision-Making Power in Questionable Hands

These medical directors play a crucial role in determining the fate of treatment requests and claims. However, their backgrounds and qualifications are often shrouded in secrecy, leaving patients and treating physicians in the dark about who is making these life-altering decisions. The report uncovers that at least 12 doctors employed by insurance companies had troubling pasts, including histories of malpractice payments or disciplinary actions.

The implications of this practice are profound. Medical directors like Kasemsap, who have left clinical practice under a cloud, are now in high-paying positions that allow them to overrule the judgments of treating doctors, potentially denying critical and lifesaving treatments. This situation not only raises ethical concerns but also poses significant risks to patient safety and well-being.

In another example, Dr. Jon Erickson was barred from performing orthopedic operations after a series of problematic surgeries but was employed to review such cases for an insurer. This raises questions about the alignment between the qualifications of these directors and the nature of the cases they review.

The article also explores the motivations for doctors to shift to the insurance sector, noting that it offers a lucrative and less demanding alternative to clinical practice. However, this transition places these individuals in roles where their decisions can significantly impact patient care and outcomes for many, many people.

Transparency and Rigorous Standards in Health Insurance

The article stresses the need for transparency and accountability in the health insurance sector. It calls into question the criteria used by insurers to appoint medical directors, the impact of these decisions on patient care, and the lack of medical malpractice consequences for doctors.

From the perspective of medical malpractice attorneys, this investigation reinforces the importance of vigilance in protecting the rights of patients and ensuring that healthcare decisions are made with integrity and competence.

As legal advocates committed to justice and patient welfare, we believe it is crucial to scrutinize the practices of insurance companies and hold them accountable for their choices in medical director appointments. The health and well-being of countless individuals may depend on ensuring these roles are filled by professionals with unblemished records and a clear commitment to patient care.

For families like Shawn Murphy’s, discovering that a doctor responsible for a loved one’s tragic outcome is in a position to affect the care of others adds an extra layer of distress to their grief. This situation raises questions about the individual accountability of doctors like Kasemsap and points to a larger systemic issue within the health insurance industry. It suggests a possible disconnect between the qualifications considered for these influential positions and the imperative to prioritize patient safety and quality care.

Advocating for Change

For attorneys who handle medical malpractice claims, these revelations confirm the necessity of our work. We stand as advocates for those harmed by medical negligence, fighting to ensure that similar tragedies are prevented in the future and for impactful medical malpractice consequences for doctors. We also play a crucial role in challenging insurance practices that may prioritize cost-saving over patient health, advocating for policyholders who face unjust claim denials or treatment refusals.

This report serves as a stark reminder of the complexities at the intersection of healthcare and insurance, highlighting the need for ongoing vigilance, advocacy, and reform. At Colling Gilbert Wright, we are passionate about advocating for the rights and well-being of our clients. We take our responsibility to heart and fight vigorously to ensure that the healthcare system is both just and focused on the genuine well-being of its patients.

How Can a Medical Malpractice Attorney Help?

Medical malpractice can profoundly impact the lives of patients and their families, often leaving them in a state of uncertainty and distress. Understanding the law in Florida, including the medical malpractice consequences for doctors and the potential for lawsuits against insurance companies, is crucial for anyone affected.

Handling claims related to these complex areas of the law can be daunting, but the experienced medical malpractice attorneys at Colling Gilbert Wright can provide invaluable assistance. We can help gather necessary evidence, consult medical experts, negotiate with insurance companies, and represent a client in court if needed. Our knowledge is crucial in navigating the nuances of Florida law and ensuring that rights are upheld and justice is sought.

What Are the Medical Malpractice Consequences for Doctors in Florida?

In Florida, doctors found guilty of medical malpractice are supposed to face significant consequences. These can range from civil liability, where they must compensate the victim for damages (Florida Statutes § 766.102), to disciplinary actions by medical boards, including license suspension or revocation. The Florida Board of Medicine, for instance, strives to impose strict regulations and can take disciplinary action against physicians who violate professional standards (§ 458.331).

Can I Sue If My Health Insurance Company Has Denied My Claim?

When a health insurance claim in Florida is unfairly denied, policyholders have the right to sue for bad faith insurance practices. Under § 624.155, insurers are obligated to handle claims with honesty and fairness. Failure to do so can lead to a bad faith claim, allowing the policyholder to seek compensation beyond the original claim’s value. This includes damages for stress, inconvenience, and attorney’s fees.

Dealing with an insurance claim denial starts with understanding the reason behind the denial. Policyholders should review their policy terms and the denial letter closely. If the denial seems unjust, filing an appeal with the insurance company is advisable. In cases where appeals are unsuccessful, legal action for bad faith may be necessary.

Consult with the Lawyers of Colling Gilbert Wright

Dealing with medical negligence can be challenging. Understanding your rights and the legal avenues available is essential. With our commitment to justice, integrity, and empathy, Colling Gilbert Wright stands ready to guide and support you through these difficult times.

If you’re facing a medical malpractice claim, don’t hesitate to reach out for legal assistance. Contact us online or call (407) 712-7300 today for a FREE case evaluation. We are proud to serve our neighbors in Orlando and throughout Florida.

The post When Doctors with Malpractice Records Become Insurance Gatekeepers appeared first on Colling Gilbert Wright.

If you’ve been injured in a car accident in Florida, you could benefit from the assistance of the trusted car accident attorneys of Colling Gilbert Wright. Call (407) 712-7300 today to schedule a FREE case evaluation. We are proud to advocate for the rights of our neighbors in Orlando and throughout Florida.

Understanding Florida’s No-Fault Insurance Law

Florida is one of 12 states that follow a no-fault insurance law. The Florida Motor Vehicle No-Fault Law dictates that every vehicle owner must carry a certain amount of Personal Injury Protection (PIP) and Property Damage Liability (PDL) insurance.

According to § 627.736(1)(a)&(b), in the event of a car accident in Florida, your PIP coverage will cover:

• 80% of your medical expenses up to $10,000
• 60% of your lost wages and earning capacity up to $10,000

These are mandated coverages no matter who is at fault in the car accident.

Importance of PIP Coverage

No-fault insurance aims to minimize the number of car accident lawsuits clogging the courts and to expedite recovery of losses for the injured. Because Florida adheres to the no-fault insurance system, your PIP insurance is used first to cover your own losses.

PIP coverage is mandatory and provides initial financial support, helping you avoid the delays often experienced when determining fault. The minimum PIP coverage in Florida is $10,000, which is the limit your insurance will pay for medical expenses related to your injuries and those of your passengers.

When Does At-Fault Insurance Come Into Play?

While PIP covers minor accidents, what about severe accidents where damages far exceed the PIP limits? For significant or permanent injuries, the at-fault driver’s insurance can be pursued for additional compensation.

Florida law § 627.737(2) defines a significant injury as one that results in:

• Permanent loss of a significant bodily function
• Permanent injury within a reasonable degree of medical probability
• Significant and permanent scarring or disfigurement
• Death

To prove that your injury is significant or permanent, you will need to seek medical attention promptly (within 14 days) and keep documentation of all diagnoses and treatment.

Seeking Compensation Beyond PIP

If the accident results in injuries that meet the significant injury threshold, you can step outside the no-fault system and file a claim against the at-fault driver. You can also pursue damages for non-economic losses like pain and suffering.

Here, the at-fault driver’s Bodily Injury Liability (BIL) insurance could cover your expenses. Unfortunately, Florida does not mandate drivers to hold BIL insurance, potentially complicating the compensation process if the at-fault driver is uninsured or underinsured.

Read More: How To Recover Full Compensation After a Car Accident

Uninsured & Underinsured Motorist Coverage

A 2019 study by the Insurance Research Council found that 20.4% of Florida drivers were uninsured. In cases where the at-fault driver does not have adequate insurance to cover your expenses, your Uninsured/Underinsured Motorist coverage, if you have it, will come to your aid. This coverage pays for your medical bills, lost wages, and other damages when the at-fault driver’s insurance is insufficient, providing an essential safety net.

Third-Party Liability in a Car Accident in Florida

There may also be scenarios where third parties can be held liable for a car accident in Florida. Beyond the drivers involved, liability may extend to vehicle manufacturers for defects that contributed to the accident or a mechanic shop for negligent repairs. Employers might be held accountable if an accident occurs while a driver is operating a vehicle for work-related tasks.

Additionally, if the accident is due to poor road conditions or faulty traffic signals, the governmental body responsible for road maintenance could be liable. Establishing third-party liability requires a thorough investigation and strong evidence. Legal assistance from experienced attorneys is crucial to navigate these complex situations, ensuring all liable parties are held accountable.

Handling Insurance Claims in Florida

Handling insurance claims post-accident is complex, especially when multiple parties and insurance companies are involved. Documentation, timely filing, and negotiation with insurance adjusters are all crucial aspects that can significantly influence the compensation you receive.

When trying to recover from your injuries, you need to focus your energy on yourself, your family, and getting healthy again. You needn’t be overwhelmed with the legal ins and outs of your claim.

An experienced car accident lawyer can guide you through the intricate maze of Florida’s car accident and insurance laws, ensuring that you pursue all possible compensation sources. They will champion your rights, handling negotiations and legal processes, allowing you to give all of your attention to your recovery.

Contact Colling Gilbert Wright Today

Understanding whose insurance pays in a car accident in Florida is fundamental for anyone on Florida roads. While PIP coverage provides initial relief, the various avenues for additional compensation in more severe accidents can seem confusing. Equip yourself with a robust insurance policy, and do not hesitate to contact a Florida car accident lawyer in the event of an accident.

Timely and adept legal support can make a monumental difference in securing the compensation you deserve. If you or a loved one is injured in a car accident in Florida, do not delay in contacting Colling Gilbert Wright for legal guidance. Our dedicated and experienced team is here to support you. We will ensure your rights are upheld and you pursue the compensation you are entitled to.

We will remain by your side throughout this process, securing the peace of mind you need during these trying times. Let us be the beacon that guides you through the legal intricacies, steering you toward justice and recovery.

The post Whose Insurance Pays for a Car Accident in Florida? appeared first on Colling Gilbert Wright.

Knowing your rights regarding compensation after a car accident is always important. Insurance companies are typically more interested in their bottom line than in your recovery. The more you know about the losses you should be reimbursed for and your legal options in the event you need them, the better.

If you’ve been involved in a car accident in Orlando, it may be in your best interest to contact a lawyer to discuss your situation and ensure you are pursuing all the compensation you deserve. Call Colling Gilbert Wright at (407) 712-7300 today for a FREE consultation.

What Does PIP Cover in the State of Florida?

Florida is a no-fault state, meaning that no matter who is at fault in a car accident, each party involved will first rely on their own insurance to cover medical bills and lost wages. This insurance policy is called Personal Injury Protection (PIP). 

Each Florida motor vehicle owner is required to purchase a PIP policy. The policy ensures that a percentage of medical expenses and lost wages are covered no matter who is responsible for the car accident. However, it also limits the victims of motor vehicle accidents’ “right to claim damages for pain, suffering, mental anguish, and inconvenience.” (§ 627.731)

According to the Florida Motor Vehicle No-Fault Law § 627.736(a)(b)&(c), you are required to carry a minimum of $10,000 of PIP coverage. In the case of an accident, you are mandated:

• 80% of all reasonable medical expenses up to $10,000
• 60% of any loss of income or earning capacity up to $10,000
• $5,000 per individual in death benefits

Simply put, PIP does cover lost wages for a car accident in Florida. However, your compensation will only be 60% of your total lost wages up to a $10,000 limit. If this coverage isn’t going to cover your expenses comfortably, it could be in your best interest to contact a car accident lawyer.

Read More: Do I Need a Lawyer for my Car Crash?

How Does PIP Work?

Personal injury protection (PIP) insurance is your first line of recovery after a Orlando car accident. Understanding how to use your PIP insurance in case of a car accident is essential. It will ensure you receive payment of your benefits for medical expenses and lost wages for a car accident in a timely manner.

Each car accident is different, requiring its own individual approach when it comes to compensation. Sometimes, your only recourse may be filing a claim with your PIP insurance. 

How to proceed after a car accident in Florida:

1. Report the Accident to the Police

If the accident requires immediate medical assistance, call 911 and accept emergency treatment. If not, contact the police to report the accident.

Reporting your accident to the police is important for many reasons, the top two being (1) the police report will strengthen your claim, and (2) it is required by Florida Statute § 316.065.

You must report a car accident to law enforcement if:

• Injury or death occurred
• An intoxicated driver caused the accident
• It was a hit-and-run accident
• Property damage exceeds $500

2. Seek Medical Treatment

Seek medical treatment as soon as possible, even if it is not an emergency. PIP insurance requires that you seek medical treatment within 14 days of a car accident. Keep all relevant paperwork involving your injuries, treatment plans, and prescriptions.

In your initial exam with a medical provider, they will establish whether you have an emergency medical condition (EMC). An EMC, per § 627.732(16), constitutes “a medical condition manifesting itself by acute symptoms of sufficient severity…such that the absence of immediate medical attention could…result in any of the following:

(a) Serious jeopardy to patient health.

(b) Serious impairment to bodily functions.

(c) Serious dysfunction of any bodily organ or part.”

If diagnosed with an EMC, you will be eligible for benefits up to $10,000. If not, you would only be eligible for benefits up to $2,500.

3. Report the Accident to Your Insurance Company

Again, it is essential to report your accident promptly. PIP will be your first source of financial recovery. PIP requires that you report a claim within two weeks of an accident. The sooner you report, the smaller the risk of complications with your claim.

Remember to keep all relevant paperwork from law enforcement, medical providers, and insurance companies. This will be vital if you seek additional damages by other legal means.

Additionally, always follow your medical provider’s instructions, including not returning to work or activity before approval. This will make it easier for you when dealing with the insurance company. As kind as insurance adjusters can seem, they have their own interests in mind.

If you are concerned that you are not getting the compensation you deserve for your injuries or lost wages for a car accident, you should contact an attorney. They can ensure you maintain your eligibility for your PIP benefits and that every legal option for compensation is pursued.

Read More: What Should I Do If I Was Involved in a Car Accident in Orlando?

How Can I Recover My Remaining Losses?

PIP insurance is mainly meant to cover minor injuries following a car accident. No-fault insurance, in general, is intended to limit the number of lawsuits following car accidents by taking care of medical expenses and lost wages automatically, no matter who is at fault.

Yet, PIP will not cover medical expenses or lost wages over $10,000 or medical treatment received more than 14 days after an accident. This means that if you have injuries that are “significant or permanent” or that surface later and you’ve used up your PIP insurance, you may need to seek compensation elsewhere.

You may be eligible to file a lawsuit against the at-fault driver and/or their insurance company for your remaining medical expenses, lost wages, and other damages. However, proving fault and comparative negligence will become factors in your suit.

Read More: How Is Fault Determined in a Florida Car Accident?

How Can an Attorney Help You Seek Compensation for Your Medical Expenses & Lost Wages for a Car Accident in Orlando?

Trying to pursue just compensation in an no-fault state is complicated. The most important actions to take if you are injured in a car accident are to:

• Report the accident to law enforcement
• Act quickly to seek medical attention
• Report the accident to your insurance
• Keep all paperwork regarding the accident, your medical care, and your insurance
• Contact a capable car accident attorney

An experienced car accident lawyer can navigate the complexities of Florida’s Motor Vehicle No-Fault Laws to ensure that you receive just compensation for your injuries. If you’ve been in a car accident in Orlando and need someone to advocate for your rights, contact Colling Gilbert Wright. Let’s schedule a FREE case evaluation to ensure that all appropriate action is taken in your claim.

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The danger of Hurricane Matthew has mostly passed. Now, we are left to piece back together our quality of life. Countless insurance claims need to be filed, and hurricane victims should be wary when dealing with their insurance providers. Natural disasters often bring communities together, but insurance companies worry more about their bottom line than honoring contracts with those affected by the storm.

Insurance policies are required by Florida Law to cover hurricane damage caused by high winds, but providers often act in bad faith and attempt to discredit incoming insurance claims after hurricanes. Back when Hurricane Katrina and Hurricane Sandy hit our coasts, many insurance companies took advantage of the natural disasters by denying or delaying valid insurance claims. Sometimes offering pennies on the dollar for homeowners to rebuild or denying coverage for business income losses. In some cases, insurance providers completely refused to honor their agreements.

Our attorneys in Orlando have decades of experience dealing with insurance companies. We can fight for you during this difficult time. We know the deceptive strategies these providers employ and can make sure you’re given the full amount of compensation you’re owed.

Our thoughts are with those affected by Hurricane Matthew. We hope you and your family members and friends are safely out of harm.

If your property was damaged due to the 100 mph winds of Hurricane Matthew, please call our attorneys in Orlando today at (407) 712-7300 to schedule your FREE consultation. Colling Gilbert Wright serve clients throughout Florida and nationwide.

The post Hurricane Matthew Victims Need to Be Wary of Denied or Delayed Insurance Claims appeared first on Colling Gilbert Wright.

The opposing insurance company will not have your best interest in mind because they want to take as little financial responsibility as possible. If anything, they will be trying to eliminate or reduce the other driver’s liability in the matter.

If you feel you have been injured due to the negligence of another driver and may have a case, contacting an experienced attorney is your best option.

At  Colling Gilbert Wright, our Florida attorneys not only have the experience but also the compassion and willingness required in your time of need. Please call (407) 712-7300 or contact us online to schedule your free case review.

The post Should I Talk to an Insurance Company after My Car Accident? appeared first on Colling Gilbert Wright.

We buy car insurance to protect ourselves. But we also buy it because it’s mandatory (except in the state of New Hampshire).  Of the estimated 200 million people who drive cars in the U.S., an estimated one in seven (or 13.8%) is uninsured.  These uninsured motorists cost their law-abiding counterparts billions of dollars every year – not only in damages, but in uninsured motorist coverage as well.

Uninsured-underinsured motorist coverage is not mandatory. However, if you don’t have it, you might want to consider adding it to your policy. It’s a way of insuring yourself and protecting your assets.  Think about it.  Let’s say you are hit by an uninsured or underinsured driver and need on-going medical care, including rehabilitation.  You are unable to work during your recovery time and lose wages.    In addition, your home needs to be modified (for example, if you are in a wheel chair and need a ramp).  Who’s going to pay for all this?  Not the driver who hit you.  They don’t have insurance. And, more than likely, they don’t have coverage because they can’t afford it.  You could try to take them to court; but regardless of what the court rules, if they can’t pay, they can’t pay.  Uninsured motorist coverage can cover all this, including the pain and suffering standard insurance does not.  And, the really good news about this type of coverage is that your insurance rates should not rise as a result of using your coverage.

When deciding whether or not to add uninsured motorist coverage to your policy, ask yourself the following questions:

• Do you live in a state with low minimum insurance requirements?  Florida doesn’t require any liability insurance of most other drivers on the road.
• Does your state have a high percentage of uninsured drivers?  Many estimate that over 2 of every 3 drivers in Florida have little or no liability insurance.
• How much do you value peace of mind?  Most people only have about three months of savings for emergency situations.
• How much do you have to lose if you are hit by an uninsured/underinsured driver?  Everything you have worked so hard for is at risk.

If you have questions, please call our office for assistance.  We’d be happy to go over your policy and make recommendations to help you ensure that you are fully covered in any accident situation.

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Everything you need to know about the act – especially in regards to how it will affect you and your household – can be found on the HealthCare.gov website. If you already have insurance through your employer, your parent’s or spouse’s plan, Medicaid, Medicare or VA healthcare, there is nothing much you need to do. If you are concerned that your employer-provided insurance does not meet the “minimal essential” coverage set forth by the laws “individual mandate” (basically, get insured or possibly pay a penalty at tax time), check with your human resources department and go from there. HealthCare.gov has a page on this subject. (What if I have job-based insurance?)

If you aren’t currently covered and haven’t visited the HealthCare.gov website yet, you have until the end of March to research your options and buy coverage. As the “Health Insurance Marketplace” exchange won’t allow you to browse insurance options without first entering your personal data, you may want to start your investigation by visiting The Henry J. Kaiser Family Foundation’s subsidy calculator. The tool – labeled “Premium Assistance for Coverage in Exchanges” – will help you determine how much of your premium (if any) the government will cover through tax credit.

To help you get started on your research, we’d like to share a few quick facts about the new law.

The ACA:
• Stops insurers from rejecting someone for a preexisting condition, dropping their coverage due to illness or placing an annual or lifetime cap on their coverage
• Requires policies to cover a slew of preventative care including mammograms, colonoscopies, cholesterol tests, prenatal care, vaccines and more, and
• Holds insurance companies accountable for rate increases

If you do not have coverage and choose not to enroll, there is a possibility you will face a penalty. All exemptions can be found on the HealthCare.gov website and include the following:

• You’re uninsured for less than 3 months of the year
• The lowest-priced coverage available to you would cost more than 8% of your household income
• You don’t have to file a tax return because your income is too low
• You have experienced “hardship” that has affected your ability to purchase coverage

There is a lot to absorb. Please make sure you are informed and understand the proper healthcare benefits for you and your family.

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According to most estimates, at least 24% of Florida motorists are uninsured.  Of the roughly 75% that have insurance, a large number have relatively minimal liability policy limits of $ 10,000 per accident.  Many more have liability insurance coverage in limits well under $ 100,000.  Remarkably few drivers have high limits liability coverage and umbrella liability insurance.  Conclusion?  If you are involved in a serious accident and sustain serious injuries with tens or hundreds of thousands in medical bills and wage loss, well over half the drivers on the road have inadequate insurance to compensate you for injuries they cause when they are behind the wheel.  How do you deal with this hard cold fact?  You buy uninsured and underinsured motorist coverage.

UM coverage is designed to take the place of the other driver’s insurance when you are hurt in a car accident with an uninsured or woefully underinsured driver.  Don’t rush through the paperwork when buying or renewing your auto insurance.  Pay attention to what you are getting for your money.  And above all, be sure to buy the most important coverage offered in Florida, UM coverage, to protect your family from catastrophic injuries and expenses from accidents with underinsured drivers.

The post THE Most Important Thing To Know When Buying Auto Insurance appeared first on Colling Gilbert Wright.

Injured in a trucking accident?  Call us for a free consultation about your legal rights.

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In any event, this tragedy highlights the unfairness of insurers’ recent demands for laws that restrict the definitions of sinkhole activity and limit their responsibility to repair and correct sinkhole activity on insured properties.  It is unfair to Florida consumers and homeowners to enact laws that take the place of good engineering judgment of what does and doesn’t present a sinkhole risk on a given piece of property.  Even more importantly, restricting home insurers’ exposure for sinkhole reparations needlessly endangers Floridians who live in the sinkhole-prone zone of Central Florida.  Insurers are currently lobbying the Florida Legislature for more anti-consumer legislation on sinkhole insurance claims.  We hope that the Florida Legislature will take notice that this is not only an issue of basic fairness for homeowners, but also a public safety issue.

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