Protecting Doctors Who Protect the Injured

Here is what one of our clients has to say:

“I am a doctor who built a successful pain management practice with multiple offices in one of America’s biggest cities. Little did I know this made me a target. Everything I had worked for my entire life – my practice, my employees, my patients, and my reputation – was being threatened with complete ruination based on lies. Then I met Andy Baratta. Andy explained in clear terms what I was up against, mapped out an aggressive strategy to expose it, and then fought relentlessly until we had achieved complete victory. If you are a doctor or owner of a medical practice which serves injured patients anywhere in the country, you too are vulnerable to what I faced. Do yourself, your employees, and your patients a favor. The moment any insurance company suggests “concern” about any aspect of your practice, call Andy Baratta. He will not only help you, he will help you win.

– Dr. Peter S.

Over the past 20 years, Baratta Law has represented and advised hundreds of medical providers across the country in disputes with insurance companies over the doctors’ treatment of patients injured in accidents. Baratta Law has sued major insurers for Defamation, Intentional Interference with Business Relationships, Declaratory Judgments, and more as the result of wrongful attacks by the insurers.  Baratta Law has also defended doctors victimized by lawsuits filed by insurers against them.  In numerous federal and state litigations across the country, Baratta Law has repeatedly exposed an insurance industry-wide scheme, developed and perfected most ruthlessly over the past 20 years by the major auto insurance carriers, of attacking doctors who treat personal injury patients with manufactured and knowingly false accusations of “fraud”.

The scheme involves the creation of a “fraud funnel” and it originated from recommendations made to the largest insurers in the country by the global corporate consulting giant McKinsey & Co. in the 1990s. McKinsey is of course legendary for teaching corporations how to increase profits with a mercenary focus on the bottom line.

Before McKinsey came along, insurers understood generally the duty to adhere in their claims operations to the indemnity and fiduciary principles which underlie all bad faith laws and insurance regulations. But after McKinsey, insurers “redefined the game” and “radically altered” their “whole approach to the business of claims” in order to maximize profits.

McKinsey famously called this new way of thinking a “zero-sum economic game” in which the insurer competes with its insured for a limited pool of claim dollars. While this zero-sum game has many facets, one of its strategies recognized that the vast majority of bodily injury claims submitted across the country involve treatment for entirely subjective complaints of pain to the soft tissue areas of the body. McKinsey pointed out that insurers could and should aggressively attack this universe of claims as exaggerated and fraudulent because, in the end, the legitimacy and value of each such claim is simply a matter of credibility. If the patient and the doctor’s credibility can be undermined, then so can the insurer’s payment obligations.

The major insurance carriers have developed entire units of adjusters devoted to attacking the credibility of doctors who treat personal injury patients and have reaped billions of dollars in avoided claim expenses doing so. The strategies utilized range from abusing the civil process in “fact” depositions of treating doctors, to knowingly wrongful denials of payment for treatment rendered, to trumped-up federal lawsuits against doctors accusing them of fraud.

Unfortunately, the vast majority of doctors targeted by the zero-sum game are unprepared and easily victimized. By the time they realize they are in an insurer’s crosshairs, it is too late. Once targeted, a doctor will be cut off from payments from the insurer while at the same time incurring crippling legal expenses, the combination of which is deadly to just about any medical practice.

The key for doctors is to first understand how and why they are vulnerable to this scheme, and then take necessary but fairly simple steps to armor themselves against it. No one knows better how to help doctors do this than Andrew Baratta at Baratta Law.

Contact Baratta Law