Category: Insurance, Medical & Healthcare Tips for Collecting Your Health Care Claim against Self-Insured Health Plan TASA ID: 3307 Obtaining reimbursement on a health care claim is not easy today because of all the different laws and regulations and insurance plans. I recently worked on several cases to recover claims involving a large self-insured health plan. All self-insured plans are governed by the federal ERISA law and have “trustees” to administer the Plan. Many health care providers, including surgeons, surgery centers, chiropractors, and physical therapists have had their legitimate claims denied over recent years because of alleged fraudulent claims, but legitimate claims are payable. Read more
Category: Food Safety and Production, Medical & Healthcare Long-Term Sequelae of E.coli 0157:H7 TASA ID: 733 As we eat in places other than our kitchen, poor sanitation and contamination of food sources become a significant problem. Although the FDA has established a series of guidelines for food safety, CDC incidence reports of Listeria, Salmonella and E. coli 0157:H7 are on the rise. Some of the acute clinical symptoms related to these types of bacterial infection appear to be self-limiting, but the reality is that life-long problems persist. Of interest to the lawyer and patient is to ensure that these significant risk factors are considered when the damages to the person are assessed. Read more
Category: Medical & Healthcare Disputes between Physicians – Rights and Obligations of Professional Medical Corporation after Death of Sole Shareholder Doctor TASA ID: 3307 Health care is one of the largest components of our national GDP (17.4% in 2013). Doctor services are a large part of that, comprising $587 billion in 2013. Doctors traditionally operate through professional medical corporations in which they are the sole shareholder. It is the law in most, if not all states, that only other doctors can own a controlling interest in the corporation, and only doctors can be an officer or director. (See for example California Corp. Code Sections 13406-13408). Read more
Category: Medical & Healthcare, Toxicology Scientific Evidence and Causation of Toxicity TASA ID: 1111 Establishing causation is a critical - if not the most important - task when allegations of harm are made. This is particularly true for adverse consequence arising from illicit drugs, pharmaceuticals, dietary supplements, and other chemicals. Causation of adverse health effects and even wrongful death requires more than demonstrating an association or connection. Knowing whether or not there is a causal link between a toxicant and a claimed adverse health effect is important for both plaintiffs and defendants. Read more
Category: Articles, Insurance, Medical & Healthcare How to Get Evidence Admitted or Re-admitted by Use of Rule 703: The Advantages of a Life Expectancy Using Life Insurance Underwriting and Life Settlement Methods in the Legal Setting Whitepaper TASA ID: 2409 The investigation and use of personal attributes and personal history in assessing mortality risk is standard practice in the life insurance and life settlement industries. Life insurers want to ensure that the premiums charged for a life insurance policy accurately reflect the mortality risk of an applicant. Life settlement providers similarly want to ensure that the calculated life expectancy accurately reflects the mortality risk of the insured seeking to settle (sell) his/her life insurance policy. Read more
