One of the worst things to happen to injury law is the ability of the defense attorney to create a conspiracy between the doctor, lawyer and injured victim. There is no doubt that America now literally hates the injured victim. If you are in a car accident, literally sitting still, and you are hit from behind, you better be lily white and pure if you expect to collect reasonable money from a jury. If you have prior accidents, if you are partially at fault, or if your injuries are not observable on an X-ray or MRI you have almost no shot at getting a fair settlement on your case. This is because the general belief in our country is that most accident victims are frauds and that small injuries are not worthy of a jury’s time and attention.
How is that relevant to the use of a Letter of Protection (LOP)? (An LOP is the contract between the victim and the doctor to pay the doctor’s bill out of the settlement or verdict funds.) It is relevant because when there is a financial incentive for the doctor to trump up the medical diagnosis to make the victim “more hurt” in the diagnosis and then charge “more for medical services than is reasonable or typical” it becomes very easy for the defense attorney to hold that contract in front of a jury and shout conspiracy!
Doesn’t it make sense? There is a conspiracy when there is an agreement between all three parties (doctor/patient/lawyer) in that all three share in the money the case generates! You know why that works for the defense attorney? Because there is a small element of truth to the statement. The doctor, by necessity, can’t get paid unless the jury believes the victim and the victim’s lawyer, and gives them a decent verdict. So the doctor, who is typically seen as the most credible source of information in an injury case, becomes no better than the victim or worse, his lawyer. He is biased by his need for payment from the injury case! That is a loss of credibility the victim’s case many times cannot overcome. The truth is not as simple as a conspiracy. The victim many times has no other choice but to beg the doctor to wait for payment. Further, the victim can’t tell a jury the reason he did not get medical care was financial because he doesn’t have health insurance. That is against the rules. So, while it hurts the case, it may not have much real truth weight. Nonetheless, the element of truth is all the defense attorney needs to discredit the doctor and the case!
The real truth is that the LOP does more harm than just hurting the case. It actually often creates a bad relationship between the doctor and the lawyer. Assuming there is a settlement or a verdict, then at the end of the case the lawyer will want to negotiate to lower the doctor’s bill. The doctor, who did bear risk by waiting to get paid, deserves some reward. The reward he wants is to be fully paid. That negotiation is always a tough one for the doctors. During the process, bad blood develops between the doctor and his/her patients who are told that the doctor is being greedy and wants the patient’s rightful money. The doctor’s services are now not as needed, so they are emotionally devalued. Even though the doctor treated the patient for months, in the end, the patient will want to pay the doctor the lowest rates. In order to do a good job, the lawyer must, by definition, represent his client’s best interests against a doctor.
As you can see, the entire BI Lien /LOP system is messed up.
Our office represents victims in accident cases. We also represent doctors and medical providers in their collection of medical bills. We have seen both sides of this coin. We have determined the LOP must go.
Doctors should use all available insurance sources and then deal with a payment plan directly with their patients. The patient’s injury lawyer should never sign the LOP or BI Lien, assuming there is such a document. The patient must understand medical services are not volunteer activities. Doctors must get paid. They must also understand that the doctors must be treated fairly if they want the doctors to support and deal with the aggravation of the injury case.
At LaBovick Law Group, we concentrate on getting the available insurance money to fully pay the medical bills. We do not allow our doctor/clients to lose a dollar to the insurance company’s medical payment responsibility. We try to avoid becoming the middle man between the doctor and the patient but make it clear to our client’s doctors that we represent the client when we do. We believe having clear roles at the beginning of the case will be better for everyone. It allows the medical providers to maximize the value of their services within the market, and it is much better for our victim’s accident case. Now that is a win/win/win!
See my previous blog on LOPs: Letters of Protection: the Good, the Bad and the Ugly... Everything Consumers and Doctors Need to Know About LOPs.