One insurance defense lawyer has sparked a new trend that gives new meaning to “kick ‘em when they’re down.”
George Rawlings has been called the “father” of a burgeoning industry that helps health insurance companies recover money from policyholders that are hurt by someone else’s negligence. This schemey practice was borne after a 2013 U.S. Supreme Court decision that gives health insurers power to recoup expenses for medical treatment.
Critics are saying that people who are hurt end up being victimized twice. Even though they’ve paid their premiums, they end up having to reimburse the insurance company for whatever compensation they initially received.
Rawlings argues that accident victims are the ones taking advantage of the system after they are hurt; “if an insurer didn’t meet its financial responsibilities,” Rawlings told Bloomberg Business, “people would be screaming bloody murder. The insured has obligations in that contract. Are you going to honor the contract or not?”
An Insurance Subrogation Example
Some concepts in this insurance defense strategy can be pretty tough. The insurance companies want them to be, because then you won’t know when you’re about to be taken advantage of. We talk about the intricacies of the legal perspective on our blog “Insurance Subrogation Reimbursement,” but this is an example from the victim’s side that might make a little more sense:
Let’s say that your 5-year-old daughter is playing and running around at her grandma’s house when she trips and falls down the stairs. In the emergency room, the doctor takes an x-ray, and puts her fractured forearm in a cast. In a few weeks, you get the cast removed, and your daughter will be good as new.
Of course, your health insurance company paid for most of the ER trip, and the follow up appointment. However, you did have small co-pays for both. That’s to be expected.
Months later, you get a letter from The Rawlings Company, or a similar law firm. It explains you’re your health insurance needs more information about your daughter’s incident. Enclosed is a questionnaire that you must fill out, sign, and return. “Was the injury accident-related? Did it happen at school or work? Did it happen on someone else’s property? Will you file a lawsuit against that person?”
Some warning bells go off in your head; is your health insurance company about to sue your mom?
“Fairness & Decency”
Rawlings’ company alone generates eight million of these letters every year. Back in the office, over one thousand employees scour through court filings, newspaper articles, and even social media for clues about how people were injured. Any emergency room visit is almost immediately flagged; those could mean big money for an insurance company to regain.
So, is the insurance company about to file suit against your mother? Well, a lot depends on the wording of your insurance plan. That’s why it’s so important to read those things before you sign. In Steve’s video, he explains a similar situation involving a car accident:
“When I started out, companies didn’t come after this money or they at least would consider the human element,” says attorney John Adams. Now, “it is just all about the money.” At Schultz & Myers Personal Injury Lawyers, we don’t think this is fair.
Calling A Personal Injury Lawyer
If you or a loved one is injured, whether it be in a car accident, work-related injury, or just a nasty fall at a friend’s house, you can’t always expect your own insurance company to take care of you.
We certainly don’t want you to be so afraid of spending money that you have to call an attorney before dialing 911 – Hey, ambulance fees are expensive! – But most personal injury lawyers offer free consultations. That’s where you can arm yourself against attorneys like George Rawlings.
If you’ve been injured, you’re always more than welcome to call Schultz & Myers Personal Injury Lawyers at 314.444.4444. We recommend that you do so as soon as possible. This way, you’ll know what to expect from the insurance company, and determine whether or not you need an attorney to go to bat for you.