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Orthopedic Associates v HIG
Congratulations to our Hawaii doctors and medical providers for their recent court victory against the billion-dollar insurance industry! Insurers in Hawaii routinely refuse to pay medical bills, by making excuses such as unilaterally down-coding doctors' bills. Such insurance company profit-fattening practices are driving good doctors out of our state and even out of the practice of medicine. In Orthopedic Associates v. HIG (Haw. Sup. Ct. 12-7-05), the Hawaii Supreme Court ruled that auto insurers failed to comply with statutory denial and notice requirements when they "down-coded" tens of thousands of medical bills owed to doctors for treatment arising out of motor vehicle accidents. "Up-coding" tens of thousands of these claims will get our Hawaii providers paid hundreds of thousands of dollars wrongfully withheld. Such payments may also allow the person injured in the related auto accident - whom the auto insurers had wrongfully prevented from making Hawaii's $5,000.00 medical expense tort threshold - to bring claims for their accident-related injuries.
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Accident Lawyer Hawaii
William Lawson, Esq.
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1188 Bishop St. Suite 2902
Honolulu, HI 96813
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So-called "medical records reviews" by defense medical experts who review medical records but never examine the plaintiff have been found to NOT meet the admissibility requirements of Daubert. A Federal court in Virginia has ruled that a doctor's comments on a patient whom the doctor has never seen (1) evades meaningful testing, (2) eludes peer review, (3) has error rates which are incalculable and (4) fails the test of general acceptability. Diagnoses made simply by reviewing the notes of other doctors and considering tests and procedures which have been performed without the benefit of the patient's own words and a direct physical examination of the patient are simply too unreliable to allow such testimony in court. Hartwell v. Danek Medical, Inc., 47 F. Supp. 2d 703 (W.D. Va. 1999)
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