Welcome to Weasel-Dom

Dear faithful blog readers - Entering Weasel-Dom has caused the longest hiatus of my blogging career. Sorry for the delay...... here is what happens in Weasel-dom.....

A few years ago, the lower courts were flooded with these cases. Many cases engender motion practice. In Queens, for example, the motion calendar has approximately 150 motions every day!! There are so many motions that a separate part was created just for the motions. This is the real weasel-dom habitat. These motions are usually about some technical detail.....for the claimants trying to win the case on a technicality (if they had to win on the merits they'd not start a lot of these cases). Defense motions are also trying to knock the plaintiff case out on some technical grounds, so they don't have to spend more money defending.

Wht kinds of technicalities? Here are a few.....

Was the denial notice timely served? How do you serve it? Who can you serve it on? What must it say? What can it not say?

What if the claimant is a medical corporation, but the doctor files the claim? What if the doctor is under indictment? What if the papers assigning the claim from the patient to the doctor were in the name of the medical corporation?

Does the doctor have to attend a deposition if the insurance company wants it? What if they want it on EVERY case, large and small? What if the doctor sends a billing clerk to the deposition? What if the plaintiff wants to depose the claims examiner?

Can a plaintiff combine all his claims with many patients arising out of the same accident, and make one larger case against the same insurance company?

For awhile, the courts were so inundated with motions that they were giving one year adjournment on any motion where one side requested time to respond. I observed that this did not slow the onslaught of motions at all.


The "trial" side of the calendar is also backing up the lower courts. In some ways, this part of the system works, as many of the cases do settle. Still the calendar is huge, and one sometimes wonders why they cannot be settled pre-court. Of course, it is possible that many cases ARE settled pre-court, and we are only seeing the leftovers in court.

The most interesting no-fault cases are the ones with a "fraud" defense. In these cases, the insurance company smells a rat (or a weasel) and investigates a group of claims. I am aware of a case where the "patient" had been in 8 accidents in a 6 month period, and was treated at several different facilities. Not only that, but when the insurance companies investigated further, they found ten other people in the same apartment building with a similar history. I guess they all had bad luck.

Anyway, if anyone would like to come on a tour of Weasel-dom, just e-mail me and I will arrange it.

Now.....I can blog about some other things.

New Weasel-dom

I know.....everyone has had their seatbelts fastened, waiting for the trip to New Weasel-dom. Sorry for the delay, but I actually spent a few mornings in New Weasel-dom this week, getting good and weaseled up. Unfortunately, it was not conducive to the writing process, so today I crawled out of the hole, and now.....it's off to New Weasel-dom



The New Weasel-dom is "no-fault" litigation. Let me start with a disclaimer and a WARNING: I am going to give the cynical (though all too real) version of what happens. I recognize that sometimes, people really ARE hurt, and are treated by REAL doctors, and represented by REAL lawyers, and those cases are really interesting. Most of the cases in the courthouse are related to accidents and injuries, and I would not call them Weasel-dom......a hyena and vulture convention maybe, but that's another blog entry. New Weasel-dom is that small section of the car accident cases, the "no-fault" medical bills aspect.



Let's look at the most common scenario, and talk about what happens, factually and legally:



1. There is a car accident.

2. It's POSSIBLE someone got hurt.

3. There are insurance companies for both cars.

4. There are "doctors", "lawyers", and accident participants who want to make money.

5. There are laws and rules regarding who is entitled to get paid, and how much, when there is a car accident.

6. If there are a lot of claims being made, at some point insurance companies start to try to draw the line and defend themselves.



OK, so there are laws covering this stuff, and they apply to the real cases too, but their application on the marginal cases creates no-fault Weasel-dom. There are thousands of these marginal weasel-y cases in the system. You may wonder, why are doctors and lawyers filing these thousands of marginal cases? For the same reason that dogs lick their balls.....



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..........BECAUSE THEY CAN!!!!!



I would try to spare you the legal technicalities, but bear with me, New Weasel-dom is more fun with a little legal knowlege.



I only know the basics anyway....if I claimed to be an expert, you'd have the right to call me a weasel. I only want to tell you about Weasel-dom, I don't want to actually join.



The law: when there is a car accident, there are certain things which are paid by the insurance for the vehicle the injured person is in. These things include reasonable medical expenses, medications, diagnostic tests, therapies, transportation to medical treatment, and the like. It includes chiropractic, accupuncture, and psychologists. It includes lots of tests (x-rays, MRI, CT scans, EMG). You don't have to wait for a case to be "decided" as far as who was at fault in the accident. These things are paid by the "host" vehicle, the car the injured person was in, regardless of whose fault the accident was. Hence the term "no-fault".

Like many things, there were good intentions behind the "no-fault" system. The idea was, people who are hurt should not have to hold off needed treatment, while a case is being decided. This apparently used to happen. Many states now have a no-fault system, and injured people can get treated quickly, and the insurance has to pay for it. At the same time no-fault systems came in, many States also adopted a serious injury "threshold", essentially limiting monetary recovery to the so-called serious cases. One paradox arising out of this, is that the way to establish a serious injury is with as many tests and as much treatment as you can get, and so to some extent, meeting the serious injury threshold is often driven by pounding on the no-fault system.



How much treatment can someone get? When can they get it? How long can it go on? The standard is "reasonably necessary". For many years the insurance companies could not even challenge the reasonable-ness for 90 days. If you were an unscrupulous canine testicle slurper, what would you do with a system like that? You'd open "medical centers" and take every minor fender bender you could bring in, and give each "patient" as much treatment as you could think of, over and over and over again. This would often include MRI's, physical therapy, exams with orthopaedists and neurologists, dentists (for "TMJ") and even psych evaluations. Ever wonder why your auto insurance costs so much? It was common practice for the medical providers to not even send in their bills until the 89th day. A few years ago, the 90 days was reduced by statute to 30 days, which helped a bit, but the beat still goes on. You can still treat after 30 days, but the insurance company can contest the reasonableness, and other aspects of the bills.



OK....we are not IN New Weasel-dom yet, but we are getting there. When the insurance companies start contesting, a whole bunch of laws and rules apply. A whole lot of money is at stake, not on each particular case, but collectively. The system of contesting this stuff, and the intricacies and nuances of the law, and the economics of it all, has spawned an entire industry. If you can bear it, in my next post I will tell all about it....

Weasel-dom

A few years ago, I was covering cases in the UM/SUM part. These were cases involving "uninsured and underinsured motorist" insurance. I won't bore you with the technicalities, except to say there were a lot of technicalities. They were always talking about the size of the type on the cancellation notices, and how you had to mail the various notices (do you count the day of mailing? what about holidays? what if the address was wrong? what if you mailed it to the attorney?). It was the Seinfeld of courtrooms, a show about "nothing". It was here I heard one of my favorite phrases, when Allstate attorney Frank Sena referred to the part as "Weasel-dom". After he said that, I noticed how all the attorneys were hunched over, how their noses wriggled, and how they avoided sunlight. Sometimes in the UM/SUM part, there were three parties to the dispute, two insurance companies (each trying to get out of paying, though one of them had to) and the plaintiff. The plaintiff's attorney didn't really have to do anything, and when I would get calls for the UM/SUM part, I would ask, "Do I have to do anything, or am I a spectator?" I even made that a box on my intake sheet. Circle one: primary carrier? Uninsurance carrier? Spectator?
I never wanted to learn about point sizes and cancellation notices, so after awhile, I only took spectator cases in the UM/SUM part.

Eventually, the UM/SUM laws evolved, and the part became less weasel-y (Is that a word?) However, there is a new front in Weasel-dom, the so called "No-fault" cases. Fasten your seatbelts.....tomorrow we are going to the new Weaseldom.....