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....