Doctors Accused of Malpractice Hired To Work For Insurers

Doctors With History Of Big Malpractice Settlements Getting Hired By Insurance Providers To Rule On Thousands of Care Requests

NEW YORK, NEW YORK (December 19, 2023) – A new report from Propublica has revealed that doctors with histories of big malpractice settlements have gone to work for insurers.

In one case, a doctor was sued for malpractice by five different patients or their families. The doctor denied he was negligent in all five cases.

One patient claimed that the doctor negligently stapled her rectum to her vagina. In all, the five malpractice claims against him settled for a combined $3 million.

Despite the medical malpractice cases, he still managed to get a job in the health insurance industry as a medical director. In that position, he wields broad authority to impact the lives of patients he would otherwise be unqualified to see as a medical doctor.

These medical directors have the authority to overrule the judgement of doctors who make requests for their patients. The stakes can be incredibly high for families.

When a health insurance provider refuses to pay for treatment, this can drive a family into bankruptcy. In fact, medical directors can rule on as many as 10,000 claims per year.

Liability For New York Malpractice Claims

Medical errors remain one of the leading causes of injury and death in the United States. According to the National Institutes of Health, “Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States (U.S)., making medical errors the third leading cause of death.” There are a number of different medical errors that a doctor or hospital might make.

• A doctor or nurse may administer the wrong medication.
• A doctor or nurse may administer the incorrect dose of a medication.
• A doctor may fail to diagnose a serious medical condition.
• A doctor may have failed to follow infection prevention protocols.

Medical malpractice occurs when a patient is injured or killed by a doctor or hospital’s deviation from the applicable standard of care. There is no single standard of care for any health-care field. However, a doctor’s or hospital’s standard of care is met when a doctor or hospital with an equivalent skill set would have followed the same procedures and guidelines under identical circumstances. There are four elements that must be shown in order to demonstrate liability for a medical malpractice claim.

• A Duty of Care Was Owed: The doctor-patient relationship typically means that a duty of care is owed. In most situations, it is not that difficult to establish that a doctor or hospital owed a patient a duty of care.
• A Duty of Care Was Breached: A doctor isn’t necessarily negligent if their efforts are not successful. Rather, for a breach to be established, the plaintiff must demonstrate that the standard of care they were given differed substantially from what prudent medical peers would do in the same situation.
• Proximate Cause: The breach of care must have been the proximate cause of the patient’s injuries.
• Damages: The injury sustained by the patient must have caused actual damages.

It is important that victims of medical malpractice understand that they do have rights. Any person that is injured due to a medical error may have legal recourse through a civil claim. Sadly, though, hospitals will often do everything in their power to deny responsibility if a patient is injured or killed. This is why it is so important that all evidence is properly preserved. A medical malpractice attorney can examine the unique facts of your case and let you know what your legal options are.

Investigating New York Medical Errors

We at Gersowitz Libo & Korek, P.C. extend our best wishes to all of the people who have been injured by medical malpractice. Far too many people die every year due to medical errors. It is our sincere hope that steps are taken to prevent as many deaths and serious injuries as possible. 

Have you or someone that you care about been injured due to medical errors? There are a number of laws designed to help you. Our team of medical malpractice attorneys are here to assist you in any way that we can. We care deeply that accident victims are aware of their rights and that those rights are being protected. Whether you just have legal questions or need any type of support we are here for you. You can reach out to us anytime at (516) 908-9792.