A major insurer is introducing a new policy on MIST cases. Apparently, this insurer has decided to make our lives more difficult and more work. How, this time, you ask?
This insurer refuses to settle any MIST case without getting the bills directly from the health insurer. Why? Because then they are placing the name of the health insurer on the check. In California, at least, the health insurer does not have a lien, but only a right of reimbursement. So, why do they do this?
It creates one more issue for the attorney to deal with. By creating new issues, they are causing the attorney to work more. More work for the same amount of money makes a case less attractive. And that, my friends, is why they are doing it. They want to force these cases away from us.
Remember, they do not need the bills from the health insurer. You just need to provide something showing the reasonable charges. There are outside vendors who will do this for under $100. There is no need to wait and create more work, especially since some health care providers are taking six months to provide the bills (another reason for the insurance company to insist on those bills - it makes our cases take longer).
Don't be fooled by this. If they refuse to settle, take an aggressive approach with the insurer and their insured.
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MIST cases need to be reviewed for reimbursement benefits.
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