Recclaim Payment Solutions Blog - Comments

Anonymous: Wal-Mart or bust

nospam@example.com () — Thu, 06 Dec 2007 10:23:35 -0600

Jay:

Most ethical canons require attorneys to charge reasonable fees. On a case of this magnitude with these types of injuries and assuming clear liability, where is the risk in handling this claim? I bet the total specials were at least double what WalMart recouped. The mystery is what did plaintiff's counsel collect for fee and how much time and effort was spent in doing so?

Jay: Wal-Mart or bust

nospam@example.com (Jay) — Wed, 05 Dec 2007 15:56:17 -0600

My 2 or more cents.

1. The injured Plaintiffs atty in this case should be hung out to dry for a 40% contingency fee, and very likely should be getting hit with Bar complaints E&O claims etc.
2. Wal-Mart being Wal-Mart did their typical don't care about any one else approach to handling these.
3. Rulling like this hurt everyone in the long run.

I know a few folks that started out with wal-mart in the begining. some are long time stock holders. This did not sit well with them even in the profit and loss word we live in. As they put it, "Sam measures how many time he roles over in the grave in rpms these days."

Sheila Olson: Health Care Blog Part II

nospam@example.com (Sheila Olson) — Sat, 13 Oct 2007 21:55:41 -0500

I've been involved in healthcare subrogation for the last 11 years. I work for a major medical provider who also owns a TPA. This has given me experience with subrogation for self-insureds through TPAs, as well as subrogation on behalf of the provider.

For the TPA, our claims system flags based on ICD-9 codes and automatically sends the insured a questionnaire. Claims are pended until the questionnaire is returned and then we practice "pay and chase" for nearly all claims, except no-fault MVA claims and workers' compensation claims (unless a denial from the WC carrier was received).

For the provider, we often pursue subrogation or intervention on workers' compensation claims and even on MVA or other liability cases. This process is manual and begins when our patients alert us of their inability to pay due to an event that is pending or undergoing litigation.

We do not outsource our subrogation. We have quite an extensive department that includes attorneys, paralegals, and subrogation specialists. These professionals are able to handle all aspects of about 95% of our cases. We do hire outside counsel in the remaining small percentage of cases.

We have had great success in our efforts, both for the provider and for the TPA.

Sheila