Over the past 15 years, Russell Law has represented and advised hundreds of chiropractors across the country in disputes with insurance companies. BRB has sued major insurers and defended doctors against them. Most notably, BRB has been at the forefront of exposing the industry-wide scheme, developed and perfected most ruthlessly over the past 20 years by the major auto insurance carriers, of attacking chiropractors with manufactured and knowingly false accusations of “fraud”.
In federal and state cases over the past decade BRB has exposed this scheme, which originated from recommendations made to the largest insurers in the country by the global corporate consulting giant McKinsey & Co. in the 1990’s. McKinsey is of course legendary for teaching corporations how to increase profits with a mercenary focus on the bottom line.
Before McKinsey, insurers understood generally the duty to adhere in their claims operations to the indemnity and fiduciary principles which underlie all bad faith laws and insurance regulations. But after McKinsey, insurers “redefined the game” and “radically altered” their “whole approach to the business of claims” in order to maximize profits.
McKinsey famously called this new way of thinking the “zero sum economic game” in which the insurer competed with its insured for claim dollars. While this zero sum game has many facets, one of its strategies recognized that the vast majority of bodily injury claims submitted across the country involve treatment with a chiropractor, often for entirely subjective complaints of pain. McKinsey pointed out that insurers could and should aggressively attack this universe of claims as exaggerated and fraudulent because, in the end, it is all a matter of credibility. If the patient and the doctor’s credibility can be undermined, then so is the value of the claim.
The major insurance carriers developed entire units of adjusters devoted to attacking the credibility of doctors, chiropractors in particular, and have reaped billions of dollars in avoided claim expenses doing so. The strategies utilized range from abusing the civil process in “fact” depositions of treating doctors to knowingly wrongful denials of payment for treatment rendered to trumped up lawsuits against doctors accusing them of fraud.
Unfortunately, the vast majority of chiropractors targeted by the zero sum game are unprepared and easily victimized. By the time they realize they are in an insurer’s crosshairs, it is too late. Once targeted, a doctor will be cut off from payments from the insurer while at the same time incurring crippling legal expenses, the combination of which is deadly to just about any chiropractic practice.
The key for chiropractors is to first understand how and why they are vulnerable to this scheme, and then take necessary but fairly simple steps to armor themselves against it. No one knows better how to help doctors do this than Russell Law.
