|
|
Monday, March 19, 2012
By Michael Nichols
Categories: Personal Injury
Damage done to surgical implants, or the requirement of new implants in event of personal injury is a cost the Court of Appeals thinks should be billed wholesale to insurance companies.
In Bronson Methodist Hospital v. Home-Owners Ins. Co, the person injured in an automobile accident required surgical implant products to repair broken bones. The plaintiff was the medical care provider or doctor. The question was whether the injured person’s auto insurance company or the no-fault carrier had the right to request the doctor to provide the actual/wholesale cost of the implant or metal used to repair the broken bones. The Court of Appeals said yes. Since the surgical implants are stand-alone items that can be easily quantified, the doctor had to disclose what it cost the doctor to purchase surgical implants.
This case involved surgical implant products being used by a medical provider to treat an auto-accident victim. The no-fault insurer paid the bulk of the charges billed by the doctor but questioned the charges for the implant products. The auto insurance company disputed the product charges as reasonable under the no-fault act and requested the wholesale cost of these products. Apparently, the insurance company alleged the doctor charged the insurance company more than what the actual cost was for the product. The doctor refused to disclose the information.
The Court of Appeals found that the no-fault act permits the automobile insurance company to discover the doctor’s wholesale cost of surgical implant products for which the injured person was charged in order to question the reasonableness of the fees being charged by the doctor.
If you, or someone you know has been injured and needs an attorney, call Wendy Schiller-Nichols at 517-432-9000.