Many people who require medical tests or procedures use insurance to pay for the services they receive. While insurance companies often conduct reviews to determine if care is necessary, they do not provide medical care. Thus, as discussed in a recent opinion issued in a New York case, they generally cannot be held liable for medical malpractice. If you suffered harm due to negligently rendered medical care, it is in your best interest to consult a Syracuse medical malpractice lawyer about your potential claims.
The Plaintiff’s Harm
Allegedly, the plaintiff visited her doctor in November 2018 with complaints of pain in her right hip. She underwent physical therapy for several weeks, but her symptoms did not improve. Her doctor then referred her to an orthopedic surgeon, who ordered an MRI. The surgeon sought pre-authorization for the MRI from the defendant, the plaintiff’s insurance provider. The defendant denied the request for pre-authorization after a doctor reviewing the plaintiff’s request, and health history determined that she failed to show that the MRI was medically necessary.
Reportedly, the defendant elaborated that the plaintiff had not demonstrated that she failed to improve following a six-week regimen of rest, physical therapy, and medication, despite that she had completed the course of physical therapy and pain medication recommended by her doctor. The doctor appealed, and after several weeks the MRI was approved. The plaintiff underwent an MRI, which revealed cancer in her right hip. Her leg was amputated, and her treating doctor advised if she presented a month earlier, her leg could have been saved. She then filed a lawsuit against the defendant asserting numerous claims, including medical malpractice. The defendant moved for dismissal. Continue Reading ›