It is common to think of personal injury law as straightforward:
– Step 1 – Bob gets hurt;
– Step 2 – Doctors help Bob recover;
– Step 3 – Bob hires an attorney to help him go after the bad guy; and
– Step 4 – The bad guy compensates Bob for his injuries.
Simple enough, right?
Unfortunately, it’s rarely that clean. To put it simply, the worst kind of personal injury lawyers, commonly given the affectionate name “ambulance chasers,” have been playing a game with the insurance companies for decades, which has resulted in a very common loop. The process is much closer to this:
The Game
– Step 1 – Personal injury lawyers relentlessly advertise that they can get you money for even the smallest accident;
– Step 2 – Bob gets hurt;
– Step 3 – Bob contacts his or the bad guy’s insurance company for compensation;
– Step 4 – Because insurance companies are constantly bombarded with bogus claims, the insurance companies automatically deny or significantly undervalue Bob’s claim for damages;
– Step 5 – Bob has no choice but to hire an attorney;
– Step 6 – The attorney and the insurance company engage in a strategic tug-of-war, often feeling more like a game than a search for truth. The game is that some personal injury lawyers try to maximize their recovery to get paid more and insurance companies, which are for-profit entities, try to minimize the amount of money they have to pay to better their bottom line;
– Step 7 – Bob, who just wants to be made whole, has to sit there and wait;
– Step 8 – Eventually, the bad guy pays money, but the attorneys, doctors, and seemingly everyone else gets paid before Bob, and Bob may remain “not-whole” in the end.
This is because beneath the surface of nearly all personal injury cases lies a quiet but troubling problem: the pressure personal injury attorneys feel to make the most money they can with each case by inflating medical costs.
Let’s unpack what that means and why it can matter a lot more than people realize.
The Bigger the Bills, the Bigger the Settlement… Right?
In theory, the ambulance chasers are absolutely correct. Most personal injury attorneys work on a contingency fee, meaning they only get paid if you win and their fee is usually a percentage of your total settlement. This creates a built-in, powerful incentive to make the case look as valuable as possible, even though a personal injury settlement is supposed to just compensate you for your actual injuries and losses, and nothing more.
How? One of the most common ways is by maximizing the medical bills, current and future.
When Attorneys and Doctors Work Too Well Together
Most injury attorneys have a list of doctors they regularly refer clients to. This is not inherently a bad thing because it can help injured people get taken care of by qualified doctors quickly. In fact, many personal injury attorneys I know have the doctors they’ve been working with for decades on speed dial, and they can have their clients seen within a day or two. This relationship can lead to a better overall outcome. However, in some circles these relationships go far beyond convenience and start to resemble something closer to a business partnership where the doctor and attorney are prioritizing their own wealth over the health of the client.
Some doctors may feel pressure (spoken or unspoken) to recommend aggressive, expensive, and sometimes completely unnecessary treatment plans. Not because the patient truly needs it, but because it makes the case more “valuable.” I’ve personally seen cases where patients were referred for high-dollar procedures like:
- Multiple rounds of epidural steroid injections;
- Pain management programs that stretch for months; and
- Invasive surgeries with questionable necessity.
Meanwhile, the client may not understand that this treatment path could negatively affect their recovery, their settlement, their health and their personal financial responsibility down the road, especially if the case doesn’t settle as expected.
The Policy Limit Problem: A Case Study in Gamesmanship
Years ago, I encountered an article that uncovered a troubling pattern in certain personal injury practices. (For the life of me, I can’t remember where I read it and I can’t find it published now.) Here’s what it said:
- A client begins treatment after an accident, which included just basic stuff like chiropractic care or physical therapy;
- The insurance company discloses the at-fault driver’s policy limits;
- Suddenly, the client’s treatment intensifies and includes more procedures, more visits, and more billing; and
- Once the total medical bills approach the policy limit, treatment levels off again and go back to the basics.
In other words, the medical care wasn’t driven by the client’s condition or health, rather, it was driven by the dollar amount available for settlement. While this helps a lawyer negotiate a settlement close to the policy limit, maximizing their client’s (and their) possible recovery, it raises serious ethical concerns. Are patients getting the care they actually need or the care that fits the dollar maximizing strategy?
Why This Matters to You
If you’re the one who’s been injured, all of this behind-the-scenes maneuvering can come at a cost:
- You could be steered toward unnecessary procedures. Never mind the additional potential medical expenses, this can be incredibly dangerous, especially when the unnecessary procedures are invasive.
- Your final settlement could be eaten up by inflated medical bills, leaving you with little to show for it.
- You might get stuck owing money if your case doesn’t resolve as expected or if some medical providers refuse to reduce their bills later.
In other words, you could walk away from a settlement technically ‘winning’, but feel worse off in the end. This isn’t just a theoretical risk. It happens a lot, and I’ve seen it.
What You Can Do
Here’s how to protect yourself:
- Choose an attorney who puts your health first, not just your case value. Ask them to explain their relationships with the doctors they refer clients to. Don’t let them give you an easy, evasive answer. Dig.
- Stay involved in your own medical decisions. Don’t just go along with procedures you don’t understand or feel unsure about. Please, please, please if you aren’t sure, get a second opinion.
- Ask how your medical bills will be paid. Make sure you understand whether your doctors are working on a medical lien, using your health insurance, or billing in some other way.
Final Thoughts
The truth is, this legal system we have is far from perfect and the problems outlined above are nearly impossible to avoid entirely. This game is intrinsically coded into our legal and medical systems. However, not every attorney or doctor falls into these traps. Some actively avoid them, while others dive in headfirst. There are attorneys and doctors who truly have their clients’ best interests at heart. In a system where money and medicine mix, it’s easy for priorities to get blurred.
While I can’t guarantee that any attorney I refer you to will avoid the practices I’ve described here, I want you to know that I take these concerns seriously. I do my best to vet the attorneys I recommend and prioritize those who show a strong track record of putting clients first ethically, medically, and financially. My goal is to connect you with someone who values your well-being as much as your case outcome.
