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Injury Law Alert - Summer 2009 Issue • page 2

Hemmings & Stevens, PLLC Law Firm of Raleigh, NC

 

MEDICARE LIMITS PAYMENTS FOR TREATMENT OF INFECTIONS

In a potentially helpful development, the federal government has passed new rules that limit the payments Medicare will make to a hospital to pay bills incurred in treating preventable infections and medical errors the hospital should have avoided. These same regulations also specify that neither may the hospital bill the patient for this care.

Proponents of these regulations claim that making the hospitals pay for their own mistakes will give them a financial incentive to take steps to prevent infections and errors that can be avoided. However, some ask whether Medicare will be able to adequately monitor these rules, while others ask whether these rules might endanger patients because hospitals are unwilling to provide high-quality care if they know they will not be paid.

DEALING WITH AN INSURANCE COMPANY

Although no one enjoys it, from time to time it may be necessary to deal with an insurance company, usually to make a claim. Although the process may seem overwhelming, a few common-sense tips will help to prepare you.

First, read the policy. Although policy language is often hard to understand, some states require policies to be written in "plain language," and, in any case, the policy is what the insurer will look at to evaluate your claim. The policy's declarations page often contains a useful summary of the coverage provided and the dollar limits.

Next, start a file. Everything related to your claim should go into that file: the policy, letters sent and received, notes of calls made and conversations, information about the claim, evidence of damages, etc. Having a single file prevents things from getting lost, and is valuable to show what was and was not done.

When you contact the insurer, it is best to do so in writing. While people often disagree about what was said over the phone, the text of a letter or an e-mail should be clear. If you do speak with someone on the phone, it is a good idea to immediately follow up the call with an e-mail, confirming what was discussed or decided.

When dealing with the adjuster, be civil. The old saying that you catch more flies with honey than vinegar is still true. However, being polite does not mean giving up a valid claim. You can be firm while still being polite.

Finally, if you are unable to settle the matter yourself, consider contacting an attorney. Lawyers speak the same language as insurers, and hiring a lawyer shows that you are serious and are not to be ignored. If you have kept a good file of your communications and evidence, it will be easier for a lawyer to help you make your claim.

CARBON MONOXIDE POISONING

Carbon monoxide (CO) is a colorless, odorless gas given off by fuel-burning appliances such as gas heaters and gasoline-burning engines. CO can become deadly when these types of appliances are used indoors or without adequate ventilation. According to the CDC, about 500 Americans die every year from CO poisoning not related to a house fire, and more than 15,000 are injured.

Deaths and injuries peak in midwinter, when heater use is highest and when houses are tightly closed. Symptoms of CO poisoning include headache, dizziness, weakness, nausea, and confusion, and, because they resemble symptoms of other illnesses, people often do not realize they are being poisoned by carbon monoxide until it is too late.

In order to protect yourself against CO poisoning, you should have your gas heating system inspected every season. Don't use generators or gasoline-powered heaters or tools inside or in an enclosed space like a garage. Also, keep these CO-producers away from windows and intake vents, which can spread CO throughout the house.

Because CO is hard to detect, the best way to protect yourself from CO exposure is to buy a CO detector. They look like smoke detectors and will sound an alarm if CO levels get too high. Be sure to play it safe and protect yourself against this deadly gas.

COMMON TREATMENT TIED TO JAW PROBLEMS

According to a recent university medical study, a drug commonly prescribed to treat osteoporosis in women may have the unintended side effect of causing a serious jaw disease.

The drug, called Fosamax, is made by the pharmaceutical company Merck. It is the most common drug prescribed to treat osteoporosis (which affects about 10 million Americans) and is one of the 20 or so most common drugs prescribed in this country. Unfortunately, researchers at the University of Southern California have linked its use with a condition known as "jaw necrosis" (also known as "ONJ" or "Dead Jaw"), which causes the jaw bone to decay. Symptoms can include jaw pain, sores on the jaw, and loss of teeth. The condition can be disfiguring, and is often very difficult to treat.

CONCLUSION


 

Hemmings & Stevens PLLC
Attorneys At Law
(919) 277.0161
5613 Duraleigh Road Suite 151 • Raleigh, North Carolina 27612

Notice:

We help injured persons seeking compensation for their injuries. We represent individuals and small businesses with insurance claims that have been denied or other contract disputes.  We DO NOT represent insurance companies or big business.

 

   
Hemmings & Stevens PLLC Law Firm Hemmings & Stevens PLLC
5613 Duraleigh Road
Suite 111
Raleigh, NC 27612
(919) 277-0161