Accident Angels: Injury Consultants

Written by on August 3, 2017

Accident Angels: Injury Consultants.

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Please see the attached document.  Things to note:
a.  Mrs. Bahri filed attendant care forms for care she said was related to the accident.  2 things significant: (1) she included two weeks of care BEFORE THE DATE OF HER ACCIDENT and said on those days she received care because of her accident — obviously impossible and she should have known that before sending those forms.  (2) Defense did surveillance and reported, backed by videotape, that NO ONE came or went from the Bahri house during the entire day, but Mrs. Bahri submitted forms claiming that caregivers came to her house and cared for her on those days — clearly fraudulent.
b.  Mrs. Bahri only committed fraud as to her attendant care claim, but the insurer was allowed to NOT PAY ALL CLAIMS including medical expenses, medical mileage, household services, and wage loss claims — the fraud in one small part of one type of claim caused her to lose EVERY no-fault benefit she was otherwise entitled to.
c.  Only the doctors appealed the trial court’s decision, not Mrs. Bahri herself.  The Court of Appeals explicitly held that when Mrs. Bahri’s claim was barred, any claim by any care provider was also barred, even if the care provider had nothing to do with the fraudulent submissions to the insurance company!  This would be even stronger after the Covenant case, presumably, since that decision said that the provider has no claim except a claim assigned by the patient, and the patient cannot assign what the patient is barred from bringing himself.  [There is a counter-argument against that, but I think it probably would not succeed.]
d.  Bottom line of Bahri case is that a patient that commits any fraud, no matter how small, loses every type and kind of claim for medical, replacement services and wage losses, in their entirety, and when the patient loses the claim, all providers lose any rights they might have also.

Bahri Opinion (1)

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