IME Insurance Malpractice Suit-Adams vs. Gelman

Adams v. Gelman, concerning IME Insurance, was decided on November 10, 2016. The case involved three insurance claimants who jointly filed a lawsuit against a Delaware physician claiming that his work for insurance companies over decades, and perceived bias in favor of those companies, amounted to fraud, breach of fiduciary duty, battery, racketeering, and conspiracy. The trial court dismissed the case, determining not only that the physician’s actions were protected by the legal principle of witness immunity but also that none of these claims were legally valid. Plaintiffs appealed on the issue of fraud only and the Delaware Supreme Court affirmed, agreeing with the lower court that the physician’s actions did not amount to fraud.

Historically, witness immunity has been limited to suits for defamation or related torts but the lower court in Adams held, without explanation, that immunity protected the IME physician from the claims which were before the court – fraud, battery, breach of fiduciary duty, etc. The lower court decided that as long as the examinations and reports were reasonably germane to the litigation, the IME physician was immune from suit. The Delaware Supreme Court did not address immunity and so this ruling remains good law in Delaware. 

  • Though the case was dismissed the doctor had to provide his own defense and pay all expenses inherent in protecting himself.
  • Don’t be a bare IME physician!
  • IMEs are a great way to make supplemental income but make sure you are protected before you do another one!
  • Does your practice properly protect itself in this situation?
  • Your regular medical malpractice coverage covers bodily harm but not the above allegations.
  • In order to protect our insureds, PPIX has created a LOW-COST proprietary IME insurance product. Please contact us so we can tell you about our IME Insurance Product.

FAQ: Medical Malpractice Concerning Narcotic Pain Medication Addiction

FAQ: If a patient gets addicted to a narcotic pain medication, who’s fault is it and could it be considered medical malpractice?

To figure out if a patient’s addiction to pain medications constitutes medical malpractice, you have to prove that the patient’s doctor was negligent. This means that the doctor did not act reasonably in treating the patient.

Opiate overdosing is a growing problem in the United States. As a result, the number of addicted people continues to increase throughout the country as do opiate-related suicides and deaths.  In Montgomery County, PA, where Positive Physicians Insurance Company is based, the death toll by opiate overdosing increased by 123% this year.  

Many times the doctor gets the blame for having set patients on that course. When a patient suffers an injury as a result of a prescribed medication questions will always arise as to whether the medication was needed, whether a proper history and physical exam were conducted or whether the physician properly documented the encounter. Any failure on the part of the physician can create the opportunity for liability.

Plaintiffs who overdosed have sued doctors successfully. In April 2012, a woman was awarded $1.9 million after she sued her family doctor. She claimed he overprescribed her methadone, leading to brain damage after she stopped breathing.

Pain specialists are often in short supply so all practitioners need to be very well-versed in the guidelines of how to treat pain. The following are some Best Practice guidelines if you have to prescribe opiates:

  • Register and participate in your state’s Prescription Drug Monitoring Program (PDMP)
  • Have patient’s sign a contract agreeing not to abuse his prescriptions (Such contracts reinforce a doctor’s right to terminate care if patients break promises they have made or use the drugs inappropriately.)
  • Conduct regular monitoring of patients on prescription medication
  • Physicians should share addiction risks of drugs with patients
  • Make sure to thoroughly document each patient encounter

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