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November 2010 Archives

McArdle to Serve on Ability Center Board

The Ability Center is a Center for Independent Living (CIL) serving Lucas and seven surrounding counties. The Ability Center is run by and for people with disabilities and provides services including information and referral, advocacy, independent living skills, training, peer support and community living. www.abilitycenter.org.Tom has also long served on the on the Board of The Toledo Bar Association Pro Bono Program and is on the Advisory Board of Toledo Grows. www.toledogarden.org/content/toledogrows

Tax Payers Benefit from the Efforts of Injury Attorneys

Many accident victims have health insurance coverage through Medicare, Medicaid, the Veterans Administration and the health programs available to active duty military personnel and their families. Injury related medical bills are often paid under these programs but with the condition that the government is reimbursed out of any eventual settlement.Auto accident injuries sometimes occur while employees are working. In this case bills may be paid under the Ohio workers compensation program. Again, any medical bills paid by the state are subject to reimbursement in the event that the accident victim receives a settlement.Government health care programs often also pay medical bills for victims injured by other types of negligent conduct, including but not limited to defective products, medical negligence, and substandard nursing home care. Reimbursement is similarly required in these instances.The amounts returned to the public coffers can be quite significant. As an example of our efforts, the Ohio Bureau of Workers Compensation was reimbursed $197,087 in a single case in 2009. In that year Cubbon and Associates was responsible for returning a total $272,275.02 to the Bureau and the tax payers of the State of Ohio.

Disputing insurance denials under health reform law

A community VOICE for Sylvania,about SylvaniaFirst NovemberReprinted from the First November 2010 Issue of Sylvania AdVantageDisputing insurance denials under health reform law Even though the enactment of the health care reform continues to be the source of considerabledebate and controversy, some of its provisions are being implemented this fall.The legislation includes some significant consumer protections that all health care consumers should understand. In the past, patients and their doctors haveoften been frustrated when health insurance companies refused to authorize services or procedures or denied payment after medical services were provided and medical bills incurred. One of the first provisions to go into effect changes the rules for denials of health services and payments by health insurance companies. The provision will make it easier for patients and their medicalproviders to challenge managed care decisions.Under the Affordable Health Care Act, often referred to as Obama Care, all health care plans must:
  • Provide consumers the right to internally appeal denials of payments or services.
  • Provide consumers an explanation of the internal appeals process when denying a payment or service.
  • Decide appeals promptly, 72 hours to sixty days depending on the urgency of care.
  • Provide an opportunity to appeal to an independent reviewer not employed by the health plan.
  • The plan must explain this process to the consumer.
The new requirements apply to new health insurance plans created after March 23, 2010 and all annual renewals occurring after September 23, 2010.For more detailed information, go to www.healthcare.gov or the Ohio Department of Insurance www.insurance.ohio.gov.Thomas McArdle is a Sylvania resident, personal injury attorney and partner atCubbon and Associates a Toledo Law Firm providing legal services to injured persons.419-243-7243.www.cubbon.com.Thomas McArdle

ACCIDENT VICTIMS BENEFIT FROM LEGAL REPRESENTATION BEFORE THEY SPEAK TO INSURANCE REPRESENTATIVES

Over the years, many individuals who were injured in a car accident have told us that they didnt want to contact us until after they had spoken to the insurance companies involved, preferring to wait to see if they needed an attorney.Our experience tells us that we can always be of more help to a client if we speak to them before they speak to the insurance carrier. Why? Because we can prevent missteps that will prevent, delay or reduce recoveries. While most of us have a fine relationship with our own insurance agent (the person that sells us insurance) once an accident has occurred you deal with an adjuster (a person whose job is to pay the least amount possible on behalf of the insurance company.)The adjusters first job is to take a statement (often recorded) of the injured parties. This statement is not required, will never help and often hurts. People are injured, taking medications, frustrated, and unsure of the nature and extent of their injuries are not in the best position to give a statement that may later be used against them!Some insurance adjusters attempt to persuade accident victims not to seek legal representation, saying lawyers will only take a portion of your recoveryyoull end up with less money. Nothing could be further from the truth! After a free consultation, if we determine that you do not need an attorney, well tell you. But if your case is one in which you will benefit, well tell you that as well. Were onr case is one in which you will benefit, well tell you that as well. Were on your side! The insurance adjuster has no reason to help you and every reason to prevent you from making a full recovery.At Cubbon and Associates, all cases are screened by attorneys. All initial consultations are free and without any obligation. Before you speak to an insurance representative, please take a moment to call us. We can help you protect your rights!

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