PI Marketing for Chiropractors: Three Tiers of PI Attorneys

Dr. Paul Hollern, Chiropractic Internet Marketing Expert

Three Tiers of PI Lawyers

Start your PI marketing for chiropractors with the right target marketing. The following is a short list of some of the characteristics for selecting your target PI lawyers.

1. Lower PI Lawyer Tier.

• Takes almost any case

• Represent people with dubious backgrounds

• Few lawyers and many paralegals have one page demand reports and include some of the records for settlement

• Case outcome average is less than $5,000

• Cases settled quickly

• Cases never taken to trial

• Clients don’t get phone calls returned

• Fair to poor “out of court” work product quality

• Poor to fair trial outcome record

• Lawyer has no clue whether he/she represents the client.

• The firm accepts more than 300 cases per year

• Have poor level of knowledge of conditions which affect their client base

• Exhibit little desire to increase their legal skills/medical knowledge. Don’t want to “rock the boat” to get a better settlement for their client.

• The firm has a poor reputation among the law and insurance industries

• Make the client believe that they are going to “win the lottery” with their case

• Have an overaggressive Rambo-like quality in front of the client, but process each case in the same manner.

• Clients never to rarely meet the attorney, only the assistants Not supportive to alternative health care providers. Often ask providers to “cut their bills” because the settlement was insufficient. Rarely participate in legal trade organizations.

• Do not get asked to speak at continuing ed. Seminars.

2. PI Lawyer marketing is reasonably selective (turns down 10-70% of cases)

• Variable firm size-fair to good work product

• Fair trial verdict outcome with some moderately high verdicts

• Dictated or typed communication of case by lawyer

• Case value between $5,000-$500,000

• Length of representation based on the reasonable offer made to a client, or if litigation is necessary

• Pre-litigation settlements are favored, but these lawyers will go to trial

• Firm accepts 50-300 clients per lawyer at a time

• Lawyer has a mild to advanced level of knowledge of medical conditions affecting their client data base

• Lawyer has mild to moderate desire to improve their legal skills

• Time or money constraints make these lawyers slow to change.

• Most likely to “rock the boat” for bad faith claims, IME results and patient advocacy issues.

• Often respected by their peers and the public, but are treated lukewarm by defense lawyers and the insurance industry

• Are very realistic with clients about the expectations for their case outcome

• Generally use a cooperative style more than an ultra-aggressive approach

• May or may not recommend alternative therapies for their clients

• May have ads up to Yi page

• More likely to have a web site for clients

• Often ask providers to reduce their bills

• Are familiar with Colossus and are interested in better serving their clients with this knowledge or in pursuing lawsuits against insurance carriers.

• Almost never personally take medical malpractice cases.

3. Top Tier PI Lawyers

• Very selective; turns down 70-99% of cases

• Often a small firm

• Moderate to excellent work product outside the court

• Exceptional in court work product

• Much of the communication either typed or dictated

• Rarely take cases under the $100,000 with many in the $250,000 to several million range

• Will litigate every case in which a good settlement is not offered

• Settlement only taken for policy limits

• Lawyer only accepts 1-50 clients at any one time

• Are very selective about the client’s personality knowing that 90% of the case is based upon the plaintiff himself

• Do not represent clients who view themselves as “victims” Do represent those who were hurt by someone else, have tried to return to normal, and are left with residual pain and impairment

• Have a moderate to advanced knowledge of medical conditions affecting their clients

• Are seen as leaders in their field by their peers and teach within the legal profession

• Practice with their own individual style

• Often do not “rock the boat” for bad faith or patient advocacy issues

• Will advise a patient not to attend an IME performed by a doctor who is known to be insurance company friendly

• They are revered by plaintiff attorneys, are feared by insurance companies, and are respected by defense attorneys.

• Are cooperative but can be very aggressive in the litigation process

• Are very good in maintaining contact with their clients

• Are intimately familiar with their cases

• Are often very courteous to jurors and the court while in trial

• Often don’t like alternative providers or specialists

• Almost never take low property damage costs

• Don’t advertise much, and get many cases from middle tier lawyers who want them to litigate their big cases

• Many don’t know about Colossus and don’t care because they want to litigate all cases, and Colossus doesn’t deal with cases that have gone to litigation

• Often have over 100 trials in their careers

• Will often invest: over $100,000 of their own money in a case

• May also be successful in medical malpractice cases

• Take a long time to resolve cases

• Are very honest

• With both doctors and attorneys being tracked, it is most important to work with attorney’s who are willing to go to litigation as well as not settling cases at the lowest level possible. Working with lower tier attorneys for every case lumps the doctor and the attorney together and will cause a decreased value to the individual case. It also flags the doctor and the attorney as a reason to lower the score on every case in which a low tier attorney involved as well as the doctor/s who work with them on a regular basis. Worst of all continually settling cases for less than they are worth causes the overall reimbursement for injury cases involving a particular type of treatment to be worth less across the country.

PI Lawyer Factors Possibly Considered:

• The lawyer’s type of office (franchised, “one main operation”, established, etc.)

• The firm’s employees, including paralegals, etc

• The lawyer’s negotiation style

• The lawyer’s settlement record

• The lawyer’s trial record

• The number of lawyers and staff of the firm

• The key argument of focus in negotiations

• The size of the firm’s legal library

• The firm’s income

• The individual lawyer’s net worth

• The providers on file who worked with this lawyer

• Days before the first demand

• Deposition type

Special Investigations Unit

An Allstate adjustor signed an affidavit that a system known as Casualty Hub is capable of and is in fact used for tracking the relationship between attorney and provider.

If either the doctor or the lawyer has a history of taking cases which for whatever reason were considered as possible fraudulent, both the doctor and the attorney could end up o the SIU (Special Investigations Unit) list.

Once on this list all future cases in which the doctor and/or the attorney will be involved will be considered suspect of fraud.

Providers may be placed on the SIU list if they provide treatment that does not match the diagnosis, as well as for not diagnosing injuries correctly. For example, continual treatment for a sprain/strain of greater than eight weeks creates a problem in that a sprain/strain should not take that long to treat.

If an insurance company asks to come to the provider’s facility to “review some files” that a provider can assume that they are on the SIU list.

If the clinic is multidisciplinary in nature and the question revolves around billing for services provided, it is recommended that you show the company representative that all billed modalities/procedures are present in your office.

Ways to be placed on the Special Investigations Unit

1. Billing or treatment practices of the provider are “contrary” to the insurance company’s definition of reasonable and necessary. This will result in continual denials or reductions of billings

2. Being a “patient advocate”, rather than an “objective clinician”

3. Clinics that are suspect due to ownership, race of patients treated, suspect practices of billing or treatment.

4. Multidisciplinary clinic

5. Treating providers who have provided false names or other information, or who were not involved in an accident or were involved in setting up accidents for fraudulent purposes.

6. Being involved in diagnostic testing in which the fees are split between the provider and the diagnostic company

7. Property damage of an accident less than $1,000

a. If there is a legitimate case of injuries, a lawyer who specializes in these cases must be selected because jurors don’t believe that people have real injuries WHEN property damage is low.

b. These cases do not go to Colossus at all, and are worth no more than $3,000 total settlement. In these cases, it may be better for the patient to not get an attorney.

How to Get a Case Out of Special Investigative Unit

• Notable damage on a depreciated vehicle

• Frame damage

• Seat damage

• The collision involving the patient was part of a multiple car accident

• Damage to the second car of more than $1,000

• Actual damage of the vehicle was more than $1,500

Many times the actual damage to the car is underestimated because the car was not put through a “tear down” where the bumper is removed and the frame and other components are completely inspected. To perform this, a specialty assessor should be hired if the body shop will not perform the procedure.

Insurance companies have contracts with body shops to cut their costs for referrals. They also arrange for the body shops to use used or aftermarket parts that are cheaper and therefore keep down the cost of the repair, thus making the case worth less money for the bodily injury.

Suggest that people with less than $1,000 damage get a second opinion from a reputable, independent body shop.

Once on SIU, the provider’s life is scrutinized, with investigation of all personal and business practices, relationships, and purchasing habits placed under a microscope. This includes business relationships and associations.

Other than the basic information concerning the patient (adjustor’s name, patient date of birth, etc) Economic region is the only other factor entered into Colossus that is not taken from the doctor’s notes. Economic Region will determine a relative case value. In other words, an accident in Beverly Hills will automatically be worth more than the same accident in Bozeman, Montana.

PI marketing for chiropractors is what we do best, give us a call!