Health Care Provider & Fraud Cases

Case Study Caption

About This Case

Our client was told by physicians at a hospital that she would deliver her third child vaginally and with the assistance of a nurse mid-wife rather than a doctor despite the fact that her second child was delivered by way of Cesarean section.
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Despite obvious signs of fetal distress on the fetal heart monitor, the nurse midwife negligently failed to recognize that our client’s uterus had ruptured and that placental abruption had occurred. The baby was delivered with catastrophic birth injuries by way of Cesarean section. The case settled because we were able to show that the hospital was negligent in forcing our client to have a vaginal delivery without the care of a physician.

A well-known health insurer sold outpatient riders to its health insurance policy. Hidden within the fine print of the insurance contract was a provision that the policy would only pay if the insured incurred a “room charge” during outpatient visits. We were able to prove that the insurer knew that its insured would not have a room charge during the course of an outpatient visit.

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