RUSS POLLOCK QUOTED FOR PLAINTIFF’S PERSPECTIVE ON WHETHER AN INSURER’S REFUSAL TO PAY FOR A REFERRAL PROVIDES A DEFENSE TO LIABILITY FOR THE PHYSICIAN IN JULY 2013 ISSUE OF PHYSICIAN RISK MANAGEMENT

June 18th, 2013 by Bergstresser & Pollock

Russell X. Pollock was interviewed for the plaintiff’s perspective on whether the failure of an insurer to permit a referral to the specialist can provide a defense to liability if the physician is sued in a medical malpractice lawsuit. The answer is a resounding “no.” At Bergstresser & Pollock, we handle cases involving, for example, the negligent failure of a primary care physician to refer a patient to a specialist or the negligent failure of an emergency department physician to obtain a surgical consultation. Regardless of whether the failure was because the physician did not think the referral was needed or because the insurer or hospital guidelines did not permit the referral, the ultimate question on negligence will be whether the failure to refer the patient was a departure from the standard of care of the average qualified practitioner practicing in that medical specialty at the time. While the issue of obtaining a referral from an insurer may be a procedural morass for the treating doctor, “the physician will likely not regret the effort he or she expended on the patient’s behalf, but might regret the failure to do so.” To review the articles Russ Pollock was quoted in, please go to our Publications and Presentations page.