Synergy Blog

Maryland Suspends Attorney for Failure to Repay Healthcare Reimbursement Claim

Maryland Suspends Attorney for Failure to Repay Healthcare Reimbursement Claim

By: David L. Place, J.D. Vice President, Director of Lien Resolution Services

Failing to deal with the subrogation/reimbursement claims of health insurance carriers has proven to be a possible career ending mistake for one Maryland personal injury attorney.  In the September 2013 Maryland Court of Appeals’ review of the disciplinary ruling of Attorney Grievance Commission of Maryland v. Leonard Sperling, Misc. Docket Number AG 47, the Court sanctioned an attorney who failed to properly resolve a health insurance reimbursement claim. In this case, attorney Leonard Sperling, who had been admitted to practice in Maryland for nearly 46 years, had his license suspended indefinitely, with the suspension duration lasting a minimum of six months.

Despite this being the second time Sperling was sanctioned for failing to resolve third party lien claims, the Court found no intentional malfeasance. Sperling seems to have been overtaken by changes in the practice of personal injury law as he attempted to use antiquated tactics in negotiating the interest of the health plan’s claim. These tactics might have worked a few decades ago, but they backfired in modern day personal injury practice.

For almost five years Sperling proceeded to either forestall the prosecution of the third party claim or negotiate the outstanding balance and followed principles and practices that had been common place in his previous lien negotiations, but which were now obsolete. One such example is the blanket idea that a claim for health insurance reimbursement must be reduced by attorney’s fees and costs.  While this appears to be logical, the ground work required in order to obtain such a reduction requires expert understanding of today’s federal and state health insurance statutes and case law. 

Health insurance companies have spent the last quarter of a century training, growing, and expanding their recovery groups and vendors. They have experts, nearly inexhaustible resources, and case law to help them prosecute their subrogation/reimbursement claims.  As evidenced in the Court’s decision, the playing field has changed. Today’s plaintiff’s attorney must know that in order to significantly reduce or eliminate a health plan’s subrogation/reimbursement claim, an expert is required.  At Synergy we fight these battles daily and our expertise ensures that our clients are not exposed to the aforementioned risks that have jeopardized Mr. Sterling’s legal career. Contact us today and see how we can help preserve the hard fought settlement funds you have obtained for your client, and in a manner that protects you and your firm.

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