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Luks v. Empire Health Choice

This case was about whether the surgeons were supposed to be given insurance reimbursement due to the excess work they deed. According to the information provided, it was evident that the surgeons more procedures within a single incision. This means that the physicians were given much work as compared to what they were supposed to do. To add on that, it is actually not wrong for physicians to be overloaded that is if they are willing to do so (Hawkins 2017). In most cases, you will find people willing to work for more hours in order to maximize their income. But the problem comes in when they are not given much compensation whenever they provide more services.

The case action which was filed by an orthopedic surgeon against the insurance group, it maintained that the accused misused the compensation policy and prevented the physicians from receiving extra compensation on the multiple operations they deed in a single incision. They only compensated for a single procedure done during the incision. This was an instance of violation of state business and the laws of insurance. It also showed that the accused failed to observe the rules of the contract, and they carried out their duties in an unfair manner.

In settling the case, the involved parties agreed on revising the reimbursement policies, so that there can be compensation for all the procedures done in one incision (Hawkins 2017). Such cases are very common today, where you find corruption running all the way from the higher offices, making those who are working to suffer. For this reason, whether one is newly employed or not, it is important to first understand various policies that affect they whole job, in order to avoid misused in such a way that the compensation is not worth the efforts. In case of such cases then it is important to ask for the court to intervene, to ensure that justice prevails.

References

Hawkins, D. (2017). Subrogation-Reimbursement. Wisconsin Law Journal.

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