What is MES Solutions Lawsuit?
MES Solutions, a third-party administrator (TPA) that provides medical reviews for insurance companies, has been involved in a number of lawsuits in recent years. These lawsuits have alleged that MES Solutions has engaged in a variety of misconduct, including:
- Failing to properly review medical records: MES Solutions has been accused of failing to properly review medical records and of providing inaccurate or misleading information to insurance companies. This can lead to insurance companies denying or terminating benefits to claimants who are rightfully entitled to them.
- Conflicts of interest: MES Solutions has also been accused of having conflicts of interest. For example, in some cases, MES Solutions has been paid by both the insurance company and the claimant. This can create a conflict of interest, as MES Solutions may be incentivized to rule in favor of the insurance company in order to keep its business.
- Misleading marketing: MES Solutions has also been accused of misleading marketing. For example, MES Solutions has claimed to be a “neutral” third-party administrator, when in fact it has financial ties to insurance companies.
Examples of MES Solutions Lawsuits
Here are a few examples of MES Solutions lawsuits:
- Barber v. Sedgwick Claims Management Services, Inc. (2016): In this case, the plaintiff alleged that MES Solutions failed to properly review her medical records and provided inaccurate information to her insurance company. As a result, her insurance company denied her disability benefits. The plaintiff sued MES Solutions for negligence and breach of contract.
- Cigna Insurance Company v. Wojno (2015): In this case, the plaintiff alleged that MES Solutions was a “hired gun” for insurance companies and that its medical reviews were biased against claimants. The plaintiff sued CIGNA Insurance Company for denying his disability benefits based on a medical review performed by an MES Solutions doctor.
- MES Investments, LLC v. Dadson Washer Service, Inc. (2013): In this case, MES Investments, LLC purchased a property that was subject to a lease with Dadson Washer Service, Inc. MES Investments, LLC argued that the lease was not enforceable because it had not been properly recorded. The court ruled against MES Investments, LLC, holding that the lease was enforceable even though it had not been recorded.
Conclusion
MES Solutions has been involved in a number of lawsuits in recent years, alleging a variety of misconduct, including failing to properly review medical records, conflicts of interest, and misleading marketing. These lawsuits raise serious concerns about the quality and objectivity of MES Solutions’ medical reviews.
FAQs
Q: What is a third-party administrator (TPA)?
A: A TPA is a company that provides administrative services to insurance companies. TPAs may handle tasks such as claims processing, medical review, and customer service.
Q: Why do insurance companies use TPAs?
A: Insurance companies use TPAs to save money and improve efficiency. TPAs can often provide services at a lower cost than insurance companies can provide them in-house. TPAs can also help insurance companies to handle high volumes of claims and medical reviews.
Q: What are the risks of using TPAs?
A: There are a number of risks associated with using TPAs, including:
- Conflicts of interest: TPAs may have conflicts of interest if they are paid by both the insurance company and the claimant.
- Misleading marketing: TPAs may engage in misleading marketing in order to attract business from insurance companies.
- Poor quality reviews: TPAs may not always perform high-quality medical reviews.
Q: What can I do if I am a claimant and I believe that my medical review was biased?
A: If you are a claimant and you believe that your medical review was biased, you should contact an experienced disability attorney. An attorney can help you to review your case and determine whether you have a legal claim against the TPA and/or the insurance company.
Q: What are the benefits of filing a lawsuit against a TPA?
A: Filing a lawsuit against a TPA can have a number of benefits, including:
- Holding the TPA accountable for its misconduct: A lawsuit can help to hold the TPA accountable for its misconduct and deter it from engaging in similar misconduct in the future.
- Obtaining compensation for your losses: If you are successful in your lawsuit, you may be able to obtain compensation for your losses, such as lost wages, medical expenses, and emotional distress.
- Helping other claimants: A successful lawsuit against a TPA can help other claimants who have been harmed by the TPA’s misconduct.
Q: What are the risks of filing a lawsuit against a TPA?
A: Filing a lawsuit against a TPA can be time-consuming and expensive. It is also important to note that there is no guarantee that