Joseph Romano Law

I was counsel to a client who was catastrophically injured in a boating accident. He was receiving sixteen (16) hours of LPN care at home, paid for by his private health insurer. He received notice that the insurance company was substituting eight (8) hours of attendant care for his skilled nursing care. I was able to reverse the insurance company's decision regarding length of care and level of care, by providing two expert reports and a medical article showing that the client would be "at risk" if his nursing services were reduced.Maintaining your home nursing care benefits if you are catastrophically ill or injured has never been more difficult. Insurance companies have a "game plan" to systematically reduce the amount of home nursing benefits and reduce the level of care from skilled care to attendant care. Family members and health care professionals should be vigilant and use all legal means, including the appeals process, bad faith arguments, and litigation to protect the long-term nursing benefits that were paid for under the private health insurance policies.