The DePuy Hip Replacement Claims Process Could Be Deceptive

After issuing a massive hip implant recall that affects an estimated 93,000 ASR XL Acetabular and ASR Hip Resurfacing Systems, DePuy Orthopaedics has displayed mixed signals about the well being of affected patients. On its website, DePuy states that, “Your safety and health is important to DePuy and we do not want cost to be […]

After issuing a massive hip implant recall that affects an estimated 93,000 ASR XL Acetabular and ASR Hip Resurfacing Systems, DePuy Orthopaedics has displayed mixed signals about the well being of affected patients.

On its website, DePuy states that, “Your safety and health is important to DePuy and we do not want cost to be a barrier to treatment. DePuy intends to cover reasonable and customary costs of testing if you need services associated with the recall of ASR.”

The process of reimbursing patients for testing and treatment related to the ASR recall, according to information on DePuy’s website, proceeds in the following manner.  First, patients contact the ASR call center and confirm that they have an ASR implant.  This begins the claims process.  After that, a patient will be contacted by a DePuy claims representative.  The claims representative provides the patient with a letter of payment authorization, an ASR claim number, and an authorization form that, once signed, grants DePuy access to the patient’s medical records.  Once this is done, DePuy recommends that a patient visit their orthopedic surgeon for testing (such as blood samples and X-rays, to determine that the ASR is functioning properly) and treatment (such as a revision surgery, if necessary).  While at the hospital, the patient is to provide their doctor with the letter of payment authorization so that DePuy can provide reimbursement for out-of-pocket expenses.  Note, however, that reimbursement is not guaranteed.  Once the completed payment authorization form is submitted to DePuy, the company alone decides if a patient is eligible for reimbursement.

While it appears that the claims process described above is designed to promptly and fairly reimburse patients for ASR recall costs, new developments in the DePuy recall suggests a more dubious scheme.

DePuy recently retained Broadspire, a subsidiary of Crawford & Crawford, the largest insurance and claims adjuster in the world.  Broadspire has advertised itself as an insurance adjustor that can “reduce the costs associated with claims.”  All insurance companies, it should be pointed out, are businesses, and as such, aim to cut costs to maximize profits.  Unfortunately, when it comes to the insurance business, those costs are your claims.  The less they pay you, the more profitable their business is.

Patients need to understand that neither DePuy nor Broadspire owes them a duty of confidentiality when they contact the ASR call center.  Broadspire and DePuy say your call may be recorded for “quality assurance purposes.”  However, it is much more likely that DePuy is recording your conversation hoping that you make a statement that will allow the company to blame you for your injuries.

Another potential source of trouble for ASR recall victims is DePuy’s request to access your medical records.  By signing a release form and allowing DePuy to see your entire medical history, you are waiving your federal right to medical privacy.  DePuy states on their website that “signing this form does not waive your right to pursue legal action.”  While this is technically true, once DePuy has access to your records, anything in your medical history can be used as evidence against you if you decide to take legal action against DePuy.

These accusations against DePuy may seem suspicious, but there is plenty of reason to believe they are true.  The company recently filed documents with the California Supreme Court arguing that people who needed a new hip replacement because their original ASR implant failed “were negligent, careless, and at fault and conducted themselves so as to contribute substantially to their alleged injuries and damages.”

To make sure you are legally protected and DePuy and their lawyers are not able to deflect blame for your ASR related injuries, it is important that you speak with an experienced hip replacement lawyer.  A lawyer can advise you on the best way to proceed with your ASR reimbursement claim and make sure you receive maximum compensation if you decide to file a DePuy hip replacement lawsuit.

 

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