Grand Rapids, MI asked in Personal Injury for Michigan

Q: catastrophic auto claims adujuster authorized amputation surgery when she knew it didn't need to be done

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1 Lawyer Answer
Tim Akpinar
Tim Akpinar
Answered
  • Little Neck, NY

A: There wasn't a question here. If you're wondering whether the claim adjuster is liable for the amputation, the answer would generally be "no" in most any jurisdiction. A claim adjuster does not owe anyone a duty of care on the level of a medical practitioner. A claim adjuster needs to apply accepted claims practices and the insurance carrier's standard operating procedures. They review claims, pay them, deny them, authorize procedures, request medical information, and handle related duties. If anyone would be liable for an unnecessary and improper amputation, it would be the surgeon, if it could be demonstrated that they breached a duty of care owed to the patient. Since insurance practices are governed by state law, you could check with a Michigan attorney if there are provisions of Michigan law that would result in a different assessment of the matter. Good luck

Tim Akpinar

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