There are many factors that can affect whether or not you receive medical funding, so that’s why you should employ yourself with knowledge and improve your chances of receiving funding for medical expenses.

8 Medical Funding FAQs

Have you been injured and need medical treatment while you wait for your personal injury lawsuit to go to trial but have no insurance or a high deductible? How do you get the money to get the treatment you need? Should you consider medical funding? How do you select the correct provider? What questions do you ask while looking for what you need?

Getting answers to these questions can help you narrow the field when researching a medical funding company to help you with your financial needs. Learning the specific details of the medical funding process and how these companies operate will help you get the medical funding you need.

1. What Is Medical Funding?

If you’ve been injured and need to pay for healthcare bills right away, medical funding could be a solution. While your attorney handles the complexities of your personal injury case, you can receive a pre-settlement cash advance, allowing you to pay for the treatments you need.

Once your case is settled, that amount will be deducted from your settlement. This is a great solution for those who are worried about paying bills because it allows you to receive those treatments without having to stress over any financial burdens.

2. How Much Funding Can I Receive?

The amount of medical funding you can receive is based on the treatment you need, and the money is paid directly to your medical provider, which is enough to cover the cost of your treatment. After your settlement has been reached, the amount will be deducted from your compensation.

3. Are There Limits to the Treatments I Can Receive?

Receiving this aid isn’t much help if it doesn’t cover the care you need. Before you apply for funding for medical treatment, ask the pre-settlement funding company if it restricts paying for treatments in any way.

From consultation to surgery and from therapy to medications, you want to be absolutely sure that the funding will cover what you need and that you won’t have to fight to get treatment or receive an inferior procedure or medication.

4. How Much Is It to Fund Medical Costs?

Ideally, when you apply for medical funding, you will not have to pay anything out-of-pocket. That is why these services are so beneficial. You receive the treatments you need while your attorney handles the burden of fighting for the financial compensation that you deserve.

You don’t want to work with a company that will expect you to pay any out-of-pocket expenses before receiving the payments.

5. Do I Need to Pay Fees or Interest?

You are already dealing with a lot as it is. Since you are not paying anything out of pocket, you will not be expected to deal with any interest rates or surprise fees. Make sure to clearly communicate your situation with your representative so you can get an accurate plan.

6. When Do I Pay Back the Medical Bills, and What Happens if I Don’t Win My Case?

Ideally, after you receive the payment and treatment, you won’t have to pay that money back. However, some companies, unfortunately, don’t operate like that.

Here at Gain, however, our medical funding services are non-recourse, which means that they are not loans. Rather, Gain pays the healthcare providers for your medical treatment and, if you win a settlement, gets paid back from that. If you lose your personal injury case, you will not be required to pay us back.

7. How Does Gain Make Money?

Medical funding companies like Gain do not invoice the patient who needs the treatment. We give the money directly to the medical provider so that you can receive the treatment in a timely manner. Once your case is settled, we will deduct the amount used for your treatment as repayment.

8. How Quick Is the Process?

When you’re injured or in pain, you need treatment right away. That means you want to get the funding you need as quickly as possible. At Gain, our experts understand the direness of your situation and will work quickly to provide financial support. Depending on your circumstances, you may be able to receive funding in as little as 24 hours.

How to Get Funding for Medical Treatment

When you need emergency medical funding, turn to our experts at Gain. We have earned a reputation for honesty and transparency and for offering the best service in the industry.

If you are considering medical funding to cover the costs of treatment after an accident, we’re happy to answer your questions and review your case with you and your attorney. Contact us today to find out more about how we can help you.

The post Questions to Ask About Medical Funding appeared first on Gain Servicing.

During the 1990s, there were also a number of damaging storms, which began to fundamentally shift how insurance companies conducted business. In 1989, Hurricane Hugo ripped through South Carolina, leaving in its wake $4.2 billion of insured, yet damaged property. In 1992, Hurricane Andrew stormed through, creating $15.5 billion in claim payments and resulting in the bankruptcy of 11 separate insurance companies.

When the payout is greater than the insurance premiums customers pay, there is no profit.

For the insurance companies that survived, and who depended on insurance premiums and investments for income, they believed something had to be done. Storms were gaining magnitude. Catastrophe models weren’t as predictable and face-to-face assessments were dubbed as being useless, time-consuming, old-fashioned, and inefficient.

Now, computer programs and software are calling the shots, like Colossus, which determines claim payments based on statistics, technical data, and mathematical probabilities all designed to pay out less in settlements. But, are these computations fair and non-discriminatory to injured parties? Or, are the probabilities rigged in favor of insurance companies?

Around the same time as those destructive storms, Allstate, an American insurance company, hired McKinsey & Company, a New York consulting firm, to show them how they could increase their bottom line. McKinsey & Co.’s PowerPoint presentation, complete with more than 12,500 slides, was a fundamental shift in the insurance business model. The industry quickly went from being “For the benefit of policyholders” to “For the benefit of shareholders.” It boiled down to this: avoid paying claims, and when you do pay—pay less. After heeding McKinsey’s advice, Allstate saved $700 million and their stock price rose dramatically. (Note: Allstate ended up paying $2.4 million in fines to the U.S. courts for not initially handing over this documentation.)

Allstate raked in the profits. In the first few years of the Colossus implementation, average payouts for bodily injuries dropped more than 20 percent. Mark Romano, a former Allstate senior executive and top expert in Colossus described his work utilizing the program as “turning the knobs.” In fact, the 1996 McKinsey team even noted initial resistance from Allstate claim agents, stating there was a “lack of buy-in.”

After any major accident, urgency matters for the injured insurance policyholder. The first 180 days hold tremendous financial pressure. Claims, fees, payments, and medical bills immediately start piling up. If an individual can no longer work, who pays the mortgage? Companies, like Allstate, understand this predicament, which is why they drag their feet on paying insurance claims.

David Berardinelli, author of From Good Hands to Boxing Gloves: The Dark Side of Insurance, details this courtroom power-play. Berardinelli turns Allstate’s motto on its head when notes that the policyholders who accept initial, but much smaller, claim settlement amounts are “in good hands.” But for those policyholders who choose to fight and seek legal representation, they receive Allstate’s  boxing gloves.”

Companies, like Allstate, pressure policyholders to settle quickly and to accept some money (even though it’s a fraction of what a policyholder is due). Or, they deny and diminish claims, so that policyholders have to use their own resources and seek legal representation to fight for a fair settlement. If resources are already scarce, where will the money come from to cover legal fees? Policyholders, concerned they could spend years in court while their bills go unpaid, often feel forced to take what is initially offered. In fact, one McKinsey & Co. slide for Allstate simply read, “Win by exploiting the economics of the practice of law.”

Berardinelli added: “All this is a plan for switching money from the policyholders’ pockets to the shareholders’ pockets.”

The Alligator Approach to sit and wait is done deliberately to frustrate policyholders, so they’ll accept less and walk away. Legal and medical funding, like what Gain provides, offers an opportunity to gain access to critical funds in a timely manner and allows attorneys the necessary time to fight for a fair settlement or go to trial. Nobody should have to choose between taking a lesser settlement and waiting for a fair settlement or trial because they need money to pay for essentials and their medical care. Legal and medical funding also isn’t a loan, so if plaintiffs don’t win, or if the amount they’re awarded is less than the bills owed, they only pay what they have recovered. Repayment is contingent on the success of the lawsuit or the settlement of the case.

After the fundamental shift in the 90s, plaintiffs need to be their own advocates. Insurance is a business model and it’s one that is weighted heavily to tip the scale in favor of the insurance company, not the policyholder.

The post Reduced Payouts, Increased Profits: How the Insurance Industry has Shifted Away From People, Towards Profits appeared first on Gain Servicing.

Which is better: A high-deductible health insurance plan where you pay more before insurance actually kicks in, or a low-deductible plan with higher premiums? And, how do you choose?

Why do people pay for the “Cadillac” of insurance when they still end up having to pay out of pocket for medical care?

Insurance companies want to scare consumers into paying for premium plans. Why? Because it’s good for business.

Parsing Out Coverage Costs

The average cost of healthcare coverage is increasing for consumers. Rates are rising, and they’re rising fast. Per month. Per year. Per plan. All while covering less. In April, health insurance hit a five-year peak, spiking 10.7 percent over the previous 12 months and making it hard for consumers to keep up with the added expenses.

These days consumers are also increasingly in the dark as to what healthcare actually costs. Vague and discretionary pricing, especially in emergency rooms, which is where the majority of personal injury victims end up, makes it difficult for consumers to know what they’re being charged. This, coupled with constant health insurance updates, high deductibles, uncovered procedures or facilities that are out of network, and government regulations – tax penalties or no tax penalties – and it’s easy to see why it’s difficult for most people to stay up to date on health insurance coverage, let alone to understand what they’re actually getting out if it.

Finding appropriate insurance is a balancing act between deductibles, premiums, and what might happen. Insurance companies are hoping you’re expecting the worst.

Healthcare & Unanticipated Personal Injuries

Personal injuries are unexpected circumstances. No one has a calendar reminder set for an incident that is going to leave them injured, unable to work, and with hundreds of thousands of dollars in expensive medical bills.

Does the 1994 product liability lawsuit between Stella Liebeck and McDonald’s ring a bell (Liebeck v. McDonald’s Restaurants)? This was the highly publicized “hot coffee” case. Liebeck, a 79-year-old woman in New Mexico, had no plans of spilling scalding hot coffee on her lap resulting in severe burns, hospitalization, and multiple skin graft surgeries. She was left with mounting medical bills and a corporation trying to dodge paying for any of it, which is why a court case ensued.

Why would anyone pay a pretty penny for health insurance with nominal coverage? Then again, why would anyone overpay to cover medical expenses they’re not expecting and may never need?

Two forms of coverage that are well worth the cost, in my opinion – and are actually part of your auto coverage, not healthcare coverage are Medical Payment Coverage (MedPay) and Uninsured/Underinsured Motorist Coverage (UM/UIM). MedPay covers the cost of injuries to you or your family members, no matter who causes the accident, while UM/UIM covers your medical expenses when you are injured by an uninsured or underinsured driver. Both are great options. (For more information on the two, I recommend giving this article a read: How to choose Medical Payments, Personal Injury Protection & Uninsured Motorists coverage.)

The Business of Insurance

Insurance and healthcare coverage are business models and they’re designed to be profitable. HMO. POS. PPO. EPO. These aren’t ticker symbols on the stock market, they’re healthcare coverage options for consumers, and instead of leaving people with peace of mind and optimal coverage, they’re leaving them broke.

Are these business models working when consumers are unable to afford the care they need? Insurance companies think so, since they’re the ones coming out on top.

Consumers expect health insurance to cover doctor visits, hospital stays, prescription drugs, and preventative care – it’s what they’re paying for after all. The reality is, health insurance is just like any other business model, so insurance must be priced higher than what a company actually ends up paying out. They make their money through underwriting profits (premiums minus payouts and expenses) and the income they collect on premiums. As a business, they have to cover their overhead costs: administrative expenses (the endless paper bills being sent back and forth), executive salaries, advertising (Superbowl ads are expensive) and rent for office space. But the model, for consumers anyways, is simply not working.

How Does Insurance Work for You?

Alternate insurance plans come at different costs. Depending on specific plans, some offer distinct services. Want more services and added flexibility? That will cost you. Is the individual seeking health insurance a smoker or a non-smoker? Family plans cost more than individual plans. Where you live and how old you are can also affect your rates.

It’s frustrating to pay high rates each month for health insurance coverage that doesn’t cover what you need when you actually need it.

Variables, like types of health insurance plans, the tier of the plan, the sub-divided tier of the plan (there are even metal tiers like Bronze, Silver, Gold, or Platinum) and a lower catastrophic tier, and an individual’s medical history, all affect the underlying costs. Platinum may sound like the best, but this coverage may not make sense for you or your family. It all just depends.

But it’s not only about being able to afford your monthly insurance payments, it’s also about putting your insurance to work once you’ve been hurt. When you hit your deductible—say, it’s $5,000 you’ll still be on the line to pay coinsurance, another form of cost-sharing, until you reach your out-of-pocket maximum. Once this is met, insurance kicks in covering 100 percent of covered services. Covered being the optimum word here.

If you did have a $5,000 deductible set aside for one medical emergency, you’re still not in the clear. Until you hit your out-of-pocket maximum, and only if these services are covered, you’re still on the line for covering the rest of those funds.

And on and on it goes.

Growing Profits & Cutting Costs

Insurance companies don’t want to break even they want to make a profit.

In the 90s, after a series of catastrophic storms and expensive payouts to consumers, insurance companies began going out of business. It wasn’t until they implemented computer programs like Colossus to turn the knobs that they were able to tip the scales back in their favor, and to the benefit of their shareholders, not their policyholders.

This same trend is alive and well in the healthcare industry today: insurance companies make more money when they avoid paying for care.

With any amount of insurance coverage, consumers are still expected to pay the remaining funds to cover their non-negotiable care. This can be especially frustrating in personal injury accidents where people are injured at no fault of their own. Top-tier insurance coverage in these cases often doesn’t matter because of the insurmountable costs associated with these catastrophic events.

Health insurance, no matter the level of coverage, is often just a drop in the bucket.

The post “Super Good” Insurance Doesn’t Matter. Here’s Why. appeared first on Gain Servicing.

Medical liens are a risk for healthcare providers to hold. Most doctors and hospitals avoid providing treatment on medical liens and instead opt for immediate payment by treating patients with insurance or those who can pay out of pocket.

The problem with this, of course, is that nearly half (46%) of all Americans are uninsured or underinsured, and most do not have enough in savings to pay out of pocket for medical treatment. So, a medical lien on a personal injury settlement could lead to a disproportionate return for the healthcare provider.

With a medical lien, a healthcare provider could wait years for a case to settle, and after waiting, the patient could end up not receiving the settlement amount that was initially anticipated. When case values are lower than expected, this can result in healthcare providers having to reduce their medical bills and/or risk those bills going unpaid altogether.

More than that, if a healthcare provider provides treatment to a plaintiff with a medical lien in a personal injury case and then holds that lien within the practice, there is then a vested financial interest in the case settling, which ultimately can be viewed as a major conflict of interest.

The Biggest Issues of Holding Medical Provider Liens In-House

One of the primary targets of insurance defense counsels is healthcare providers holding their own medical liens. Some of their common defense mechanisms include:

• Questioning whether healthcare providers who service their own medical liens are acting as investors in litigation.
• Operating a playbook designed to trap providers into appearing that there is a conflict of interest, that their medical opinion is biased, and that they are “investors” in these lawsuits.
• Examining communication, including text messages, emails, phone logs, and more, between providers and attorneys regarding insurance policy limits, case values, ongoing case updates, settlement influence, negotiations, case involvement, and insurance opt-out requirements.
• Looking for the separation of patient and clinical records and bringing in forensic medical billing experts to search for dual charge masters, varied billing, upcoding, charges that are beyond usual and customary, and more.

In short, in-house medical liens can wind up being a major headache for healthcare providers. Not to mention, medical lien management requires a lot of expertise, manpower, and/or specialized software, as well as extensive and proactive follow-up and negotiation.

The Benefits to Healthcare Providers of Using Third-Party Medical Liens

In order to avoid the headache that comes with managing and servicing medical liens in-house, many providers turn to service companies to sell their medical liens.

Some of the benefits of turning over medical liens to a third-party servicer include:

• Outsourcing is more cost-efficient
• Outsourcing increases operating efficiencies
• Outsourcing mitigates risk, including insurance defense attacks, expensive discovery demands, medical opinion bias, financial interest bias, and billed charges
• Third-party outsourcing solves many and varied legislative risks
• Healthcare providers make more money

Ultimately, medical liens require time, dedicated expert resources, due diligence, and follow-up in order to be managed properly. The benefit of outsourcing medical liens to a third-party servicing company is that they bring all of these to your portfolio of lien receivables, which often results in more liens being collected.

How Third-Party Servicing for Medical Liens Works

Before treating a personal injury patient on a medical lien, it is important to have an understanding of the case value.

In short, when a healthcare provider partners with a servicing company like Gain, the process of medical liens works like this:

1. The healthcare provider determines if medical treatment is necessary and related to the accident.
2. The healthcare provider gives the servicing company a breakdown of fees for treatment to be approved.
3. The servicing company evaluates the underlying personal injury case to see if the case is viable to enter into a medical lien agreement with the patient and his or her attorney.
4. If the servicing company assesses the case and determines it is viable, the healthcare provider is paid for the cost of the treatment after treatment is provided to the personal injury patient.
5. The servicing company recoups funds at the conclusion of the personal injury case.

All of the risk associated with placing a medical bill lien on personal injury settlements is almost completely reduced by using a third-party servicing company. Not to mention, treating this population of personal injury patients on medical liens can result in a substantial increase in patient flow, especially as attorneys start to refer their clients to the practice for treatment.

This, coupled with partnering with a servicing company that is efficient in collecting medical liens, can result in substantial cash flow and revenue for the healthcare provider.

Are you in need of assistance with managing and servicing your medical liens? Contact us today to see if Gain’s services might be a fit for your healthcare practice.

Our innovative platform is the proven leader in letter of protection (LOP) servicing, collections, and medical lien funding, and we’d love to help give you the support you need to provide quality care for your patients.

The post Why Healthcare Providers Should Never Hold Medical Liens appeared first on Gain Servicing.

And trust me, they are not at all in the spirit of giving.

I see it every year, the acceptance rate of settlement offers speeds up right around the time of the holidays, and what might have previously been – for example a $10,000 settlement offer is suddenly upped to $11,000 or $12,000 to settle before the end of the year.

Plaintiffs, or those with the money and bills on the line think, “If I settle now, I’ll have cash in time for Christmas.””

Do not fall for this.

Insurance companies hope and prey on the fact that most people, especially those who are already living confined within their current means because of their case, will fall for the little extra cash that is being offered to them.

Meanwhile, with all of the circumstances of the case being accounted for, it is actually worth significantly more than what is being offered.

Do not make a long-term decision, like settling, based on short-term circumstances, like the holidays.

I implore you to think beyond today, tomorrow and the end of the year.

The Top 3 Insurance Company Ploys to Be on the Lookout for This Holiday Season
If you receive a settlement offer that is slightly more than what was previously being offered, look closely at the total of your medical bills and expenses before accepting. Consider the total amount of money you will actually take home after all bills, fees and expenses are paid. Regardless of the extra money they are offering, often it is still well below what the case is worth and should settle for. At the same time, be practical. Fighting for every last dollar versus the certainty of settlement and moving on with your life is also something to seriously consider.

If you have been waiting weeks, or months, and all of sudden you receive an offer to settle and the date is sometime in December, consider what is being offered very closely. Insurance companies want to get cases off of their books before the end of the year, but this should not alter your expectations and the settlement amount that is owed to you. Oftentimes, your attorney can use the insurance company’s desire to settle at year-end to your advantage.

If you are offered an amount prior to trial and just before the end of the year, consider all of the points of your case before accepting. If an insurance company knows you have a solid case with clear liability and damages, they will opt to settle as soon as possible – but only when it is convenient for them and long before your case would go to trial. Make sure you consult with your attorney to come up with the best plan for you. Settling prematurely is often not in your best interest.

Public Service Announcement: Insurance companies make money by investing the premiums you pay and turning a profit on that money through investments. To avoid paying additional legal fees to their defense attorneys, especially in the instance of a potential trial case where they risk the chance of losing and owing additional funds, they will attempt to settle with you beforehand.

Remember this: Insurance companies only pay you when it is good timing for them. They will entice you with slightly higher offers in the hopes that you will accept the settlement amount based on emotional decision making, like trying to pay for Christmas.

Think Big Picture, and Beyond Christmas Day
The holidays can be the most wonderful time of the year. Or, they can also feel like the worst, especially if you are in the midst of a lawsuit.

While it may be tempting to accept a quick settlement payment, it is important to realize that even if you settle several weeks before Christmas, on average, it will still take 20 days to receive funds. Which means, if you are settling solely to fund something short-term, like the holidays, you could be causing yourself additional financial hardship in the future.

The post Cash for Christmas! And Other Insurance Company Ploys to Avoid This Time of Year appeared first on Gain Servicing.

Have you been injured in a car accident, slip and fall, or another incident—and now you’re staring at medical bills while your case moves at a legal pace? You’re not alone. The CDC reports 43.5 million injury-related emergency department visits in the U.S. (injury/poisoning/adverse effects), with Gallup estimating 12% of U.S. adults borrowing money for healthcare in 2025, totaling about $74 billion. 

This is a stark reminder of how often sudden injuries disrupt lives and budgets.

That’s where medical funding can help. If your claim supports it, funding can pay providers directly so you can get treatment now—without letting unpaid bills or financial pressure push you into a rushed settlement decision.

Medical Funding Explained

Health insurance doesn’t always cover the full cost of your healthcare bills. If you’ve been injured, you may have to pay a considerable amount out of pocket. It can be through a high deductible or for procedures and medications your insurance doesn’t cover.

That’s where medical funding comes in—especially when a medical funding case involves ongoing treatment needs that can’t wait.

With a strong case and a great lawyer, you might be awarded a high enough settlement to cover the costs of your medical treatments in a personal injury or medical malpractice lawsuit. But, it often can take months or even years for that money to actually arrive in your bank account. Funding for medical procedures covers the cost of the treatment you need while you wait for your settlement. In many medical funding case situations, that time gap is exactly what creates the biggest stress.

The Purpose of Medical Funding

Medical funding lets plaintiffs get the treatment they need when they need it. It covers an array of medical treatments, such as initial consultation, MRIs and other imaging, lab tests, physical therapy, and surgery. This funding pays the medical provider directly so that you don’t accumulate a large amount of debt while you wait for the settlement. Many people seek medical funding companies as one of the funding options for plaintiffs because the help is built around your claim and treatment timeline and it is not a typical loan. 

Who Medical Funding Helps

Receiving funding for your medical bills does two things:

• It aids individuals who have been injured and require medical treatment.
• It supports the doctors and medical providers who administer treatment to the injured person.

Since the money goes directly to the hospital or doctor’s office, the facility doesn’t have to bill a patient or wait to receive payment. Direct funding helps healthcare providers improve their cash flow, especially with the rising costs of healthcare. This is one reason providers often prefer working with a medical funding company that can pay reliably and quickly.

This also reduces the burden on the office staff, as they won’t have to chase after patients about bills or constantly follow up regarding the status of a patient’s legal case. When providers partner with medical funding companies, they can spend less time on collections and more time on patient care.

Your personal injury attorney can also benefit from this funding. When a patient’s medical bills are covered, the pressure to settle quickly is alleviated. That means a lawyer can focus on getting a client the compensation they deserve instead of a deal that will pay out the quickest. In a complex medical funding case, that breathing room can make a meaningful difference in the outcome.

How to Get Funding for Medical Treatment

As a plaintiff, you apply for such funding yourself, even though the money goes to the doctor or healthcare practice. 

If you are wondering what medical funding services help with patient care financing, look no further. Medical funding companies like GAIN Servicing offer pre-settlement funding. This type of funding can help bridge the gap between getting treatment now and receiving your settlement later, so you can keep your care on track while your case moves forward.

The process is fast and simple, and most patients are approved the same day they apply. Working with the right medical funding company can also make it easier to coordinate documentation and keep the approval process moving.

What to Do if Medical Funding is Denied? 

If your medical funding application is denied by the insurance provider, it usually doesn’t mean your claim has no value. It often means the funder can’t confidently evaluate risk yet based on the information available or the current posture of the case.

Common reasons medical funding gets denied include:

• Liability is unclear: fault is disputed, evidence is thin, or there’s limited third-party coverage.
• Damages don’t support an advance: treatment costs or wage loss may be too low relative to the expected case value.
• Documentation gaps: missing medical records, itemized bills, treatment plan, or proof of lost wages.
• Liens reduce expected net recovery: Medicare/Medicaid, health insurance, child support, or prior advances may take priority.
• Attorney-related issues: you don’t have an attorney, or your attorney won’t cooperate with verification.
• Timing/jurisdiction limits: the case is too early to assess, moving unusually fast/slow, or the funder doesn’t operate in that jurisdiction.

What to do next

Ask the provider for the specific denial reason and what they would need to reconsider. Then work with your attorney to strengthen the file—request updated records, bills, imaging, and incident/police reports. If your diagnosis or treatment plan is still developing, consider reapplying later once the long-term impact is clearer. Finally, you can opt for pre-settlement funding, so that you can get the required medical attention while your case is still on. 

What Happens After You Receive Funding?

Gain pays for the plaintiff’s bills directly to the hospital or doctor’s office, so the plaintiff doesn’t ever have to handle the funds. Medical funding from Gain is non-recourse and is not a loan. That means that if you don’t win your case or a settlement, you don’t have to pay the money back. If you do win, GAIN is paid back from the settlement amount. You don’t have to worry about paying any fees or interest out of pocket, ever.

If you’ve been injured, have a case pending, and need medical treatment, contact us today to see if medical funding is the right choice for you. We’ll go over the details of your case and approve it quickly. Don’t let an inability to pay keep you from getting the medical care you need. We’re here to help.

The post What is Medical Funding? appeared first on Gain Servicing.

Amicus briefs are legal documents filed in appellate, or appeals, court cases by someone who is not a party to the case, who may or may not have been solicited by a party, and who is someone able to offer information, expertise, or insight that has a bearing on the issues in the case.

The purpose of the briefs is to advise the court of additional relevant information or arguments that the court might wish to consider before making a ruling.

Proponents and Opponents of Litigation Financing: Here’s What They’re Saying
Proponents of litigation financing, including the Alliance for Responsible Consumer Legal Funding (ARC), which is a trade and advocacy group for the consumer legal funding industry, and Jeremy Kidd, a tenured law and economics scholar at Mercer University’s Walter F. George School of Law, have recently filed amicus briefs in support of litigation financing, specifically in support of Cherokee Funding in a case that has made its way up to the Georgia Supreme Court. ARC has defined the contingent nature of litigation financing in this way:

[In] investment or insurance transactions, for example, money changes hands and the potential for future compensation is created. Individuals or entities receiving investment funds incur an obligation to pay a portion of future profits, if any, to investors.

Similar to when Insurance companies receive insurance premiums and incur an obligation to provide funding if an insured event occurs.”

The mere possibility of repayment being contingent creates an element of risk, thereby making transactions like those in litigation financing a form of investment, and therefore eliminating their guidance by financial regulations like the Georgia Payday Lending Act (PLA) and certainly by the Georgia Industrial Loan Act (GILA), for example.

Opponents of litigation financing, which widely include the big businesses and insurance companies themselves who have the most financial gain to be had by limiting the available resources to the plaintiffs they are subject to pay, argue that litigation financing clogs the court system and elongates case proceedings. One of the most frustrating realities for them, I’m sure, is that it gives people, who otherwise wouldn’t have the financial ability to wait, a fighting chance to a fair settlement – which often results in those very companies having to pay those fair settlements.

One of the pillar and most widely-known cases I like to point to when arguing against how frivolous plaintiffs actually are is the Liebeck v. McDonald’s Restaurants case. I’m always amazed by how many people remember the case but also by how inaccurately they remember the facts of it. To this day, I hear people make comments when they read the hot contents warning label on coffee cups and say something to the effect of, “Well, that’s because of that woman who sued McDonald’s because her coffee was too hot. Why do you have to be warned that coffee is hot?””

What people don’t remember is that 79-year-old Stella Liebeck was told she might not survive from the injuries she sustained from her coffee spill. That after skin graft surgeries, and physical therapy appointments she was left in excruciating pain, not to mention medical debt. So, when Liebeck’s family reached out to McDonald’s for help with her medical bills, which at that time had come to roughly $10,000.00, McDonald’s came back to offer $800.00.

For more information about this case, read my article Hot Coffee, and Understanding and Overcoming Tort Reform Claims.

Big businesses and insurance companies have proven time and again they cannot self-regulate. If lawsuits like Liebeck’s didn’t happen, more severe burn cases would. And to defend their financial well-being, these companies have taken to attacking litigation financing as an industry – the involvement, of which, protects people’s Seventh Amendment right, where everyone has their day in court.

We may not always be able to guarantee the fairness of these case proceedings, but litigation financing does help to level the playing field.

Legal Funding: How It’s Categorized and Why It Matters
Because repayment is contingent on the success of the lawsuit, litigation funding is not and should not be covered by GILA, PLA, or other lender rules and regulations. To be a loan, the law requires that repayment be mandatory in order for these rules and regulations to be applicable, and litigation funding is non-recourse. In the instance of Cherokee Funding, if our clients do not recover anything, neither do we. This stipulation, of course, is the cornerstone to our existence and is what makes us different from a variety of other financial arrangements and obligations.

The balance litigation funding provides is necessary in the court system, especially when considering the majority of legal funding consumers are uninsured, underinsured, and otherwise ill-equipped to go up against big businesses and insurance companies with deep pockets. Contrary to opposing arguments, legal funding does not increase litigation by volume or by case duration, nor is there any statistical proof that it causes a back-up in trial courts. By all accounts, litigation funding is an equalizer. The friendly characters representing insurance companies, whether an animated lizard or a middle-aged woman with big hair and a white smock, are being paid for by hard-earned premiums and they’re coming at the expense of everyday people. In my humble opinion, those are the businesses we should be regulating more closely, not the other way around.

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What about personal injury victims who can’t work due to injuries and have no financial resources to take on deep pocketed insurance companies who have no urgency to settle cases? Or when plaintiffs are forced to live off credit cards and run up debt to pay their bills when the average case takes 9 months to settle? Proponents of legal funding say this happens to thousands of personal injury victims every day. And, that legal funding through cash advances offer plaintiffs the ability to take back control by giving them the financial breathing room to wait for a fair, reasonable settlement.

To get an informed view, it’s important to know all the facts and myths surrounding legal funding.

The 3 Myths of Legal Funding

Myth no.1: Legal funding encourages frivolous litigation.

Rebuttal:
This myth is based on the assumption that legal funding companies are on board with filing lawsuits that have little-to-no chance of being won – not only would this not be a sustainable business model, it is not the business legal funding companies are in.

This myth also assumes that plaintiffs – attorneys are comfortable with putting their reputations on the line and do not mind wasting their time working on frivolous lawsuits. Given that personal injury attorneys work on a contingency basis and do not get paid if they do not win, this is obviously not a position they would knowingly want to put their practices in.

Myth no.2: Legal funding exploits vulnerable plaintiffs.

Rebuttal:
This notion relies on the assumption that all plaintiffs are financially unstable, or that they are unsophisticated. And if that is true, then all plaintiffs, no matter the case, are equally vulnerable to being exploited by insurance adjusters and defense counsels to accept a less-than-fair settlement because they need funds to pay bills.

The myth also assumes that plaintiffs have no choice. Legal funding is a relatively new industry, but there are more companies and options than ever before. Plaintiffs get to pick who to trust their funding with, and more importantly, who will take the risk on their behalf. Plus, consumers of litigation financing have more resources available to them to research and review potential funders.

It is also important to note that many people simply do not want to burden relatives with the financial risk of pre-settlement funding, or risk bankrupting themselves while waiting for the legal system to work for them.

Myth no.3: Legal funding reduces the likelihood of settlement.

Rebuttal:
Legal funding allows plaintiffs time to wait for a fair settlement, this is true. Plaintiffs do not have to rush into unfavorable settlements because they have financial support to wait for a more favorable outcome. This does not mean, however, that settlements are somehow drawn out longer. It simply means that financially disadvantaged plaintiffs are not forced to take unfair settlements due to a lack of financial means.

A court case decision is almost never certain, and it behooves everyone involved – from the plaintiff, to the defendant, to the legal funding company – when decisions are made swiftly. The plaintiff who receives a cash advance from a legal funding company, like Cherokee Funding for example, may not receive a favorable outcome in court. And, like the plaintiff in any case, the legal funding company wants decisions quickly.

The Equalizer in Court

Critics of legal funding do not take this into account: most plaintiffs who seek litigation funding do so out of choice. Like any financing, there are obligations and terms and conditions to be aware of, and those are in place regardless of the case outcome or the settlement amount.

The vast majority of plaintiffs who turn to legal funding do so out of necessity. If they get injured and are out of work for days or weeks or months, they have no other means to pay their regular bills, not to mention their medical bills. And, the very accident settlement they are fighting for is the cause of to the injuries they have suffered and their inability to work due

Should personal injury victims be forced to take low offers from insurance companies simply to pay bills?

We don’t think so.

Pre-settlement cash advances (legal funding) level the financial playing field for plaintiffs against large insurance companies who have the capital to draw out the settlement process. It provides the opportunity to wait for a fair and reasonable settlement.

Are you waiting on a court case or insurance company to settle? Want to know more about legal funding? Find out more about the funds available to plaintiffs through Cherokee Funding.

We also invite you to comment below with any questions you have about legal funding.

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Some of the legal funding factors most states agree on, however, are:

The majority of states have concluded that providing information to a funding company at the request of a client is permissible, with the informed consent of the client, of course. They have concluded that an attorney may honor a portion of the client’s settlement to a funding company.

You often hear, these same states and governing bodies commenting that when a third-party funding company is involved, clients may lack an incentive to cooperate, some even suggest it encourages frivolous litigation.
Here, we would like to offer up a different opinion, and the top three reasons why someone should use pre-settlement funding when and if they find themselves in litigation.

Three Long-Term Benefits to Using Non-Recourse, Pre-Settlement Funding
1. Preserving the Role of All Parties
Attorneys, plaintiffs and doctors are all best served when an independent, third-party is the source for plaintiff funding.

Medical providers should never take on this role, or have a financial interest in the outcome of a case, in any way shape or form, by holding their own liens. Their job is to provide the best medical care, period. The same is true for attorneys and providing the best legal advice and pursuit of their clients claims.

In other legal circumstances, this is referred to as the separation of church and state.

In either scenario, there is an inherent conflict of interest, where the party providing funds would potentially be willing to settle a case for less than it is worth to secure their own repayment.

This cannot happen.

When a third-party legal funding company is involved, attorneys and doctors should have no ownership interest in that company whatsoever, nor should they receive any compensation other than the value paid to the doctor for their professional services at the time of treatment and the time value granted the attorney to maximize case values. A doctor’s opinion and treatment plan should be based solely on patient needs and never on whether or not they will be paid for their services.

As a third-party funding company, we have no input or ability to influence the outcome of a case, thus preserving the unbiased position of everyone involved.

2. Contingency Based
Non-recourse advances are contingency based. Meaning, plaintiffs have no personal obligation to repay advanced monies, other than through the results of their settlement or judgement, which may or may not be successful.

Funding is not to be repaid by the recipient at a later date, which is why these non-recourse cash advances are not considered loans because the funds come from the settlement or judgement in a lawsuit, and only in the event of a successful conclusion for the plaintiff.

In the instances where plaintiffs lose their cases and are not awarded anything, they repay nothing.

And in the scenario where a settlement is significantly lower than the liens they have, they are never obligated to repay more than the settlement they receive.

Tip: Before using a legal funding company, plaintiffs should first seek funding from alternative sources, like friends, family, credit unions or banks. If no personal funding can be sourced, and after all personal resources have been exhausted, legal funding can become an excellent alternative, and may prevent premature settlement.

If the attorneys representing a plaintiff in a given case believe they can get a higher settlement given more time, the math and benefit of pre-settlement legal funding can be easy to follow.

3. Budgeting for Best Case Scenarios
Underwriting and risk management are keys to the legal funding business. Calculating advance rates and anticipated settlements to help assure the best outcome possible for plaintiffs and attorneys are the way funding companies add value to the inherently disadvantaged position that insurance companies force plaintiffs into.

Rolling Contracts are a responsible answer to plaintiff cash needs, especially for cases with indefinite timelines.

Supplying necessary funds in small increments over time saves the plaintiff money and potentially allows for greater take-home settlements. This, versus advancing large amounts of money upfront, which can lead to a plethora of long-term financial issues, including the mismanagement of funds and the need for more money over time.

When proper budgeting is done, everyone wins.

There are instances where case values are overestimated and advance rates, therefore, get miscalculated. In these cases, plaintiffs benefit from having received, essentially, too much money because they are not liable to repay more than the total amount of their settlement. Having worked with thousands of attorneys on over 30,000 cases, we budget to minimize the instances of over-advancing funds, but also understand when reductions on monies owed are necessary and accommodate accordingly.

Note: As cash advance amounts owed grow over time, there is a natural conversation plaintiffs have with their attorneys about the potential increased risk of going to trial versus accepting the latest valid settlement offer. Attorneys have experience in these areas and are able to guide plaintiffs to the best outcome for them and their interests. These conversations can alleviate the potential for plaintiffs to want to roll the dice and instead focus on the realistic outcome of the case given the time the attorney has had to review and consider all of the necessary facts involved.

Closing Thoughts
There are immeasurable benefits to having a legal system that is open to everyone regardless of their socioeconomic status and legal funding helps to ensure that equal playing field.

In summary:

Cash advances allow plaintiffs to say no to low offers made by insurance companies
Both uninsured or underinsured plaintiffs should not be denied proper medical treatment.
Tortious activities or wrongful acts against regular, working-class people, especially those that go undisputed, come at a cost, and that cost is usually incurred by those having the wrongful acts committed against them.

Not providing this crucial service to plaintiffs in need of funds and medical treatment to pursue justice in their individual cases can and would have ripple effects throughout the entire economy further widening an already biased economy.

Justice is owed to everyone no matter their economic status. And everyone should have equal access to this legal system.

The post The Top 3 Reasons to Use Pre-Settlement Funding appeared first on Gain Servicing.

In fact, they are quite the opposite.

When it comes to actually paying out on the claims they guarantee you coverage for, insurance companies are data-driven hardliners ready to holdfast during settlement talks and see you in a court of law.

What most people come to know as an entertaining gecko having casual conversation while he walks down a deserted road or on the tabletop of a local diner, in reality, ends up being a completely different beast when it comes to negotiating settlements or seeing them in the courtroom.

The Fact About Insurance Companies You Don’t Know
The insurance industry is a leader in data science.

On the consumer level, this means they know way more about you than you know about them. They know the demographics, income level and lifestyle of the people who have insurance with them. When they are not paying for this information, consumer data voluntarily given up through things like the social media sites we frequent, shopping behaviors and browsing is all up for sale – they are getting it directly from their customers. The information you fill out to get the insurance with them in the first place can and will be used against you.

This might not be surprising to some people, but think of the implications and the power  this inherently gives the insurance company when God forbid, you have the misfortune of actually having to file an insurance claim with them.

It no longer feels like a sunset joyride on a motorcycle next to Flo anymore, does it?

The Big Data Working Against Plaintiffs in Court
The majority of Americans cannot wait for a settlement, nor can they afford prolonged litigation any longer than is absolutely necessary.

Why?

Because the majority of Americans do not have enough in savings to cover their expenses if they are no longer able to work due to an injury.

Insurance companies have two major advantages working in their favor: time and money. They hold the checkbook and they are in no hurry to write you one.

Flo and friends have a good idea about how long you can sustain yourself in the face of inconvenience or worse, tragedy. They know what cases are worth and they know that the majority of people will be forced to settle for something less than full value if they simply wait you out.

The other fact of the matter is that insurance companies will not pay for a surgery until it has happened. And with most people unable to afford their regular bills without employment, let alone surgeries needing to be paid for out of pocket, means one of two things happens. The individual secures funding, whether from a legal funding company like Cherokee Funding or through family members, friends or by other means, or they settle, prematurely.

I do not want to go down the rabbit hole of opioid addiction, but I have to believe that if people were not waiting on the bench for surgeries they need but cannot afford, the number of people suffering from drug addiction would decrease. But alas, I digress.

The other unfortunate reality is that if doctors treat you on a lien, they turn into brokers for their own services, and end up in a business they never intended to be in. When their payout depends on the outcome of a patient’s insurance claim, there is almost always a misallocation of priorities and the right thing rarely gets done.

In addition, insurance companies love to find doctors who have a financial interest in the outcome of a case. They will use this against plaintiffs, claiming that the doctor is an investor in the case and is only saying the things they are saying in order to get paid. This never looks good to a jury, which is why we highly recommend that if you are unable to pay for a surgery yourself, make sure you have the backing of a legal funding company, like Cherokee Funding, so that doctors are paid for their services and there is no conflict of interest.

In these instances, doctors should only be involved to share their professional opinion, not the opinion they have if their own livelihood is at stake.

And Just Like That, They Settle
In all of my years in the legal funding industry, and without dating myself too terribly, I have never seen plaintiffs get rich from their settlements, and I would estimate I have probably been involved in upwards of 30,000 claims.

This is a very human business, and it is people’s lives and ways of life on the line.

But unfortunately, the average plaintiff involved in an insurance claim often gets misconstrued as greedy or money-hungry. The reality is, liability has been established and people have been involved in catastrophic accidents, due to no fault of their own, that have left them unable to work, unable to pay their bills and when they settle for what the insurance companies offer because they have to out of financial necessity they end up with long-term medical liabilities they are unable to pay.

There are exceptions to this, of course, and we often coach people who call us for legal funding away from larger advances, but the vast majority are just barely getting by.

Insurance companies have it figured out. They know exactly how much people make per year and roughly what their living expenses are. They know exactly what the bills associated with these accidents will ultimately be. And they know exactly how much to offer in a settlement, which is usually just enough to get it so that most people cannot say no. And ultimately, they end up saving tens of thousands of dollars in money owed to these plaintiffs.

Big data is a big business, but unfortunately, it is working against most people.

Enter Legal Funding
We are not lenders and these are not loans because in our business there is no guarantee of repayment. We provide non-recourse cash advances and fund medical treatment for plaintiffs filing legitimate claims for accidents that have left them unable to work.

That is what we do.

We are in the business of advancing as little cash as possible to plaintiffs so they keep as much as possible at settlement. We are in the business of paying for high-quality medical treatment to allow plaintiffs to get back on their feet and living their lives. The services we provide pay for time so attorneys are able to do their job on behalf of the plaintiffs they represent. In effect, we are simply trying to even the playing field. The data science is simple, with time, plaintiffs receive higher average settlements.

Let’s face it, insurance companies might seem relatable, but their pockets run deep and so do their interest levels. The likable characters we see in their commercials are not their adjusters and are certainly not the people that show up in the courtroom when a claim goes to trial.

The post The Human Side of Big Data in Insurance Claims and Legal Funding You Haven’t Thought About appeared first on Gain Servicing.