Judge denies NFL’s request to examine fraudulent claims

A federal judge has denied the NFL’s request to look into an estimated 400 claims on the $1 billion concussion settlement from 2017. The league requested that a special investigator look into these claims, pointing out that fraudulent ones are slowing down payments of valid claims.

The judge denied the claim recently, ruling that a special master and a claims administrator have effectively determined false claims so far. The judge conceded, however, that there was enough evidence of probable fraud to warrant concern.

The settlement

The initial settlement addresses thousands of lawsuits where former players and their families accused the league of knowing that players were at risk for neurological issues caused by concussions, including higher than normal instances of Lou Gehrig’s disease, dementia and other neurological problems. Awards so far have been as high as $5 million. As of July 2018, 499 claims have been awarded for the total amount of $485 million.

NFL questions some claims

The NFL voiced concern that some players, lawyers and doctors were taking advantage of the settle by making fraudulent claims. For example, some of the examinations took place in lawyer’s offices or hotel rooms instead of clinics, and one doctor was said to spend seven to 12 hours examining a patient yet approved as many as eight claims a day for eligibility.

Mistakes can happen

There have been decisions to tighten controls over approvals by using a specific list of physicians. Between this and special master and claims administrator, the judge ruled that false claims were being addressed and payments were happening in a timely fashion. Unfortunately, these people and others in their position can make mistakes and erroneously deny the claim or the appropriate amount of the claim. Attorneys with experience handling these disputes can be a tremendous help to individuals and their families.

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