A patient fills out a medical form in a hospital office.
Editor’s note: This is the fourth article in a four-part series on the fight to expose who and what are fueling Georgia’s lucrative market for car-wreck lawsuits. Part one, “Hush Money,” can be read here. Part two, “Money Machine,” is here, and part three, “Friend Zone,” is here.
After years of trying, defense lawyers in Georgia finally lifted the veil of secrecy over the intricate relationship between a plaintiff law firm and the medical care professionals they needed to prove their case. The jury didn’t like what they saw – like doctors waiting for permission from attorneys to perform surgery.
Previous articles in this series explain the repeat business conducted by doctors and personal-injury lawyers and the battle to expose it in court. In Fulton County Superior Court in May, jurors were told that Witherite Law Group had referred hundreds of patients to the same doctors over vehicle accidents, generating millions of dollars in medical bills for a single orthopedic clinic.
They deadlocked. Plaintiff Philip Manire was seeking $900,000, but jurors couldn’t decide between awarding him $10,000 or nothing at all.
It was a prime example of why lawyers fight so hard to keep jurors from seeing this information. To win million-dollar settlements, they need hundreds of thousands of dollars in medical bills. They also need physicians willing to testify the plaintiff needed all that treatment and his injuries were caused by the accident he is suing over.
Defense lawyers say jurors deserve to know that doctors who testify as expert witnesses have a financial interest in their patient’s success in the courtroom. Many treat lawsuit patients under medical lien arrangements, in which the doctor has a legal claim on whatever the patient wins in court. Doctors often sell those liens at a discount to third-party litigation funders, under contracts that subject them to financial penalties if they don’t support the plaintiff’s case.
“We do our best to keep premiums low, but when you’re fighting with one hand behind your back it’s hard,” said Travis Ginest, general counsel at the Owner-Operator Independent Drivers Association, which represents truckers and provides them with insurance. “A lot of states will not allow you to get discovery of communications between the plaintiff attorney and the doctor, or between the doctor and the third-party finance firm.”
That protective wall is starting to crumble. In influential opinions issued in recent years, judges in Georgia and elsewhere have ruled that a close doctor-lawyer relationship is relevant evidence that the testifying expert might be biased. And in the case of Manire, that meant the loss of a million-dollar claim.
Manire sued after his vehicle was rear-ended by a truck owned by a lawn-care company. He went to the emergency room a day later, where his medical report showed he complained of neck and lower back pain. X-rays didn’t show any acute injuries. He was given some Motrin and left before reviewing results with hospital staff. The bill came to $3,800.
His next stop was a lawyer’s office, where staff there referred him to an orthopedic specialist. The first one found rotator cuff damage, “not specified as traumatic.” So the law firm referred him to a second orthopedic clinic, which apparently found much more. By the time Manire sued in 2023, he claimed $247,000 in “special damages,” or medical expenses. He asked the jury to award him $925,000, including damages for pain and suffering, lost wages and continuing medical care.
After a hard-fought battle, Fulton County judge Wesley Tailor ordered discovery into communications between Manire’s lawyers at the Witherite firm and his medical providers, including Barbour Orthopedics. That showed Witherite had referred 532 clients to Barbour over a two-year period ending in 2022, producing $8 million in bills. In all, Barbour took in 29,000 lawyer referrals over that same period, generating $238 million in bills. (Barbour didn’t respond to a request for comment through its lawyer but typically collects about 40% of what it bills medical lien patients).
The documents also showed lawyers working closely with Barbour, including an exchange where an employee at the medical clinic repeatedly asks a counterpart at Witherite to approve a surgical procedure. The jury saw call logs repeating this pattern with other patients.
It was all familiar to Ginest of the trucking association, who has spent years overseeing the accident claims process. “I’m seeing a medical report drafted by an attorney and signed off on by a doctor,” he said.
The defendant in the Manire case never challenged liability; it was a rear-ender, and the last vehicle is almost always liable. But the defense did challenge the plaintiff’s medical bills and the jury agreed, disagreeing only on how little to award him.
For Ginest, who is constantly fighting to keep insurance costs down for independent truckers, it was a small victory in a long war.
“A lot of trial court judges simply don’t believe this is happening,” he said. “It took a long time in Georgia to get where we are.”
Rising auto-insurance rates have led to a closer look at the role car-wreck cases play in raising premiums in Georgia and elsewhere. In New York, Gov. Kathy Hochul successfully pushed for reforms that target staged crashes and insurance fraud. In Florida, rates have lowered after the enactment of laws that reduced litigation costs.
Companies have increasingly gone to court, suing lawyers and doctors over the volume of cases they bring. Uber has filed a handful of RICO cases, with its Philadelphia case against a lawyer recently getting a green light from a federal judge. FedEx, in a New York lawsuit, cites an August 2019 accident in which a plaintiff complained at an emergency room of shoulder pain but said there were no headaches, neck or back pain.
However, two days after the accident, he visited NYC Care PT at 632 Utica Ave. He was prescribed physical therapy, massage, ultrasound therapy and electrical stimulation for pain in his neck and back. Other companies at the same address also provided physical therapy, as well as acupuncture and chiropractic treatments. In the months after the wreck, he visited these providers more than 120 times, FedEx says, driving up medical costs for his lawsuit against the company.
“Greedy lawyers, doctors, and litigation funders have built a rewarding ecosystem of abuse,” said Steven Waguespack, President of the U.S. Chamber Institute for Legal Reform and senior vice president of Federation, State and Local Advocacy. “They are staging car accidents, performing unnecessary surgeries, and fabricating medical claims, all on the backs of hardworking Americans.
“These illegal schemes inflate insurance premiums and raise the costs of everyday goods and services that families depend on.”
