Shea v. Esensten
http://caselaw.findlaw.com/us-8th-circuit/1229841.html -Describe what happened in this case. Who are the parties in this case? Mrs. Shea is claiming the action of wrongful death and misrepresentation. Describe the elements of wrongful death and misrepresentation. Describe the elements for wrongful death and/or misrepresentation in this case. The doctor, in this case, is alleging human error. Discuss the evidence present in this case to support a human error defense. Did there appear to be a misrepresentation by the insurance company and if so, did it affect Mr. Shea’s ability to make an informed decision about his medical care? Please cite examples for or against the claim of misrepresentation. Mrs. Shea asserted that the insurance company’s behind the scenes efforts to reduce covered referrals violated the insurance company’s fiduciary responsibilities. Legally and ethically, what responsibilities do Managed Care Organizations (MCOs) have to beneficiaries of plans? Legally, do insurance companies have a responsibility to disclose or warn beneficiaries of all business practices including financial incentives or compensation agreements with providers? Explain. As the federal government is progressively getting more involved in healthcare plans, should they pass legislation to eliminate or criminalize financial incentive arrangements? Are financial incentives to medical providers ethical? Why or why not? If you tried this case in front of a jury, what would be your verdict? If you ruled in favor of Mrs. Shea, what damages would you award? If you ruled in favor of Esensten, discuss why you did not feel he was liable. Please support your award with a logical rationale. Your analysis should be a minimum of two pages Use APA to format your paper and cite your sources.
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