ProBonoPower

Pro Bono Power
 
PAJ Past President John M. Gallagher, Esq.
demonstrates the power of the pro bono practice

Hit and run victim Norman DeCindis of Media, who was rendered partially quadriplegic at 16, was denied financial assistance by a little-known Pa. non-profit insurance association that was established to help people in his plight. Only through the efforts of the Legal Clinic for the Disabled (LCD), and Past President, John M. Gallagher, Esq. of Media, acting pro bono, was DeCindis able to obtain the devices and services that enable him to live independently.

The non-profit association, the Pennsylvania Financial Responsibility Assigned Claims Plan (the Plan), which is funded by insurance companies who collect premiums from Pa. drivers, was established to financially assist victims of motor vehicle accidents where the wrongdoer is uninsured or, as in this case, unknown. But the Plan denied DeCindis important financial assistance.

Examples of the Plan’s denials:

1. In 2007, DeCindis, now 41, was making a daily 42-mile round trip to Magee Rehabilitation Hospital to use a functional electrical stimulation (FES) bicycle. The device, prescribed by DeCindis’ doctor, stimulates DeCindis’ leg muscles, causing them to move, providing the only regular leg exercise that DeCindis can get. But the Plan refused to pay for an in-home FES bicycle for DeCindis, claiming that he might burn himself on the bicycle motor.

2. DeCindis also applied for assistance to purchase a doctor-prescribed medical device called a “standing frame,” which enables him to maintain a standing position. This form of therapy prevents skin breakdown, improves posture alignment, increases respiration and ventilation, enhances digestion, bowel and bladder function, and increases bone density. But the Plan refused to pay for the standing frame, claiming that DeCindis might fall out of it.

3. The Plan denied DeCindis two other requests for assistance – for a MRI examination and for a van conversion so he could drive – without adequate explanation. DeCindis’ four requests for assistance totaled $25,979.93.

“The reasons for denying Norman’s claims were baseless. It didn’t matter that his doctor and physical therapist provided the required medical documentation to the Plan,” said Esther Miller, Esq., LCD Managing Attorney. According to Miller, “It was like dealing with a secretive organization. I could never get any further than a front-line claims officer. The only way for Norman’s demands to be taken seriously was to file a lawsuit.” That’s when Miller turned to the Pennsylvania Association for Justice (PAJ) and a PAJ past president, John M. Gallagher.

Gallagher asked the Plan for documents to support its reasons for denying DeCindis’ claims. The Plan’s law firm responded by dumping on Gallagher a CD containing more than 20,000 documents.

Nevertheless, Gallagher was able to win for DeCindis a $23,443.93 arbitration award and the Plan settled out for $17,852.93 in July 2013. How much the Plan paid for its defense is unknown. DeCindis is now gaining a degree of independence by giving his aging body, greatly affected by years of paralysis, the essential physical therapy he needs. Said Gallagher, “I am of course very happy that Norman can undergo therapy more independently now. But the bigger point here is that pro bono legal work can accomplish a lot of good for people in tremendously difficult circumstances.”

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