My personal injury client settled but refuses to pay the treating physicians' bills I secured with a lien. Can I pay the doctors anyway, and what are my options?

Plain-English summary

The inquiring attorney had executed an attorney-insurance carrier lien to secure payment of a treating physician's fees on behalf of a client in a personal injury case. A chiropractic physician submitted a bill for $1,545 and an emergency medical services bill for $97 was also submitted. The personal injury claim settled, but the client refused to pay the entire medical billings and agreed to pay only $500 of the chiropractor's bill.

The panel took the position that the inquiry is governed by the Interprofessional Code of Cooperation for the Rhode Island Bar Association and the Rhode Island Medical Society, whose Article 4 makes a physician's fee the sole obligation of the patient and directs attorneys to obtain authority from the client to pay medical bills directly. The panel also drew on its prior opinions 89-16 and 90-3: in 89-16 it advised a lawyer to withdraw under Rule 1.16(b)(3) where the client insisted on a course the lawyer considered repugnant or imprudent, and in 90-3 it applied Rule 1.2 (Scope of Representation), holding that a lawyer must abide by the client's decisions about the objectives of the representation and cannot superimpose the lawyer's judgment on the client.

In light of those opinions, the panel concluded that the attorney may move to withdraw from further representation under Rule 1.16(b)(3) if the client insists on a course the attorney considers repugnant or imprudent. The panel further concluded that the attorney may not compel payment of the outstanding medical bills from the settlement funds, and that if the matter is not readily resolved, the attorney, as stakeholder, should pay the funds into the court registry in an interpleader proceeding.

Currency note

This opinion was issued in 1991, after the Rhode Island Supreme Court adopted the Model Rules of Professional Conduct effective November 15, 1988, and it applies Rules 1.2 and 1.16 as originally adopted. The Rhode Island Supreme Court later revised the Rules of Professional Conduct in 2007 as part of the nationwide Ethics 2000 process, which renumbered and amended several provisions. Subsequent rule amendments or later opinions may have changed the analysis. Treat this page as historical context, not current guidance. Verify against current rules before relying on any specific rule mentioned here.

Common questions

Q: Can I pay a client's medical providers from settlement funds when the client refuses?

A: Under this opinion, no. The panel concluded the attorney may not compel payment of the outstanding medical bills from the settlement funds.

Q: May I withdraw if the client insists on not paying?

A: Per the opinion, the attorney may move to withdraw under Rule 1.16(b)(3) if the client insists upon pursuing a course of conduct the attorney considers repugnant or imprudent.

Q: What do I do with the disputed funds?

A: Per the opinion, if the matter is not readily resolved, the attorney, as stakeholder, should pay the funds into the court registry in an interpleader proceeding.

Background and rules framework

The opinion applies Rule 1.2 (Scope of Representation) and Rule 1.16 (Declining or Terminating Representation), corresponding to Model Rules 1.2 and 1.16, together with the Interprofessional Code of Cooperation between the Rhode Island Bar Association and the Rhode Island Medical Society. Rule 1.2 requires the lawyer to abide by the client's decisions on the objectives of the representation, and Rule 1.16(b)(3) permits withdrawal where the client insists on a course the lawyer considers repugnant or imprudent. The panel combined these authorities to hold that the attorney could not unilaterally pay the physicians but could withdraw and, failing resolution, interplead the funds.

Citations and references

Rules of Professional Conduct:

• MR 1.2 (scope of representation)
• MR 1.16 (declining or terminating representation)
• RI RPC 1.2, RI RPC 1.16

Statutes:

• None cited.

Cases:

• None cited.

Other opinions cited:

• RI EAP Op. 89-16: withdrawal under Rule 1.16(b)(3) where a client wrongfully refuses to release escrowed funds.
• RI EAP Op. 90-3: a lawyer must abide by the client's decisions under Rule 1.2 and cannot superimpose the lawyer's judgment on the client.

See also

• RI EAP Op. 91-32: Paying Medical Providers From a Client's Settlement Funds
• RI EAP Op. 95-12: Disputed Medical Lien on Settlement Funds
• RI EAP Op. 95-60: Paying a Health Insurer Lien Versus a Mere Claim

Source

• Landing page: https://www.courts.ri.gov/attorney-resources/Pages/Ethics-Advisory-Panel-default.aspx
• Original PDF: https://www.courts.ri.gov/Opinions/EAP%2091-37.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain; the linked PDF is authoritative.

Digest of Ethics Advisory Panel
Opinion #91-37
Issued May 23, 1991

An attorney seeks Panel advice concerning the attorney's obligations to both the client and a treating physician under circumstances in which the inquiring attorney executed an attorney-insurance carrier lien to secure payment of the physician's fees on behalf of a client in a personal injury case. The attorney advises the Panel that a chiropractic physician submitted a bill for fifteen-hundred and forty-five ($1545.00) dollars for services rendered. A bill for emergency medical services in the amount of ninety-seven ($97.00) dollars was also submitted. The personal injury claim was settled, but the client refused to pay the entire medical billings. The client agreed to pay only five-hundred ($500.00) dollars of the chiropractic doctor's bill.

The Panel takes the position that the issues raised in this inquiry are governed by the "Interprofessional Code of Cooperation for the Rhode Island Bar Association and the Rhode Island Medical Society" (hereinafter the "Code"). Article 4 of the "Code" provides in pertinent part:

ARTICLE 4
PHYSICIAN'S BILL FOR MEDICAL SERVICES

4.1 It is recognized that a physician's fee for professional services rendered to a patient is the sole legal obligation of the patient and independent of any litigation.

4.2 Attorneys must recognize that they have an obligation to the physicians who supply them with records, reports and bills to cooperate with such physicians in obtaining payment of bills for services rendered to a patient in cases where claims for medical disability are the subject of litigation.

4.3 Attorneys should advise their clients that bills rendered for such medical services by a physician are the sole responsibility of the client and are independent of pending litigation, and that such bills are due and payable when rendered by the physician. Attorneys should also incorporate into their agreements with clients an assurance that treating physicians will be paid any unpaid balances from the proceeds of the case.

4.4 Counsel should obtain authority from the client to pay medical bills directly to the physician in the event of a settlement or judgment in accordance herewith.

Page Two

The Panel takes the position that the issues raised in this inquiry were addressed in Panel opinions 89-16 and 90-3. In opinion 89-16, the Ethics Advisory Panel advised a lawyer whose client wrongfully refused to release money from an escrow account maintained by the lawyer and two other parties to a transaction that the lawyer should withdraw from representation of the client under Rule 1.16(b)(3) of the Rhode Island Rules of Professional Conduct. Withdrawal under Rule 1.16(b)(3) is proper where the client insists upon pursuing a course of conduct which the lawyer considers repugnant or imprudent. In opinion 90-3, the Panel cited Rule 1.2, entitled "Scope of Representation", in advising a lawyer who feared his/her client did not appreciate the potentially dire legal consequences of the course of action the client sought to pursue. Rule 1.2 provides that a lawyer shall abide by the client's decisions concerning the objectives of the representation. Rule 1.2 also states that the lawyer shall consult with the client concerning the means by which the client's objectives are to be pursued. In opinion 90-3, the Panel determined that the attorney had fulfilled the consultation requirement of Rule 1.2. The Panel opined that the lawyer could not superimpose his/her judgment upon the client, no matter how laudable the lawyer's motives might be.

In light of the above cited opinions, the Panel is of the opinion that the inquiring attorney may move to withdraw from further representation of this client under Rule 1.16(b)(3) if the client insists upon pursuing a course of conduct the attorney considers repugnant or imprudent. The Panel is of the opinion that the attorney may not compel payment to the physicians of the outstanding medical bills from the funds received in settlement of the client's claim. If the matter is not readily resolved, the attorney, as the stakeholder, should pay the funds into the court registry in an interpleader proceeding.

Ethics Advisory Panel advice is protective in nature. There is no requirement that an attorney abide by a Panel opinion, but if he or she does, he or she is fully protected from any charge of impropriety.