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Tag Archive for 'insurance'

Paying the Price: Getting Screwed By Your Insurance Company!

Nothing makes me madder that insurance companies screwing their customers: you and me! I have said it before and I will say it again: The insurance industry is the only business in America that does not want you to use their product. They want you to buy it, sure, but they damn well don’t like it if you actually use it. Suing an insurance company for bad business practices is one of the most fulfilling things lawyers do.

The American Association of Justice (of which I am a proud member) continues to fight for consumers when it comes to exposing insurance company tactics to make money at the expense of their customers, the people who pay the premiums for their insurance policies. In their recent report “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse” you might find an explanation of why your insurance company was so difficult to deal with. And don’t forget “The Ten Worst Insurance Companies.”

Listen to the interview, but here is a quick overview. See if you recognize your insurance company!

Executive Summary: The U.S. insurance industry has trillions of dollars in assets, enjoys average profits of over $30 million a year, and pays its CEOs more than any other industry. But insurance companies still engage in dirty tricks and unethical behavior to boost their bottom line even further. The current economic turmoil affecting the insurance industry on Wall Street has only made the outlook bleaker for consumers living on Main Street. Insurance companies are likely to demand huge rate hikes and refuse more claims than ever. Some of America’s most well-known insurance companies—the same ones that spend billions on advertising to earn your trust—have endeavored to deny claims, delay payments, confuse consumers with incomprehensible insurance-speak, and retroactively refuse anyone who may cost them money. This report describes some of the most egregious ways the insurance industry attempts to make money at the expense of consumers. These are some of the tricks of the trade:

Denying Claims: Some of the nation’s biggest insurance companies— Allstate, AIG, and State Farm among others—have denied valid claims in an attempt to boost their bottom
lines. These companies have rewarded employees who successfully denied claims, replaced employees who would not, and when all else failed, engaged in outright fraud to avoid paying claims.

Delaying Until Death: Many insurance companies routinely delay claims, knowing full well that many policyholders will simply give up. Some have gone so far as to lock paperwork away in safes. Undoubtedly, the most shameful use of delay tactics has been by long-term care insurers, who often take advantage of their policyholders’ age and ill health. In the words of one regulator, “the bottom line is that insurance companies make money when they don’t pay claims…They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.”

Confusing Consumers: Insurance contracts are some of the most dense and incomprehensible contracts a consumer is ever likely to see. More than half of all states have enacted “plain English” laws for consumer contracts, yet many Americans still do not fully understand the risks they are subject to.5 After Hurricane Katrina, insurance companies used obscure “anti-concurrent” clauses to get out of paying claims. Consumers who purchased hurricane insurance and thought they were covered suddenly found the coverage eliminated by an obscure clause they could not hope to understand.

Discriminating by Credit Score: Increasingly, insurance companies are using credit reports to dictate the premiums consumers pay, or whether they can even get insurance in the first place. The practice penalizes the poor, senior citizens with little credit, and those who have suffered financial crisis through no fault of their own. Insurance companies have denied fiscally responsible people who paid their bills in cash, but refused renewals because of a lack of credit history. Others have seen auto rate hikes near 600 percent despite clean driving records after falling on economic troubles.

Abandoning the Sick: Health insurers looking to cut costs have taken to canceling retroactively, or rescinding, the policies of people whose conditions have become expensive to treat. Some insurance companies have even offered bonuses to employees who meet “cancellation goals.” Rescission targets patients in the midst of treatment when they are at their most vulnerable—even cancer patients in the midst of chemotherapy have been targeted.

Canceling for a Call: Many people are rightly reluctant to make small claims on their home insurance for fear their insurance company will raise their premiums. But few realize that insurance companies often refuse to renew a policy because the policyholder did as little as inquire about the possibility of making a claim.Many times an insurance company will count an inquiry over the phone as the same as a claim, and then they will do everything in their power to drop the policyholder.

The moral of this story: Find a lawyer, sue the bastards!

 
 Ray Lorenzi, American Association of Justice [30:20m]: Play Now | Play in Popup | Download (313)

Voice for the Uninsured!

Do you have health insurance? Do you need health insurance? Does a pre-existing condition prevent you from getting insurance? Can you afford health insurance? These are questions facing many Americans each and every day.

You may have seen the TV ads where doctors say that people who need their services are not coming to see them because they have no insurance. Nice ad. It’s sponsored by the American Medical Association as part of its campaign “Voice for the Uninsured.” The website is full of what they call “Real People, Real Stories.”

In this interview with Dr. Joseph Heyman discusses the issue of the uninsured in America. Dr. Heyman believes that now is the time to solve this problem. Unlike the Clinton effort in 1994, solving the problem is now the focus of a wide variety of business and political interests and the chances of everyone coming together to a successful resolution is better than ever.

If you want to read the whole thing, you can, or check out the overview. Here is a portion:

The AMA proposal to expand health insurance coverage and choice is based on three pillars:

1. Subsidies for those who most need financial assistance obtaining health insurance.

This assistance could take the form of tax credits or vouchers, should be more generous at lower income levels, and should be earmarked for health insurance coverage. It is important to note that the government already gives people financial assistance to buy private health insurance—well over $125 billion each year—with an employee income tax break on job-based insurance that is hidden from public view. This tax break gives more assistance to those in higher tax brackets, and gives no assistance to those without employee health benefits. Shifting some or all of this assistance to tax credits or vouchers for lower-income people would reduce the number of uninsured and improve fairness in the health care system.

2. Choice for individuals and families in what health plan to join.

Today people are effectively locked into the health plans their employers offer, often just one or two plans, which are subject to change from year to year. A change in employment typically means a change in insurance coverage. In contrast, under the AMA plan, people could use tax credits or vouchers to help pay for premiums of any available insurance, whether offered through a job, another arrangement or the open market. As with job-based insurance today, health plans would still have to meet federal guidelines for covered benefits, but people would have greater say in what types of benefits and plan features they value. Coupled with individual choice, tax credits benefit recipients directly, and everyone indirectly, by stimulating the market for health insurance. If enough people have enough purchasing power—and enough say over how that purchasing power is used—insurers will be compelled to offer better, more affordable coverage options.

3. Fair rules of the game that include protections for high-risk patients and greater individual responsibility.

For markets to function properly, it is important to establish fair ground rules. A proliferation of state and federal health insurance market regulations has made it more difficult and expensive for insurers to do business in many markets. The AMA proposes streamlined, more uniform health insurance market regulations. Regulations should permit market experimentation to find the most attractive combinations of plan benefits, cost-sharing and premiums. It is also important that market regulations reward, not penalize, insurers for taking all types of patients. People should have a guarantee that they will not lose coverage or be singled out for premium hikes due to changes in health status. Market regulations intended to protect people who have high health risks typically have backfired, sometimes disastrously, by driving up premiums for younger, healthier people and leading them to drop coverage.

To help high-risk people obtain coverage without paying astronomical premiums, additional targeted government subsidies are needed for high-risk people that would allow insurers to keep premiums down in the regular market. Individuals also need to be encouraged to play fairly by taking responsibility for obtaining health insurance without waiting until illness strikes or medical attention is needed. People who are uninsured despite being able to afford coverage should face tax implications.

Everyone needs to write their Congressman and Senators and tell this to fix this thing!!

 
 Dr. Joseph Heyman, American Medical Association [31:05m]: Play Now | Play in Popup | Download (379)

Have You Heard About Insurance Company Rules?

Insurance Reform and Agritourism: One Step Forward, Two Back

I am happy to report that the Georgia Legislature appears to be headed toward doing something that actually benefits the citizens of Georgia. What is it? A necessary reform in the law that will help make sure that when citizens pay for insurance coverage, they get the benefit of what they pay for.

In this interview Bill Clark of the Georgia Trial Lawyers Association (GTLA) explains the change in the UM (uninsured motorists) coverage which will become law if SB 276 is enacted. It passed the Senate last year, but got stuck in the House. This year it looks like it may actually make it to the Governor’s desk and hopefully he will sign it.

EVERYONE NEEDS TO UNDERSTAND UNINSURED MOTORISTS COVERAGE! UM coverage pays you for damage to you vehicle and injuries to your body (and the bodies of other passengers) if you are involved in an accident with another vehicle that is uninsured or that is underinsured. It is dirt cheap. A lot of people elect not to purchase UM coverage because the law does not require you to have it. But it is a mistake not to have it. If you don’t know what your policy provides, you need to check it and if you don’t have UM coverage, you owe it to yourself and your passengers to get it. It is that simple.

Under the current state of the law, if you purchased $100,000 of UM coverage and you were hit by a vehicle that had a $100,000 of liability insurance, the law prohibited you from getting any benefit from your UM coverage (even though you paid for it) because your UM insurance company got credit for the liabillity coverage of the driver that hit you. It makes no sense, but that is the way the law evolved.

Just be thankful that if this law gets signed by the Governor, if you pay for $100,000 in UM coverage, you will get the benefit of that $100,000 in UM coverage. And remember, GTLA, the trial lawyers of Georgia (of which I am proud to be a member), fought to get this changed.

And when it comes to “agritourism”, GTLA is fighting the insane idea that “agritourism” businesses should not be held responsible for their negligence. Thus, if you want to hunt or fish on someone’s property, and they cause you an injury, you can’t sue them for your injuries unless they were grossly negligent (meaning they just about intended to harm you). However, if exactly the same thing occurred in some other business (Walmart), you could hold them responsible for simply being negligent, failing to exercise ordinary care.

On top of that, the Senate bill, SB 449, is entitled “Landowners Protection Act of 2008.” What does it protect landowners from? Responsibility! This is the kind of irresponsible legislation that is maneuvered through the legislature by some lobbyist paid for by some group, some business interest, that wants special treatment. It is the kind of legislation that moral leadership should oppose.

Here is the entire text of the statute:

(a) A landowner who allows a person who is 16 years of age or older to hunt or fish on the owner´s property shall be immune from civil liability for any acts done by such person on such property, provided that the landowner´s conduct does not constitute gross negligence or willful and wanton misconduct.
(b) A landowner who allows a person who is 16 years of age or older to enter the owner´s property for purposes related to agritourism, as such term is defined in subparagraph (p)(7)(B) of Code Section 48-5-7.4, shall be immune from civil liability for any acts or omissions of the landowner that do not constitute gross negligence or willful and wanton misconduct.”

Note that it excludes people under 16 years of age. GTLA was instrumental in pointing out that businesses ought not to be encouraged to injury minors needlessly. While I appreciate GTLA’s effort in protecting minors, I cannot help but point out that it makes no sense to encourage hurting people older than 15. Such is the strained wisdom of the Georgia legislature.

SB 449 has passed the Senate and is awaiting action in the House. It’s primary sponsors are Senators Bill Heath (R-31), Joseph Carter (R-13), Ross Tolleson (R-20) and George Hooks (D-14).

A similar bill was introduced in the House, HB 584, and is sponsored by Calvin Hill (R-21). At least it is going nowhere.

So there you have it. On the one hand, our legislature reforms the UM law to make sure consumers get what they pay for. On the other hand, they are considering excusing agritourism businesses for their negligence. One step forward, two steps back.

Someone needs to call their legislators.

 
 Bill Clark, GTLA Legislative Coordinator [31:06m]: Play Now | Play in Popup | Download (726)

Interview with Jay Angoff, former Insurance Commissioner of Missouri and Attorney

Jay Angoff, former Insurance Commissioner of Missouri and Attorney, tells us once again that "tort reform" was a deception by the insurance industry that has lead to higher premiums for doctors, more profits for the insurance companies and less justice for the rest of us.

 
 Standard Podcast [28:28m]: Play Now | Play in Popup | Download (635)

Interview with Charlotte Perrell, Atlanta Attorney

Charlotte Perrell, Atlanta Attorney, discusses her trip to D.C. and the growing practice of doctors and insurers requiring patients and insured to agree to arbitrate claims and disputes without going to court and having a jury decide the issues. Folks, listen up! Read what you sign and join the fight to keep medical providers and insurers from getting an unfair advantage when they injure you.

 
 Standard Podcast [28:05m]: Play Now | Play in Popup | Download (494)

Interview with David Berardinelli

David Berardinelli is an attorney from Santa Fe, N.M. David has written a book about Allstate Insurance Company and its scheme to save money by jerking its policyholders around. The name of the book is "From Good Hands to Boxing Gloves." What else could it be named. If Allstate has you in its "Good Hands", you really need to listen to this interview.

 
 Standard Podcast [29:13m]: Play Now | Play in Popup | Download (536)