Insurance Companies Still Playing Dirty

Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released by the staff of the Senate Commerce Committee. Testimony provided by three heath-care specialists highlighted the tactics the insurance industry uses to avoid paying benefits they are contractual required to pay. Insurance companies routinely use fear tactics to confuse and mislead consumers about what benefits they are entitled to.

Wendell Potter, the former vice president of Cigna, testified that “insurers make paperwork confusing because they realize that people will just simply give up and not pursue it.” Potter went on to testify that he worries "that the industry's charm offensive, which is the most visible part of duplicitous and well-financed PR and lobbying campaigns, may well shape reform in a way that benefits Wall Street far more than average Americans."

Misinformation, through PR campaigns and outright lies to consumers is at the heart of the insurance crisis in America. I have previously highlighted the type of public misinformation campaigns insurance companies employ to increase their profits. It’s time to demand more accountability and transparency from insurance companies. Why should we continue to pay increased premiums for fewer benefits while the insurance companies continue to rake in profits?
 

Automakers Balance Sheets More Important Than Human Life

A new study predicts that defective General Motors and Chrysler vehicles sold before the bankruptcies will continue to cause deaths and injuries that are immune from lawsuits long into the future. The study predicts that more than 3,400 Americans will be injured or killed by a defective vehicle over the next year. The report, "Public Safety at Risk: Bankruptcies Leave Legacy of Defects, Injuries and Deaths," also predicts fewer recalls, decreasing public safety.



In their bankruptcy proceedings, both Chrysler and General Motors are seeking exemption from pending and future lawsuits. This means that anyone injured by a defective automobile from either of these manufacturers would not be able to recover medical damages, pain and suffering damages, or other civil damages. Both companies would still be responsible or issuing product recalls, but would no longer be responsible for the damage their defective products cause. This, according to the report, lowers the incentive for the manufactures to issue product recalls on their former products.


The report, finds that between 2003 and 2008, Chrysler had 3,497 death and injury claims; GM had 15,284. With more than 40 million vehicles in the U.S. fleet, the two companies accounted for 47 percent of all claims filed against auto manufacturers during that time period. Yet, these manufacturers only represent 38 percent of the market share. From 2004 to 2008, Chrysler issued 109 recalls, affecting 11.4 million vehicles; GM launched 129 recalls, affecting 19 million vehicles.
 

Corporate America and the bankruptcy courts are telling us that injuries and deaths to American citizens are less important than the reorganization of GM and Chrysler. Somehow we have gotten away from the simple principle that when someone causes you harm, they are required to put you back in the position you would have been in but for the harm they caused you. Is this really the direction we want to take as a society? What will be next? Will all major corporations be allowed to reduce their liability by going through bankruptcy? Are balance sheets more important than human life?
 

Can Burn Victims Recover For Disfigurement in Missouri Workers' Compensation?

A Missouri worker was recently injured at work after a series of explosions inside his St. Charles workplace. The explosions created a significant fire that took several hours to put out. Fire officials report the SantoLubes worker suffered burns to over 30 percent of his body. The explosions happened at the an industrial site at 8 Governor Place just south of Highway 370 at the intersection of Elm Point Road and Governor Drive in St. Charles, Missouri.

When a Missouri worker is injured at work they typically recover medical treatment, lost wages, and disability benefits. When a worker is burned or has permanent scarring they are entitled to recover disfigurement benefits. Disfigurement includes visible scars or deformities to the body due to a work-related injury. These deformities are usually on the head, neck, hands or arms. Disfigurement is also available for loss of an employee’s front teeth. Benefits for disfigurement are determined by a formula based on wages the 13 weeks prior to the work injury and are awardable in weeks not to exceed 40. When disfigurement benefits are involved in a claim an injured worker should consult with an experienced Missouri workers’ compensation attorney to ensure they receive all the benefits they are entitled to.

 

Why Everyone In Missouri Should Check Their Uninsured and Underinsured Motorist Coverage

An O’Fallon, Missouri, teenager was recently charged with a felony leaving the scene of an accident. During these tough economic times it is imperative to take notice of uninsured and underinsured motorist coverage. Recent reports indicated that in Missouri, the rate of uninsured motorists is 14% and rising.

Underinsured motorist protection covers damages that exceed the amount of coverage carried by a negligent driver. Underinsured coverage typically pays up to the limits of your policy after subtracting the amount paid by the other driver's insurance. This type of coverage applies to you, anyone in your car, and any family member listed on your policy that is injured in another car.

Uninsured motorist protection covers you if you are in an accident with an uninsured motorist. But it also does much more. If you are injured as a pedestrian you will be covered. Best of all, uninsured motorist coverage also protects you and family members traveling in other cars.

If you get into an accident with someone who doesn’t have insurance or has a minimum policy of $25,000, you are at great risk of not being fully compensated for all of your injuries. By purchasing uninsured and underinsured motorist coverage, usually at pennies on the dollar, you ensure that you will be made financially whole if you have the misfortune of being involved in an auto collision.

If you are in a car accident with someone who has a minimum policy of $25,000 and your medical bills are $35,000 their policy won’t even cover all your medical bills. What about lost wages, future medical bills, and pain and suffering? With underinsured motorist coverage your insurance would cover the difference. This is why it is important to review your insurance policy and consider adding uninsured and underinsured coverage. If you are unsure how the details of your auto insurance policy will protect you if you are in a car wreck, contact an experienced Missouri car wreck attorney.
 

What Types Of Benefits Are Available Under Missouri Workers' Compensation?

The Missouri Workers’ Compensation system is a no-fault system that provides medical treatment, lost wages (temporary total disability), and permanent disability to injured workers. While there are other types of benefits available for disfigurement, temporary partial disability, the second injury fund, and more, most injured workers typically receive medical treatment, lost wages, and disability benefits.

Injured workers are entitled to receive medical treatment for work-related injuries. The employer or their insurance carrier will be responsible for paying the bill. Injured workers should not receive any bills for medical treatment approved by the employer or insurer. This means that the employer or insurer gets to select which doctor an injured worker will see. If an injured worker chooses to see a different doctor they may be responsible for paying some or all of the charges from the unauthorized visit.

Injured workers are also entitled to recover lost wages if they are unable to work due to their work-related injury. This type of benefit is called temporary total disability (TTD). Injured workers do not begin to receive TTD for the first three regularly scheduled workdays they are unable to work unless they are unable to work for a total of 14 days or more. TTD payments are equal to two thirds an injured workers average weekly wage. Average weekly wage is computed by multiplying wages earned over the 13 week period prior to the injury and dividing by 13. The Missouri legislature also sets a maximum average weekly wage that will not be exceeded for purposes of determining benefits no matter how much an injured worker made. TTD benefits stop whenever the doctor determines an injured worker can return to work.

Permanent disability is also available to injured Missouri workers. If a doctor determines that medical treatment is no longer necessary for a work related injury even though the worker is not back to 100%, they are entitled to disability benefits. The disability can be partial which means there are permanent physical limitations as a result of the work-related injury. Benefits for permanent partial disability (PPD) are determined by using the average weekly wage discussed above and a formula established by the legislature to determine what dollar amount is appropriate compensation to the injured worker. Injured workers who are no longer able to work as a result of their work-related injury are entitled to receive permanent total disability (PTD) benefits. PTD benefits typically result in weekly checks for the rest of the injured workers life.
 

Sun Beginning to Shine Through Tort Reform Lies

Like most of the county, Nevada bent to popular opinion by enacting a $350,000 cap on pain and suffering in 2004. To accomplish massive restrictions on negligence liability, insurance companies aired television ads of doctors walking out of town along the highway, fleeing from high malpractice insurance costs.

 

A congressional study and a national consumer advocacy group found at the time that the health care industry had spent millions of dollars exaggerating the malpractice crisis in Nevada and elsewhere in the country. Doctors overall weren’t actually leaving Nevada at a high rate. But the commercials, helped persuade voters to approve an industry-backed ballot initiative imposing a $350,000 cap on pain and suffering.

But the insurance industry didn’t bother to consider that minimizing their risk on claim payouts would lead to increased negligence. In Nevada, a Doctor is being sued for implementing cost-cutting strategies in his now closed endoscopy clinic that allegedly endangered the lives of his patients. Injured victims have claimed the Doctor re-used syringes without sanitizing them, and in many cases exposed his patients to Hepatitis C.

AB495 was recently introduced in the Nevada General Assembly. The bill seeks to eliminate the $350,000 cap. The measure also would increase the time limit for bringing a malpractice case to trial after it is filed. Instead of having two years, plaintiffs would have up to five years to get to trial.

Proponents of the bill state that the Hepatitis C outbreak has opened the eyes of the general public to the realities of tort reform. Damage caps have become vehicles that limit insurance company payouts without consideration of whether higher payments are justified based on negligence. As the public begins to see the lack of accountability in the medical profession created by damage caps they are beginning to wonder why they agreed to limit pain and suffering to $350,000 in the first place.

As more and more Americans realize how tort reform will impact their lives if they are injured, we are beginning to see judicial and legislative challenges to damage caps. While fancy television commercials can influence the public, the truth always shines through. In this case, the people of Nevada are beginning to think about how Doctors conduct themselves, not whether they are leaving because of insurance costs. Hopefully, it won’t take a hepatitis outbreak or other heath catastrophe for Missourians to realize how the insurance company cheated them into agreeing to limit pain and suffering damages to $350,000.
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Also see my other posts on tort reform myths:

Tort Reform: What’s Really Going On
Tort Reform Myths: Doctors Are Leaving
Tort Reform Myths: Jury Awards Are Out of Control
Tort Reform Myths: Greedy Attorneys File Frivolous Lawsuits
 

Illinois Outlaws Texting While Driving

The Illinois State Legislature recently made it illegal to text message while driving. A person may not operate a motor vehicle on a roadway while using an electronic communication device to compose, send, or read an electronic message. HB71 becomes effective July 1, 2009. The bill makes texting a moving violation under the traffic code, and drivers caught texting while driving a third time can lose their license and be sentencing to up to 30 days in jail. ``It’s a huge distraction and we need to stop it,’’ the sponsor, state Rep. John D’Amico, D-Chicago, said in floor debate. ``When you’re text messaging (while driving), you’re taking the lives of others into your hands.’’

Cell phone use while driving has become a hot topic throughout the country over the past few years. Missouri currently has three measures proposed that would make various uses of cell phones a traffic violation. Proponents of the ban on cell phone use often cite public safety concerns related to the increase in traffic deaths caused by cell phone use. The movement continues to create momentum even though other driving distractions such as reading a book, inattention, singing, and dancing remain unregulated.

If Missouri passes restrictions on cell phone use it will be interesting how the new law will be enforced. Will officers begin checking the call/text log of phones present in every car they stop for routine traffic violations? Will police officer’s be able to stop vehicles because they see a cell phone in use? Will the officers start using this as justification to stop certain types of vehicles/persons they would not otherwise be able to detain? This continues to be an interesting topic.
 

Fatal Collision Closes Interstate 55

The Missouri Highway Patrol recently reported that Brandon Peterson, 20 of Phoenix, Arizona, was killed in a fatal auto collision on Interstate 55. Peterson had been traveling northbound in the southbound lanes until his 1988 Honda Accord struck a semi truck head on. The collision occurred around 3:00 a.m. on March 27, 2009, and kept portions of the highway shut until 6:00 a.m. The semi driver reported he swerved into another lane to avoid the collision, but the Honda swerved in the same direction he did.

This is no doubt a horrible crash, which could have turned out a lot worse. The semi driver could easily have been injured as well as anyone else traveling on Interstate 55. My heart goes out to the family and friends of Brandon Peterson, for their tragic and heartbreaking loss.
 

Drunk Driving Accidents Plaguing St. Louis Metro Area

The St. Louis metro area has recently been devastated by several deaths resulting from drunk driving accidents. Robert Wood of Wright City, Missouri, was killed when his car was rear-ended on Interstate 70 near O’Fallon, Missouri. The man who hit Wood, Chad Frazer, was charged with involuntary manslaughter and leaving the scene of an accident. The Missouri Highway Patrol indicated that Frazer’s blood alcohol level was over three times the limit at 0.27.

Reports indicate that Wood was traveling eastbound in the right lane on I-70 in a 1990 Mercury Topaz. Frazer was also traveling eastbound in a 1991 Ford Mustang when he came up behind a tractor trailer. Frazer attempted to pass on the right and rear-ended Wood’s car sending it off the right side of the highway. Frazer’s car veered to left and came to rest along the median. Frazer was reportedly traveling at speeds in excess of 100 mph when he hit Wood’s car. Wood was pronounced dead at the scene. Frazer was taken to St. Joseph’s Health Center with moderate injuries.

Tawanda Jackson, Arnold Jackson, and Jon Moss were also recently killed in a fatal crash near Edwardsville, Illinois, on Route 255 about 1½ miles north of I-270. The other driver, Newton Keene, was drunk and driving without a license when he drove the wrong way on Illinois 255, crashing into Jackson’s car.

Keene had six previous drunk driving convictions in Illinois and Missouri, as well as two convictions for driving without a valid license. Keene had also been pulled over three times for driving on the wrong side of the road while drunk. Despite all of this, he had never served more than 120 days in jail.

Lindsey Arnold-Zimmer, who was five months pregnant, and her husband, Adam Zimmer, 26, both of Granite City, were killed in a crash on Route 111. Zimmer was a special education teacher, and Arnold-Zimmer was a finance manager for a car dealer. Donald W. Canterbery was driving drunk in his Chevrolet Corvette on Route 111 near Fairmont City when he rear-ended the couple's vehicle, sending it into the path of an oncoming pickup whose driver, prosecutors said, also may have been intoxicated.

The National Highway Traffic Safety Administration estimates that over 17,500 Americans are killed each year in car collisions related to drinking and driving. If you or someone that you love has been the victim of a car accident where drunk driving was involved, you may be able to file a civil action against the driver that hit you. There may also be a third or additional party to the claim. Additional parties typically include establishments that may have provided or sold alcohol to the individual that caused the accident. In some cases, this may even include a neighbor or friend that allowed the individual to leave the premises with a vehicle under the influence of alcohol. The law specifies that the person in the third party claim must have knowingly provided the alcoholic beverages to an individual that was visibly intoxicated and allowed that intoxicated person to leave in a car.

An injury claim involving a drunk driver can be very emotional. Everyone expects to be safe from drunk drivers even though many people know of at least one person that regularly drives drunk. The St. Louis Post Dispatch has called for harsher sentences from the Courts, and more leeway for police officer’s. While these options must be explored, our society should be facing these tragedies in a more direct way. When did we decide that drinking and driving was acceptable? It happens every day in every bar in this City. Please let these recent deaths be a wakeup call to us all that drinking and driving is not socially acceptable. Our attitude as a City can halt these deaths much quicker than the Courts, the police, or the legislature ever can.
 

Tort Reform: What's Really Going On

The late 1970’s and early 1980’s saw a hard insurance market with investment income dwindling. By the mid 1980’s insurance rates when through the roof and there were cries of a “litigation crisis.” The 1980’s tort reform movement was strikingly similar to the modern movement. In fact, many states enacted some measure of tort reform during the 1980’s that modern tort reform proponents are seeking to strengthen. In 1986, the National Association of Attorneys General (“NAAG”) produced a report studying the litigation explosion of the 1980’s, they found:

The facts do not bear out the allegations of an explosion in litigation or in claim size, nor do they bear out the allegations of a financial disaster suffered by property/casualty insurers today. They finally do not support any correlation between the current crisis in availability and affordability of insurance and such a litigation explosion. Instead, the available data indicate that the causes of, and therefore solutions to, the current crisis lie within the insurance industry itself.

Clearly, there is some correlation between the stock market and the insurance underwriting cycle. The question becomes does the stock market drive the underwriting cycle, or does litigation?

In 2003, Weiss Ratings, Inc., and independent agency, explored the relationship between insurance premiums and damage caps. Strikingly, Weiss Ratings found that damage caps produced a 15.7% reduction in payout amounts in states that had enacted them, but the insurance rates in those states were not reduced. Further, this study found that insurance rates in states with caps increased faster than insurance rates in states without damage caps. In that regard, Weiss found there were six factors driving the increase in insurance premiums: (1) medical cost inflation, (2) the cyclical nature of the insurance market, (3) the need to shore up reserves for policies in force, (4) a decline in investment income, (5) overall financial safety considerations, and (6) the supply and demand of coverage. Beyond that, Weiss specifically found that the current rise in insurance rates was due to under-reserving throughout most of the 1990’s combined with the rapid decline of the stock market in the early 2000’s, not a litigation crisis. Clearly, there is something going on with the insurance industry the general public are unaware of. Political banter pushing the tort reform agenda never discusses the inner-workings of the insurance industry itself –after all litigation is to blame. But put all that aside, where has tort reform left us, is this workable for everyday Americans?