Archive for the ‘Insurance Issues’ Category

Allstate forced to cut auto premiums in California

Tuesday, March 26th, 2013

SANTA MONICA, Calif.,

March 18

PRNewswire-USNewswire — California drivers with Allstate auto insurance will save a quarter-billion dollars under an order issued by Insurance Commissioner Poizner Friday that requires Allstate to lower its premiums by 15.9%. The savings are a result of Proposition 103′s prohibition on excessive rates and will lower each policyholder’s premium an average of $133 per car. Nearly two million drivers with Allstate insurance policies will see their rates go down. The order takes effect April 14.

The Commissioner’s order followed the recommendation of an administrative law judge that heard the case in November 2007. Allstate originally requested no change in its auto rates when it filed a new rate structure with the Department of Insurance in 2006, but a hearing was ordered by the Commissioner to justify those rates. The nonprofit Foundation for Taxpayer and Consumer Rights (FTCR) intervened to challenge the existing rate as excessive, arguing that Allstate’s rates should be lowered by 19.4% according to the rules of Proposition 103, the 1988 insurance reform initiative. The Commissioner determined that a 15.9% decrease was required.

“California Allstate drivers will save an average of $133 each, a quarter-billion dollars in total, thanks to Proposition 103′s safeguards,” said FTCR attorney Todd Foreman. “These rate reductions came about because of the ‘prior approval’ regulations that limit industry excesses and more Californians should see rate decreases soon.”

Allstate’s modified request for a mere 7% decrease after the initiation of the rate hearing was based upon contradictory tales of Allstate’s alleged financial distress in California, while at the same time, the company was boasting of record profits to Wall Street. Allstate’s net income for 2006 alone was approximately $5 billion and total shareholder return was 590% between 1994 and 2006.

“In an economy that is wreaking havoc on consumers’ bottom line, Allstate’s rate cut can be positively perceived as a $250 million stimulus package as it will provide much needed relief to nearly two million of its California customers,” said FTCR’s co-counsel Daniel Y. Zohar with the Los Angeles, CA. based Zohar Law Firm. “With everyone having to tighten their belts, we are proud that our advocacy on behalf of consumers has helped to ensure that Allstate tightens it belt, too.”

FTCR has also challenged an unjustified homeowners’ insurance rate hike requested by Allstate. If successful, the challenge will save Allstate’s homeowner policyholders approximately $350 million a year.

The Allstate auto insurance savings announced today were achieved under amended regulations issued by the Department of Insurance last year that revised guidelines for profitability and allowable expenses under the rules of Proposition 103. Prop 103 requires insurance companies to open their books and submit to public hearings to justify that rates are adequate without being excessive. Consumers may intervene in or initiate proceedings to challenge any rate that is unfair or excessive.

Using Prop 103, FTCR has helped Californians save more than $800 million dollars by challenging other auto, homeowners, and medical malpractice insurance rate proposals since 2003. A full list of previous savings is available at: http://www.consumerwatchdog.org/images/InsSavings.gif.

Posted in In the News, Insurance Issues | No Comments »

Can a personal injury lawyer really make a difference in my case?

Tuesday, March 26th, 2013

Many years ago, Allstate Insurance hired a team of consultants to help in redesigning their claims handling process. Their conclusion: Get the lawyers out of the claims process. Their studies found that by doing this, they could settle claims for substantially less money.

Even in small cases under $15,000.00, those persons represented by lawyers received substantially more in settlement, even after paying their attorney, than people who were not represented by a lawyer.

In larger cases, the difference was even more striking as the studies found that lawyers are able to get their clients exponentially more money as the claims value increases. Still want to handle your claim yourself?

Hiring an attorney early in your case will ensure that your rights and interests are protected. An attorney will usually charge a fee that is a set percentage of your eventual settlement or judgment amount. If you retain the attorney sooner rather than later, the attorney will have more time to ensure that your case is developed to its maximum potential value. The result – MORE MONEY IN YOUR POCKET.

If you have already determined that you should probably hire an attorney, these are the reasons you should hire that attorney NOW rather than weeks or months down the road:

1. An experienced attorney will be able to determine what evidence you will need to prove your case to the adjustor or at trial and how such evidence can be recorded and preserved in the meantime.

2. An attorney will help coordinate all available medical insurance coverage to make sure that you get prompt and thorough medical care.

3. An attorney can help you get medical care when you do not have any health or med-pay insurance.

4. An attorney will help you document all of your losses to make sure that you can recover for as much of your damages as possible.

5. An attorney will deal with the insurance companies on your behalf.

HOW MUCH WILL A LAWYER CHARGE?

Most accident attorneys will work on your case on a “contingency” basis. This means that you will not have to pay your attorney for any work on the case until, and unless, that attorney secures a settlement or judgment on your behalf. If your attorney does not recover any money on your behalf, you do not pay your attorney for his time. Please note that most attorneys will require you to pay for necessary expenses they incurred in preparing your case regardless of whether or not your case is successful.

Any attorney that you consider hiring is required to advise you of alternate types of fee arrangements (such as an hourly fee or flat fee) and give you the option of selecting one of these alternate types. However, these types require you to pay for your attorney’s time and work up front, regardless of whether or not they recover any money on your behalf. Consequently, most accident cases are handled on a contingent basis.

Important Tip: You will be paying your attorney the same amount whether he works on the case two months or two years. Why not give that attorney as much time as possible to make sure that your case value is maximized?

WHAT QUESTIONS SHOULD I ASK WHEN HIRING A LAWYER?

By asking the following questions when first meeting with a lawyer, you will quickly gain an understanding of the ability of that lawyer to adequately protect your interests:

1. How many years experience do you have in representing accident victims? A qualified attorney will have several years experience in representing accident victims. Make sure that your case will not simply be passed on to other, less-experienced attorneys.
2. Will I work with you directly or mainly with paralegals and legal assistants? Frequent involvement directly with your attorney will help ensure that your case is prepared as thoroughly as possible.
3. How do you keep yourself informed of the latest developments in this area of the law? Skilled accident lawyers spend many days each year at seminars learning new developments in this area of law.
4. What professional groups are you a member of? There are several professional organizations that allow attorneys to learn from other lawyers and stay better informed of recent changes in the law. Look for membership in a State Bar Association and state trial lawyers association.
5. Do you also represent insurance companies? Many qualified accident lawyers also function as “Insurance Defense” lawyers and represent at-fault drivers or their insurance companies from time to time. This may mean that your prospective attorney may have a “conflict of interest” and be legally precluded from representing you in a case that involves an insurance company with which that attorney has an ongoing business relationship.
6. Will I have to pay for your services even if you do not recover a settlement or judgment for me? If you retain your attorney on a contingent basis, you will not, in most states, be responsible for paying your attorney’s fees if they are not successful in securing a settlement or judgment on your behalf.
7. Am I liable for any costs associated with investigating and preparing my case? Under many states laws, if your attorney intends to hold you responsible for the costs necessary to investigate and prepare your case, they must advise you in writing of this fact before signing you up as a client.
8. How much will associated costs be for my case? A typical auto accident case will require expenses for such costs as copies of the accident report, copies of your medical records as well as any fees charges by expert witnesses that may be necessary to present your case. These costs can vary greatly from case to case but even a simple case can cost several hundred dollars to prepare.
9. Are there any difficult issues in my case? An experienced attorney should be able to quickly identify any problem issues and be willing to discuss these issues with you.
10. How many other cases will you handle at any given time? The more cases an attorney has, the less time and personal attention those cases will likely receive.

Caution: Many of the accident lawyers that you see advertising on television or in multi-page phone book ads handle HUNDREDS of cases at any given time. While this type of practice may be financially rewarding for the attorney, it prevents the attorney from working personally on their clients’ cases and can compromise their ability to effectively represent their interests.

You may also want to research any attorney with your State Bar Association. These resources will allow you to discover whether your prospective attorney has ever faced any disciplinary actions or had complaints filed against them by previous clients.

Caution: Not all attorneys focus on representing accident victims. Unlike some states, Colorado does not grant special designations to those attorneys who limit their practices to this area of law.

Posted in Insurance Issues, personal injury | No Comments »

New Auto Med-Pay Law in Colorado

Tuesday, March 26th, 2013

Governor Bill Ritter signed Senate Bill 011 into law earlier this month giving Colorado motorists access to a valuable avenue for paying for medical expenses in the event they are injured in an auto accident.

In the past four years since the legislature repealed the No-Fault Act (which previously required that you purchase medical insurance to cover your accident-related medical expenses) accident victims have found out all too late that they are unable to get medical treatment that they need after an accident.

Under the new law (now codified as C.R.S. Sec. 10-4-635, et. seq.) auto insurance companies must now offer $5,000 of medical payments (“med-pay”) coverage to Colorado policyholders. Those consumers who do not need this coverage are not forced to pay extra for benefits that they will not use – they can simply opt to decline such coverage much as they do for Uninsured and Underinsured Motorist coverage today.

However, most Colorado motorists would benefit from having this additional coverage added as a part of their auto insurance policies in some degree. The following guidelines should help you in determining how much Medical Payments coverage you should choose under your policy:

1. Drivers Without Health Insurance: If you do not currently have health insurance this auto med-pay coverage may be the only way you would be able to pay for your medical care after an auto accident – even if the accident was not your fault. Most doctors and medical providers will not see a patient if they do not have insurance unless it is a life or death emergency. If you are not covered by health insurance you absolutely should purchase med-pay coverage under your auto policy. In fact, I recommend that you purchase as much coverage as your auto carrier allows.

2. Drivers With Health Insurance That Excludes Coverage For Auto Accidents: In the last few years, health insurance companies have started to limit their responsibility for paying for accident-related medical care by excluding such coverage from their policy. This means that you will have to pay for accident related medical care out of your own pocket. Unfortunately, many people do not find out that they have such a policy until it is too late and they have already been injured in an accident. It is very important for you to read your policy and see if there is such an exclusion included. If so, you also need to purchase as much auto med-pay as possible.

3. Drivers With Large Deductible Health Insurance: Anyone whose health insurance does not step in and pay benefits until a high deductible threshold has been met should secure med-pay coverage to cover the out-of-pocket expenses or deductibles not paid by their health policy. For instance, many catastrophic health policies will not pay any of the first $10,000.00 in medical expenses incurred in an accident. These drivers should purchase enough coverage to cover this gap.

4. Drivers Whose Health Policies Limit Physical Therapy Coverage: Many group policies in Colorado limit the number of therapy visits that an insured can have for any one condition in a policy year. If your policy only allows 20 physical therapy visits each year, it may be helpful to have a small amount of med-pay coverage to ensure that additional therapy visits will not have to be paid out-of-pocket.

5. Drivers Who Want Zero Out-of-Pocket Liability: Even if you have a good health insurance policy with low deductibles – you can spend hundreds of dollars meeting your deductible or in co-pays. Med-pay coverage can help bridge this gap and make sure that you will not have any out-of-pocket liability.

Posted in Car Accidents, Insurance Issues, personal injury, Proposed Laws | No Comments »

Tort Wars

Tuesday, March 26th, 2013

I was sitting at the breakfast table on a recent Sunday morning reading through the New York Times and came across a feature article in the business section about the nationwide battle being waged between the various states trial lawyers associations and the vast conglomeration of pro-business interests seeking to restrict injured citizens access to our Court system.

http://www.nytimes.com/2008/06/22/business/22tort.html?_r=1&ref=business&oref=slogin

This is yet another chapter in a battle that has been raging for more than 20 years as national Chamber of Commerce organizations, multi-national corporations and insurance industry insiders decided that their bottom lines would improve if they could somehow avoid costly lawsuits from people who are seriously injured when their products or actions cause harm.

Arguably, some states have had a history of wildly outrageous jury verdicts – but that was a long time in the past and certainly not in Colorado. It is also irrefutable that certain bad elements among the trial lawyers have tarnished the good work that the rest of us try to do on a daily basis. However, the fact is that the insurance industry is trying to push the bar further away from being equal and fair to all parties to the point that small people like you and me will never face a fair playing field in the event we are injured and have to sue a large corporation.

The current method of restricting your rights is to try and push for legislation to limit the amount of attorney’s fees that us trial lawyers can charge when we take on a case on a contingency basis. It is a great approach. Lets face it, on the surface it sounds like it will benefit the accident victims more than anyone else. However, in reality, serious restrictions in the amount of fees charged by attorneys will severely limit injured persons’ choices when hiring a lawyer.

Accident law is a business. Even us trial lawyers have to be able to make a profit on what we do. What makes us trial lawyers unique is the extremely high degree of risk that we have to assume on behalf of our clients. In nearly all accident cases, a lawyer does not get paid until and unless he or she gets a recovery for their client. If there is no recovery, then the attorney will not be paid for the hundreds or thousands of hours that they can spend working on a complex case.

Additionally, an attorney will spend his own money to prepare the case for trial. These trial expenses can be tens of thousands of dollars on even a simple auto accident case. In large products liability cases, such as cases against drug manufacturers, the expenses can run into the millions. If a lawyer’s ability to be compensated under a contingent fee agreement for assuming this risk is limited by state legislation, the simple fact is that fewer attorneys will be able to handle these types of cases on a contingency basis – and this is what the business interests really are seeking to accomplish.

The business lobby hopes that the state legislatures will start restricting the percentage contingency that an attorney can charge to the point that it is not economically viable for a lawyer to take an injury case on a contingency.

They say that we can still charge our clients an hourly fee to work on the case therefore nobody will be harmed by these types of laws. However, the reality is that very few accident victims can afford to pay an hourly fee and certainly cannot do so if they have suffered a catastrophic injury, are facing hundreds of thousands of dollars in medical care and cannot work.

I find it ironic that the business lobby is saying that we trial attorneys make too much money in a time when executive compensation packages at large corporations are going through the roof. It disgusts me to think that a CEO of a large company can make millions of dollars per year and even be entitled to million dollar buyout packages when they run their companies into the ground. How much do they really care about you and I when they plunder their employees pension funds to support their bad business decisions yet still collect such exorbitant salaries?

Let me be clear that I, as a personal injury lawyer, certainly do have cases where I am handsomely compensated for my time. However, I also have cases where I barely break even, or even lose money, on a case. These are the risks I take. If I find I can make more money charging an hourly fee in another area of law – I will be forced to do it. I, and the other trial attorneys throughout the country will be fine regardless. The injured people will be the ones left holding the bag and nothing would make the business and insurance lobbyists happier.

Posted in In the News, Insurance Issues, personal injury | No Comments »

The Worst Insurance Companies in America

Tuesday, March 26th, 2013

The American Association for Justice has released a comprehensive survey of insurance company practices across the country that calls the ten worst companies to task for their practices that unfairly victimize claimants. Such practices include basing rewards for employees on how many claims they deny, refusing to pay just claims, documented instances of claims supervisors telling their adjustors to lie to claimants, and charging minorities higher premiums for the same policies offered to non-minority consumers.

The worst offender is Allstate Insurance – a company that touts itself as “the good hands” people. This company actually hired a consulting firm, McKinsey & Company, to evaluate how it could deny more claims. In what became known as the “McKinsey report” the company advised that if the company were to simply delay paying claims as long as possible – more claimants would simply give up and Allstate’s profits would rise. This began a process whereby Allstate adopted a policy of “delay, deny and defend” to minimize claims payments as much as possible – even to its own insureds.

Allstate’s practices have resulted in Allstate having the highest percentage of complaints filed against it after both Hurricane Katrina and the 2003 California wildfires. This type of conduct has resulted in numerous state insurance investigations and lawsuits against the company. Attorneys for regulators and policyholders have tried to get access to the McKinsey report and Courts have ordered Allstate to produce these documents. However, Allstate has repeatedly ignored these Court orders stating that its conduct amounted to a policy of civil disobedience. Somehow its top executives equate violating Court orders in order to hide its disreputable practices as equal to the civil rights movement.

The other poor-performing companies include:

2. Unum
3. AIG
4. State Farm
5. Conseco
6. WellPoint
7. Farmers
8. UnitedHealth
9. Torchmark
10. Liberty Mutual

Some of the most egregious examples of this conduct include Unum insurance’s denying a disability claim brought by Debra Potter. Ms. Potter suffered from MS, a claim verified and documented by her physicians. Nevertheless, Unum claimed that Ms. Potter’s illness was bogus for three years – even after the Social Security Administration declared that she was totally disabled. What makes this case even more disturbing is that Ms. Potter was an insurance agent who actually sold Unum disability policies for years prior to her claim. If an insurance company treats those who sell their policies like this – How are they treating the average customer?

In January of 2008, AIG Insurance agreed to pay more than $12 million to settle claims in several states that it conspired to charge artificially inflated premiums by conspiring with other insurance brokers to submit fake premium bids to businesses and local governments in those states. It was also noted that AIG adjustors held pizza parties during which time they shredded claims-related correspondence. Now we can only wonder what really happens when the adjustors tell us they never received our claims documentation.

State Farm was called to task for denying Katrina-related property damage claims without sufficient grounds. In fact, it was documented that State Farm actually pressured engineers assisting in the claims assessment process to rewrite reports that concluded State Farm did have a responsibility to pay the claim. Unfortunately for State Farm, one of the claims it denied was that of Senator Trent Lott, a long-time friend of the insurance industry on Capitol Hill. Senator Lott subsequently led a push to introduce legislation spelling out in plain language what insurance policies cover and what they do not.

What can you do as a consumer?

First of all, make sure that you deal with a reputable company. Every insurance company claims to have great customer service, but this seems to be limited to the side of the business that takes in your premiums. It is how a company deals with you when you have a claim that makes a difference. Research your insurance company with your state insurance commission. Avoid doing business with those companies that have a high number of complaints filed against them in your state.

More importantly, get to know your insurance agent. This person can often work on your behalf by explaining policy language to your before you even purchase the policy and also by helping you through the claims process. As insurance companies seek to maximize profits by writing more and more policies over the Internet, this resource is fast dwindling away. However, it may very well prove to worth a little higher premium to have the peace of mind in knowing someone who is willing to help you out in a time of need.

To see the complete AAJ report, go to: http://www.justice.org/docs/TenWorstInsuranceCompanies

Posted in Insurance Issues | No Comments »

UnitedHealth Group Defrauding Customers

Tuesday, March 26th, 2013

New York Attorney General Andrew Cuomo rocked the United States’ healthcare industry earlier this month after announcing that Ingenix, Inc., was providing faulty information to the nation’s largest healthcare insurers.  After an investigation into UnitedHealth Group’s- the parent company of Ingenix, Inc.- reimbursement process for out-of-network medical services, Cuomo discovered that UGH was defrauding customers by setting artificially low rates for patients, and therefore leaving them to foot most of their medical bills. Cuomo charged Ingenix, Inc., the nation’s largest healthcare billing information provider, with falsifying and manipulating their database.  The exploitation of their database had catastrophic effects because many of the nation’s largest healthcare insurance firms use the information provided by Ingenix, Inc. to determine reimbursement rates for out-of-network care.  The Attorney General is still investigating the extent to which the insurance industry as a whole is involved.  Currently, Cuomo has issued 16 subpoenas to the country’s largest health insurance providers including: Empire BlueCross Blue Shield, CIGNA, Aetna, as well as UnitedHealth Group and three of its subsidiaries.

As of current, Cuomo has not sued the company as he is investigating, in his words, “[an] industry-wide scheme perpetrated by some of the nation’s largest health insurance companies to defraud consumers.”  UnitedHealth Group has recently consented to pay $350 million to reimburse patients as settlement and terminate the lawsuit.  However, some feel a more personal attack by Ingenix, Inc.  Jeffrey Wientraub of Connecticut is rallying for a class action suit against Ingenix, Inc. itself.   Only time will tell the extent to which the health insurance industry has been infiltrated and the futures of both UnitedHealth Group and the nation’s health insurance industry as a whole.

Posted in Insurance Issues | No Comments »

UnitedHealth Group defrauding customers

Friday, June 26th, 2009

January 26, 2009 – New York Attorney General Andrew Cuomo rocked the United States’ healthcare industry earlier this month after announcing that Ingenix, Inc., was providing faulty information to the nation’s largest healthcare insurers. After an investigation into UnitedHealth Group’s- the parent company of Ingenix, Inc.- reimbursement process for out-of-network medical services, Cuomo discovered that UGH was defrauding customers by setting artificially low rates for patients, and therefore leaving them to foot most of their medical bills. Cuomo charged Ingenix, Inc., the nation’s largest healthcare billing information provider, with falsifying and manipulating their database. The exploitation of their database had catastrophic effects because many of the nation’s largest healthcare insurance firms use the information provided by Ingenix, Inc. to determine reimbursement rates for out-of-network care. The Attorney General is still investigating the extent to which the insurance industry as a whole is involved. Currently, Cuomo has issued 16 subpoenas to the country’s largest health insurance providers including: Empire BlueCross Blue Shield, CIGNA, Aetna, as well as UnitedHealth Group and three of its subsidiaries.

As of current, Cuomo has not sued the company as he is investigating, in his words, “[an] industry-wide scheme perpetrated by some of the nation’s largest health insurance companies to defraud consumers.” UnitedHealth Group has recently consented to pay $350 million to reimburse patients as settlement and terminate the lawsuit. However, some feel a more personal attack by Ingenix, Inc. Jeffrey Wientraub of Connecticut is rallying for a class action suit against Ingenix, Inc. itself. Only time will tell the extent to which the health insurance industry has been infiltrated and the futures of both UnitedHealth Group and the nation’s health insurance industry as a whole.

The Law Firm of Jason Crawford has represented accident victims and their families for more than 14 years. If you or your family needs to talk to an experienced accident lawyer, please call us today at (303) 741-0249.

For more information, please visit our website www.DenversAccidentLawyer.com.

Posted in In the News, Insurance Issues | No Comments »