Mobile Personal Injury Lawyer - Insurance

Health Insurance Is A Life Or Death Issue

Pete Mackey — Tue, 01 Dec 2009 08:53:23 GMT

A recent study by researchers based at harvard has found that the lack of health insurance causes almost 45,000 deaths annually in the U.S. The American Journal of Public Health first published the study in its Septemeber, 2009, online edition. The statistics cited by the study's authors are disturbing:

Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives."

Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate - now one dies every 12 minutes."

Do you think that any member of Congress would be willing to admit that they could not help an accident victim because they did not have health insurance? Of course not. Now that there are bills to consider, the opponents' cry is "we are for health care reform, but just not what is proposed." The debate over the best solution has been raging for a long time. It's too late in the game to pull out the "we can do better" card at this late stage. Opponents of health care reform have had plenty of time to put forth their own proposals, but decided instead to backseat drive. Time has run out, on the naysayers and on the 45,000 Americans who will not be alive next year without insurance.

Originally posted at InjuryBoard by Pete Mackey

The Healthcare Debate - Inform Yourself

Pete Mackey — Sun, 30 Aug 2009 17:17:36 GMT

The healthcare bill being considered seems to have a 1000 angles. One of the problems with tackling this monster is that it has many causes, and most of those causes lead back to a special interest group. When I am having trouble resolving a legal issue, I like to break things down in small pieces, so I can see the forest for the trees. I have been having a problem understanding the nuances of the issues in this healthcare dabate. Bill Moyers helped me out. Watch for yourself - it's powerful information that every family should know about this important subject.

Originally posted at InjuryBoard by Pete Mackey

Wendell Potter - Inside Man

Pete Mackey — Mon, 24 Aug 2009 08:52:51 GMT

Though there has been press coverage of Wendell Potter's changing role, it has been curiously light. In June, he testified before Congress on the abuses of HMOs. Now he's back in the picture, weighing in on the health care debate:

The former vice president of corporate communications at insurance giant Cigna, who left his post, says the industry is playing "dirty tricks" in an effort to manipulate public opinion.

"Words matter, and the insurance industry is a master at linguistics and using the hot words, buzzwords, buzz expressions that they know will get people upset," he told CNN Wednesday.

His former employer CIGNA's response was telling:

A Cigna spokesman would not comment directly on Potter's accusations. Instead, the company released a written statement saying officials agree that health care reform is needed. But the statement went on to say that officials don't see how a government-sponsored plan can accomplish that.

When an industry insider slams the hand that fed him for a long time, you would think that his words would get a lot of play. And if he was an embittered outcast or a fraud, it would logically follow that the evidence of such would be trumpeted 24/7. Maybe he knows what he's talking about. Maybe there really is a problem in need of a solution ...

Originally posted at InjuryBoard by Pete Mackey

Misdiagnosis

Pete Burns — Mon, 17 Aug 2009 14:36:18 GMT

Kentucky Senator Mitch McConnell is yet another anti consumer republican trying to shift the focus from insurance reform by pretending that problems in health care are the result of “junk lawsuits”. A well researched editorial published by a leading newspaper in McConnell’s home state points out that McConnell’s claims are contradicted by empirical evidence. Lexington (KY) Herald-Leader (8/16). So long as opponents of health insurance reform misdiagnose the cause of our problem they will not identify a cure.

Originally posted at InjuryBoard by Pete Burns

When your Health Insurance Policy is Rescinded

Pete Burns — Sun, 02 Aug 2009 15:38:34 GMT

Post hoc underwriting is the process the medical insurance companies use to cancel a customer’s policy after the customer develops a serious illness. If the individual develops a condition that is likely to result in large medical costs the insurance companies scour the customer’s medical records to see if there is any basis for contending that the customer had a medical condition that materially affected the customer’s health. Even if the customer did not know of the condition and the failure to disclose was completely innocent the insurer will frequently deny the claim.

According to CNN http://edition.cnn.com/2009/POLITICS/06/16/health.care.hearing/ and the NPR podcast on This American Live Podcast at http://podcast.thisamericanlife.org/podcast/386.mp3 the practice has saved the health insurers over $300,000,000 over the last 5 years. That is a huge savings to the insurance industry and a cruel burden to the ex post facto uninsured consumer.

If that happens to you consult a lawyer immediately.

Originally posted at InjuryBoard by Pete Burns

The Adjuster Says We Can Work It Out - Part 1

Pete Mackey — Sun, 28 Jun 2009 17:14:03 GMT

The other driver ran the red light. There were three witnesses to the collision. You broke both arms (the ones you use to handle the machine at work) and will be out of work for six weeks. The other driver's insurance carrier calls you the next day. "We are here to help," says the adjuster from the Big Hands company, "don't hire a lawyer - that will just get you a third less in your settlement."

What do you do? Why pay a lawyer when the Big Hands guy has a fist full of cash for you? If you can get him to pay you the same amount that he would pay if you were represented, you shouldn't. The problem is, in the overwhelming number of cases, his final offer will be far less than what he would put on the table to your attorney. But you are anxious. You don't have much money saved up and the bills won't stop while you are out of work.

We give the same advice that we would give to anyone who is thinking of foregoing professional help - do so at your own risk. The Big Hands guy is not trying to help you out. He is trying to close out the file by paying the least that he can. That is his job, and he wants to do it as quickly as he can. If he doesn't want you to hire a lawyer or to wait until you recover to settle your claim - isn't that a red flag?

Even the relatively simple example presented here has a lot of issues that a lay person has never dealt with. First, there is settling the property damage claim. If your vehicle is not a total loss, you are entitled to recover the amount that would put you in the same position you were in before the wreck. That will include an amount for the diminution in value of your vehicle after it is repaired. How do you figure that out?

What about medpay? That is the amount of money that the other driver's carrier will pay without regard to fault. Generally, that is worth $1,000, but some policies pay more. If you have health insurance, how are they to be paid back? Some health insurance companies will negotiate. If you do not have medical insurance, how will you get the doctor to keep providing service? What other damages are you entitled to? How much insurance does the other driver have? If it is not enough to cover your loss, will your own insurance come into play?

As you can see, there are lots of things to consider. In this series of posts, I will go into greater detail about all of these issues. I will even include a post that tells you the best way that you can represent yourself, if that is what you choose to do. Just remember the wise old adage, "people who represent themselves have fools for lawyers."

Originally posted at InjuryBoard by Pete Mackey

Policy Limits Demand

Pete Burns — Tue, 07 Apr 2009 14:28:50 GMT

The policy limits demand is a powerful tool for the plaintiff and should be taken seriously by the insured defendant. The plaintiff is saying that she will settle her case for a specific sum or the amount of insurance the coverage available to the defendant. If the insurance company refuses to settle the case and the plaintiff wins more than the policy limits sometimes the insurance company can be required to pay the entire judgment. That may require that the defendant sue his insurer for a "bad faith" refusal to settle. If the plaintiff will settle for policy limits and the defendant's insurance company will not agree the smart defendant will hire a lawyer to evaluate the situation immediatley.

Originally posted at InjuryBoard by Pete Burns

Uninsured/Underinsured Motorist Coverage Part 4: How To Buy Your Coverage

Pete Mackey — Wed, 11 Feb 2009 08:15:00 GMT

This post will wrap up my series on uninsured/underinsured motorist (um/uim) coverage. In Part 1, we talked about the basics of um/uim coverage and buying all that you can afford. In Part 2, we talked about “stacking” coverages and in Part 3, the issue was damages. Today, I want to give you some tips on buying your automobile insurance – specifically, um/uim coverage.

As you know from previous posts, every automobile liability insurance policy sold in this state has to contain at least $20,000 worth of UM/UIM coverage per person and $40,000 per incident. In addition to making sure you do not reject that coverage and that you buy all that you can afford, the following thoughts may be helpful:

a. Research the companies that you are looking at. There is a wealth of information on the internet. Do not look just at the cost – it does not do a lot of good to buy the cheapest policy out there if that company won’t rightfully pay claims, or provides you with a policy that lacks the features you are looking for. For instance, some companies will exclude punitive damages as a remedy for personal injuries. If that is the case, how much will you save in premiums? Who is a covered driver under this policy? If your son who is off at college covered when he drives your car at Christmas break?
b. If you can find a policy that fits your needs and is marketed by a local agent – all the better. Having an identifiable person or agency to call when a claim arises can be very helpful. Insurance agents can be investigated on the internet just like insurance policies can. Moreover, you should be able to talk to other folks about their experience with that particular agent or agency. The best person to talk to, of course, would be an insured who submitted a substantial claim.
- Was the local agent helpful and was the claim processed quickly?
- Will the prospective agent take the time to answer all the questions you have about the product that you are buying?
- When you ask about UM/UIM coverage, does the agent advise you to buy all that you can afford, or just move on to the next subject?
You want to buy insurance from someone who is looking to help you not just when it’s time to collect a premium. While your local agent does not make claims decisions, he or she can be quite helpful during the claims process.
Finally, I want to repeat something I said in Part 1 of this series – do not be hesitate to file a claim if you are injured by an uninsured, or underinsured, driver. You have paid for this coverage and filing a claim will not raise your rates. The chance of you being involved in a collision with an uninsured driver is one in four in this state and, with these economic times, will only get worse. Drive safe and drive defensively.

Originally posted at InjuryBoard by Pete Mackey

Uninsured/Underinsured Motorist Coverage Part 3: Damages

Pete Mackey — Tue, 10 Feb 2009 08:00:00 GMT

In previous posts in this series, I have described Uninsured/underinsured (um/uim) insurance and discussed "stacking" of coverages. Today, let's talk about damages. Um/uim coverage provides "bodily injury" damages, but not property damage. In short, it provides coverage for the same damages that you are able to recover against the at fault driver. Those damages include medical bills, physical pain and suffering, emotional pain and suffering, permanent injuries, disfigurement, loss of the ability to earn a living and lost wages, past and future. Your spouse may also maintain a claim for loss of consortium (also known as loss of services) subject to the same individual coverage available to you.

If that at fault driver's conduct is particularly egregious (drunk or reckless driving, for example), punitive damages may be recoverable. Check your policy, however. By law in Alabama, your insurance company may exclude punitive damages from um/uim coverage. The only instance where that exclusion would not apply would be on a wrongful death claim. In Alabama, the only damages available for a wrongful death are punitive damages and so the exclusion would not apply.

If your medical bills related to the incident have been paid by your health insurance provider, a worker's compensation carrier, Medicaid or Medicare, they will want to be paid back. There are different rules that apply for each and private insurance may not be entitled to full, or even partial, reimbursement. The bottom line - make sure that the attorney you hire you is well versed in this area of the law. Ask a lot of questions and find out what you can before you sign a fee agreement. There are a lot of traps for the unwary in um/uim law. In this series, I have only scratched the surface.

Originally posted at InjuryBoard by Pete Mackey

Uninsured/Underinsured Motorist Coverage Part 2: Stacking Coverage

Pete Mackey — Mon, 09 Feb 2009 08:00:00 GMT

If you have more than one vehicle insured under the same insurance policy and you are involved in a collision where the at fault driver is uninsured or underinsured, you can "stack" the uninsured/underinsured (um/uim) coverages of up to two more insured vehicles on top of the vehicle involved in the collision. For instance, let's say that you have four vehicles covered under one policy and the um/uim limits for each is $100,000 per person and $300,000 per incident. In that instance, you would "stack" the coverages of two more of your vehicles, raising the total amount of um/uim coverage available to $300,000 per person and $900,000 per incident.

Let's work through an example. To make it simple, I will not consider the at fault driver's "per incident" limits of liability coverage. Using the coverages above, father, son and daughter are driving to the store in dad's car when another driver runs the red light and collides with dad's vehicle. That driver has liability insurance with a $50,000 limit. At the trial of that case, the jury awards father damages of $60,000, son damages of $200,000 and daughter $400,000. Who gets what? As to father, the at fault driver's liability coverage pays it's $50,000 limit and dad's um/uim carrier pays the remaining $10,000 of the judgment. Son would get the full $200,000 ($50,000 from at fault driver and $150,000 from um/uim). Daughter, however, would have her damage award capped at $350,000 ($50,000 from at fault driver and $300,000 from um/uim) because she got the limits from each.

There is one twist to "stacking." If the four vehicles owned by dad were insured by the same insurance carrier under four separate policies, the coverages for each policy would be available to dad and his kids. Tomorrow, we will talk about damages.

Originally posted at InjuryBoard by Pete Mackey