Insurance Questions

March 22, 2012

A U.S. District Court judge ruled in favor of roughly 15,000 employees of North Carolina’s Baptist Hospitals for a class action lawsuit alleging that their insurance provider required more fees for their coverage than other corporate clients were required to pay. The judge awarded the group a settlement of $5.38 million to be paid no later than April 24.

According to The Winston-Salem Journal, NC Baptist Hospitals is attempting to lower the total amount they must pay out by claiming they should not have to pay taxes on the settlement, which could delay when recipients receive their money. Lawyers for the group filed paperwork with the courts Friday that say it’s not required to pay any amounts beyond those listed in the settlement for the MedCost Health plan.

After other minor expenses were deducted, lawyers say that approximately $1.31 million dollars should be taken off the final payout, lowering that number to $4.07 million. Baptist argues that current and ex-employees who are receiving the settlement should cover those federal tax expenses and other costs.

Counsel for those filing the class action lawsuit have until tomorrow to respond to Baptist’s filing.

The North Carolina Business Dispute Attorneys with HensonFuerst Injury Lawyers say that insurance companies are required by law to offer fair, ethical, and transparent coverage to their policyholders. Failing to offer coverage in this manner could be considered unfair and negligent on the part of the insurance company.

March 8, 2012

Recovering from an injury suffered in an accident can be a long process. Take, for instance, the story of a truck driver from Goldsboro, North Carolina, that was recently highlighted by WRAL News. The truck driver was involved in an accident on October 29, 2009, along I-95 near Godwin in Cumberland County.

Reports say that the trucker was heading north when he swerved to avoid a stationary car. The driver of the stopped car was pushing a disabled vehicle off the road. While swerving, the truck driver hit the trailer of another 18-wheeler and ricocheted back into the guardrail of the median. The truck burst into flames, trapping the truck driver inside.

A passing southbound motorist who witnessed the crash jumped into action, running to the burning truck and working to free the trapped driver. He was eventually able to pull the man to safety.

The driver spent the next two months in a coma at a local hospital after suffering third-degree burns to more than 40% of his body, and he now requires daily physical therapy. He says that he will never be able to drive a truck again, but is thankful to be alive.

The Raleigh Truck Accident Attorneys at HensonFuerst Injury Lawyers would like to wish the truck driver a speedy and successful recovery after this terrible accident. His positive attitude toward his recovery is an inspiration to others.

January 12, 2012

A powerful storm system that blew through western North Carolina Wednesday evening is being blamed for injuring at least 15 people and destroying more than a dozen buildings in two counties. According to WRAL News, the storm possibly spawned tornadoes that are believed to have touched down in Rutherford and eastern Burke Counties.

Spokesman for the Rutherford county sheriffs department, Sergeant Dwayne Wright, told reporters that the town of Ellenboro was hit the hardest. By Thursday morning, ten people had been treated for injuries, of which, two victims suffered serious harm. Wright added that at least 10 buildings had been leveled within a three-square-mile area.

The storm then moved northeast, where within minutes, the town of Icard was being pummeled with high winds and rain. Witnesses stated that they could “hear it rumbling, and knew there would be real bad damage.” Dozens were injured and nearly 75 homes suffered damage to varying degrees.

The storm skipped east before dying off in the town of Hildebrand, where reports of uprooted trees and roofs torn off buildings were piling up by Thursday morning.

Hundreds are still without power according to Burke County Fire Marshal, Mark Pitts.

While no one can be blamed for injuries that occur because of a natural disaster, insurance companies often play this to their advantage in order to pay you less for your injuries and losses. The North Carolina personal injury lawyers with HensonFuerst would advise a victim to never take a settlement from an insurance company without first consulting an attorney.

The American Association for Justice (AAJ) has published a document listing the ten worst insurance companies in America. To come up with this list, researchers at the AAJ undertook a comprehensive investigation of thousands of court documents, SEC and FBI records, state insurance department investigations and complaints, news accounts from across the country, and the testimony and depositions of former insurance agents and adjusters.

Is your insurer on the list?

AAJ’s List of the Worst Insurance Companies

1. Allstate—the worst of the worst, called a poster child for insurance industry greed. The number of complaints filed against Allstate are greater than those of almost all its major competitors combined. The company fights its clients to avoid paying for claims. According to a former Allstate adjuster, “We were told to lie by our supervisors—it’s tough to look at people and know you’re lying.” Former employees call the company’s unofficial policy the “three Ds”: Deny…Delay…Defend. Adjusters say they were rewarded for keeping claims payments low, even if they had to deceive their customers.
2. Unum—one of the nation’s leading disability insurers, with a long reputation for unfairly denying and delaying claims. As an example: Debra Potter, who developed multiple sclerosis and became totally disabled. But when she filed a claim for disability, Unum denied the claim saying, in effect, that she was making it up without doctor verification. Her doctor wrote note after note explaining that the disease and disability were real, but Unum continued to deny the claim for three years. She only got justice when she hired a lawyer.
3. AIG—the world’s biggest insurer, but with a long history of claims-handling abuses.
4. State Farm—the nation’s biggest property casualty insurance company, with a reputation for its deny and delay tactics. According to the AAJ, the extreme lengths the company goes through to avoid paying claims include forging signatures on earthquake waivers after the deadly Northridge earthquake, and altering engineering reports regarding damage after Hurricane Katrina.
5. Conseco—sells long-term care policies that are supposed to help take care of people when they are old and need help.  The company’s tactic is to wait and delay, knowing that if it waits long enough to pay out claims, its customers will die.
6. WellPoint—according to the AAJ, Wellpoint routinely cancels the policies of pregnant women and chronically ill patients.
7. Farmers—rewards adjusters who meet low payment goals, sometimes with such measly rewards as pizza parties. One example: 60-year-old Ethel Adams, who was involved in a multi-vehicle accident that put her in a coma for nine days and left her with devastating injuries, including the losing the use of her legs. Incredibly, Farmers denied her claim, reasoning that the driver at fault had acted in a moment of intentional road rage, and thus the crash was not an accident. The company’s denial caused an outcry, and Farmers Los Angeles headquarters was flooded with calls and emails from angry policyholders threatening to boycott the company. Farmers only caved when the Washington State Insurance Commissioner threatened the company with legal action.
8. UnitedHealth—this company has been plague by accusations of greed so rampant that it puts patients at risk.
9. Torchmark—this company has subsidiaries that offer low-cost burial insurance, cancer insurance, and life insurance. The company has come under fire for a variety of transgressions, including charging minority policyholders more than whites.
10. Liberty Mutual—like other companies, they adopted a policy of deny, delay, and defend. In addition, Liberty Mutual has been cited by regulators for systematic bid-rigging.

To read the full report from the American Association for Justice, click here:  The Ten Worst Insurance Companies In America

August 18, 2011

Although it is known that the urban myth about menthol cigarettes containing fiberglass in order to cause small cuts in smokers’ mouth and throat so that more nicotine and menthol can be ingested is false, new studies are showing the minty smokes may be harder to quit, especially among minorities. A news release issued Monday by the Cancer Institute of New Jersey announced the findings of the organization’s study.

The study focused on the likelihood of quitting among smokers of menthol cigarettes versus non-menthol cigarettes throughout different ethnicities, and the findings were shocking.

Smoking menthols was much more common among African-Americans, with almost 72% of black smokers choosing menthols, than among Hispanics (28.1%) or whites (21%). The study was also one of the first to break the Hispanic population down into sub categories of ethnicity and found Puerto Ricans (62%) were more likely to smoke menthols than other Hispanic groups, such as Mexicans (19.9%).

Races with higher probabilities of smoking menthols also had a harder time quitting. Puerto Ricans who smoked menthols were 43% less likely to quit than those non-menthol smokers. African-Americans also had lower rates for quitting among menthol smokers, with a 19% success rate versus non-menthol smokers.

The Raleigh Personal Injury Lawyers with HensonFuerst would like to encourage all smokers to try to put the pack down. The medical benefits could save you tens of thousands of dollars and many headaches arguing with insurance for coverage of associated medical costs.

Imagine this:  You’re in your car, stopped at a traffic light when another car slams you from behind, pushing you across the road and into a light post. Your car is totaled and you have some serious medical bills. Who do you think will end up paying your bills?

Well, if the driver who hit you is uninsured, you may end up footing the bill yourself. It could be financially devastating.

Typically, the costs of an accident are paid by the insurance company of the at-fault driver. If that driver has no insurance, you can try to go after his or her personal assets in a court of law, but if the driver has no insurance and no personal assets, there is nowhere else to turn for compensation…unless you had the foresight to purchase an insurance add-on called “Uninsured Motorist’s Protection.”

Uninsured motorist’s protection covers you in the event that you are hit by an uninsured motorist. This coverage is relatively inexpensive, and can be purchases as part of your regular car insurance. According to AAA.com, in order to properly protect yourself, review the current level of uninsured or under-insured motorist on your auto policy. The level of coverage should be at least as high as the bodily injury or property damage limits.

Now, consider that, in North Carolina, 16% of drivers are uninsured.

The risk is higher than most of us would like to believe.

To read the full article, visit the website at AAA.com/magazine.

At HensonFuerst Attorneys, we represent a lot of people who have been injured in wrecks involving left turns in intersections. If you want to learn more about your legal options following a wreck, please feel free to visit our dedicated web page: Motor vehicle collisions. Or, if you prefer the personal touch, call us anytime at 1-800-4LAW-MED. If you have questions, HensonFuerst has answers.

It turns out that Allstate’s “good hands” are a little dirty.

The New York State Insurance Department  announced that Allstate has agreed to pay New York $1.2 million as part of a $10 million regulatory settlement. In all, 45 states will share the settlement dollars. The agreement follows an 18-month targeted, multi-state examination of Allstate’s claims handling practices. What turned up wasn’t pretty.

I seems that Allstate used a giant analyzing software called Colossus to figure out how much to offer for bodily injury claims after a car wreck. However, Colossus is fallible and inconsistent, and many claimants were paid less than they should have been. Because Colossus is an in-house program, it is the intellectual equivalent of a big black box—you can’t see inside to see how it’s working. And that lack of transparency is what got Allstate in trouble.

According to the press release:

The examination found that Allstate had failed to modify or ‘tune’ the software in a uniform and consistent manner across its claims handling regions.

Allstate’s payment will be used to establish a regulatory fund. The fund will be used by the 45 signatory states, to the extent consistent with applicable state laws, to develop and train examiners to review and monitor the property/casualty industry’s use of software technology in adjusting claims.

That’s a fancy way of saying that we can’t always trust computers to do the humane thing—or even the statistically correct and proper thing. While this should help improve fairness for consumers, we’re not sure how it helps those who might have been short-changed on proper payments. And it really begs the question: Are you really in “good hands” with Allstate?

If you have been in a motor vehicle wreck and have questions about bodily injury claims, feel free to call our dedicated attorneys at 1-800-4LAW-MED. Someone is there to answer your call 24 hours a day. Or, explore our website at http://www.lawmed.com. If you have questions, HensonFuerst has answers.

When the North Carolina Department of Insurance investigated Allstate Insurance Company, it found that the insurance giant doesn’t always have “good hands.” It overcharged on auto insurance premiums, and now it has to pay. Allstate will be returning a total of more than $680,000 to 1803 policy holders–an average of $378 per policy.

According to the Insurance Journal, the announcement was made by North Carolina Insurance Commissioner Wayne Goodwin, who stated:

“That’s why the Department of Insurance is here — we work every day to find these kinds of mistakes, make sure companies fix them, and protect consumers across North Carolina from future errors.”

The overcharges occurred on some policies from July 2005 through July 2008, and were caught during an investigation into a customer complaint…which led to a review of Allstate’s practices in general. (Could we give that complaining customer a medal? About 1800 people will benefit from that one person who spoke up.)

According to the News & Observer business blog, Allstate has already begun sending out refunds. Consumers with questions about the refunds can call the NC Insurance Department’s consumer helpline at 1-800-546-5664. That’s the same number to call if you have a complaint about Allstate or any other insurance company.

If you want to call Allstate directly, their website gives the following information:

Allstate tollfree phone number: 1-800-255-7828

Corporate headquarters phone number: 1-847-402-5000

Email contact form: https://messaging.allstate.com/corp.aspx

To read the full story in the Insurance Journal, click here:  http://www.insurancejournal.com/news/southeast/2010/09/16/113295.htm#ixzz0zhgNIQ9L

Imagine that you have been in a car wreck and are unable to work because of your injuries… or that you have ongoing hospital bills due to medical malpractice. You’ve done everything right. You took your case to court and won a settlement for your losses. How long do you think it might take to receive the money you need to pay your mortgage or other bills?

If you are younger than age 65, you could receive your settlement check within weeks. That sounds right, right? Here’s the problem: If you are age 65 or older, your settlement check could be delayed by years. Yes…years. The difference is due to the red-tape run-around involving something called the Medicare Secondary Payer System (MSP).

The MSP was the product of good intentions. It was designed to help keep Medicare solvent by reimbursing the Medicare Trust Fund if another insurance or compensation source is available to pay for health care costs. The timeline (ideally) would go like this:

1. An injury occurs.
2. The medical bills are paid by Medicare.
3. A lawsuit is filed.
4. A lawsuit is won.
5. Medicare is contacted.
6. Medicare bills are tallied.
7. Medicare is reimbursed from the settlement money.
8. The remainder of the settlement goes to the injured person.
9. Other bills get paid and justice is done.

Again, that’s the ideal. In reality, this is what happens (differences are highlighted):

1. An injury occurs.
2. The medical bills are paid by Medicare.
3. A lawsuit is filed.
4. A lawsuit is won
5. Medicare is contacted. (So far, so good.)
6. Medicare sits on the request to tally the bill.
7. Medicare sits on the request to tally the bill.
8. Medicare sits on the request to tally the bill.
9. Medicare sits on the request to tally the bill.
10. Medicare sits on the request to tally the bill. (ad infinitum)
11. Other bills don’t get paid; justice is not done.

The funds that have been won in a lawsuit can be tied up for years due to the red-tape and inefficiencies of the MSP system. And remember, we’re talking about senior citizens–many of them die before they see a dime of the money that could improve their lives.

What Is Being Done?

There is currently a Bill before Congress that would streamline the process of Medicare reimbursement. The Bill (HR 4796: The Medicare Secondary Payer Enhancement Act) will do several things. Most importantly, it will require that Medicare respond to requests for recovery information within 60 days… that Medicare develop an appeals process for repayment determinations…and that there be a 3-year statute of limitations, so that Medicare can’t ignore injured seniors forever.

One has to wonder why the system would allow this kind of bureaucracy or incompetence to continue. Don’t they want funds repaid in a timely manner? Who benefits from keeping the law in place as it is? It seems like no one: The bill was introduced in March 2010 by Reps. Patrick Murphy (D-Pa.) and Tim Murphy (R-Pa.). It is co-sponsored by 26 other Representatives–Democrats and Republicans–and is backed by a varied group of organizations and businesses, including Walmart, the Defense Research Institute, the American Insurance Association, and Safeway.

HensonFuerst also supports the bill. We have seen many of our clients suffer needlessly–additional suffering on top of their injuries–because of the current difficulties with Medicare reimbursement. If you want to read the full bill and see its status, click here: http://www.govtrack.us/congress/bill.xpd?bill=h111-4796

And if you want to send a message of support to your Representative in Congress, go to the website for People Over Profits (http://www.peopleoverprofits.org), or click here to be taken to their dedicated web page: Support HR 4796.

Today, General Motors Company announced the recall of 1.5 million vehicles because the heated windshield washer fluid systems posed a fire hazard. There was a similar recall in 2008, but a second hazard was discovered in June 2009. That raises the question of why it took a year for the recall to be initiated.

Letters detailing the recall will begin to be mailed this month, but owners of recalled models can call their dealership now to arrange to have the fluid heating system removed. Washer fluid hoses will be reconnected, but the heater unit will not be replaced. As a concession for losing this feature, GM promises to pay each car or truck owner $100.

The recall covers 2006-2009 model year cars and trucks, including:

• Buick Enclave (2008-2009)
• Buick Lucerne ( 2006-2009)
• Cadillac CTS (2008-2009)
• Cadillac DTS (2006-2009)
• Cadillac Escalade (2007-2009)
• Cadillac Escalade ESV (2007-2009)
• Cadillac Escalade EXT (2007-2009)
• Chevrolet Avalanche (2007-2009)
• Chevrolet Silverado (2007-2009)
• Chevrolet Suburban (2007-2009)
• Chevrolet Tahoe (2007-2009)
• Chevrolet Traverse (2009)
• GMC Acadia (2007-2009)
• GMC Sierra (2007-2009), GMC Yukon (2007-2009)
• GMC Yukon XL (2007-2009)
• Hummer H2 (2006-2009)
• Saturn Outlook (2007-2009)

GM claims that there are no known injuries or crashes related to the fire hazard.  It makes you wonder how hard they have been looking. If you believe your car wreck may have been caused by this problem, and you want to know how to report your incident to GM and the National Highway Traffic Safety Administration (NHTSA), feel free to call us at 1-800-4-LAW-MED. If you have questions, HensonFuerst has answers.