California Personal Injury and Insurance Blog

Health insurance to be reinstated

The California Department of Managed Health Care did a good thing. It brokered a deal with Health Net and Kaiser to reinstate health insurance policies to 1,200 people whose policies were rescinded by the insurance companies. The State is trying to reach a similar deal with PacifiCare, Blue Shield, and my favorite, Anthem Blue Cross. (By the way, adding Anthem to their name does not change the humor to the YouTube video.)

In a nutshell, these people had policies cancelled when they started to run up large medical bills. The insurance companies would dig through to find some technicality to use to cancel coverage. The DMHC determined this was not proper underwriting. Health Net, in fact, agreed to a fine, but admitted no wrongdoing. (For once, wouldn't it be nice for someone to actually admit wrong doing a la Charles Barkley.)

This is good news for people who have had policies cancelled.

Disability Insurance Disaster

Suffer through a 15 second commercial and then watch this 6 minute piece from Good Morning America.  As I was told by Chris Cole, a San Francisco attorney, this succintly sums up the problem with disability insurance. This is especially true with disability insurance that you obtain through your employer as a benefit because it falls under ERISA. (By the way, if you have an ERISA insurance issue, there is one man to call: Ben Glass.)

Co-Payments Rise for Health Insurance

From the New York Times: A new insurance company practice is putting the squeeze on insured consumers who must take medications to treat serious illnesses. Instead of charging policyholders a fixed co-payment amount, insurers are starting to charge from 20 to 33 percent of a drug’s price for costlier medications. The resulting bill for many consumers can equal thousands of dollars per month.

Copies of Insurance Policies

This is a fascinating topic for me. It came up in the course of an interview I gave to a reporter on a topic. (I will leave that for another time, after the article is published.) We discussed how you get a copy of an insurance policy.

I called the California Department of Insurance. I asked for a policy. After all, they keep them all there. The answer: The DOI does not give you copies of policies. Why? Because they don't know which policy, if any, you would get from a specific insurer.

So, I called some local agents. These were agents for some of the major insurance companies. I asked for a specimen policy. I was told that I could not get a specimen (sample) policy.

It is fascinating to me that insurance companies sell a product but they will not let you see the product before you buy it. Imagine buying a car without test driving it. Or buying a house sight unseen. You would never do that, but insurance companies won't let you see what you buy until after you buy it. Amazing! 

Good news for Allstate customers?

No, they haven't decided to start paying claims quickly and for a fair amount. That would be like a Lewis Carroll fairytale. Rather, the Dept. of Insurance has ordered Allstate to cut rates by 15%.

Allstate had requested permission for a 7% rate cut. The Department of Insurance wanted a 19% rate cut, according to its calculations. An administrative law judge ordered the 15% rate cut.

Allstate contends it is being unfairly singled out because it is in a fight with the DOI about its homeowners rates. Singled out? I think the decision by the judge supports that the DOI was much closer to the right number than Allstate was.

So, if you are an Allstate insured, expect to see a rate cut from Allstate - assuming it does not appeal.

Telemarketers and Collisions: YUCK!

Well, I was going to use a stronger word, but decided against it since this is a family blog. WOAI in San Antonio has a story on its website about telemarketers who call people who have been in collisions and try to get these people to sign up with attorneys.

Technically, the telemarketer tells the person to go see a clinic to be evaluated at. The clinic then refers the client to the attorney. However, same end result: someone who has been in a collision ends up being called by someone trying to get the collision victim to hire an attorney. It is absolutely disgusting.

This should be perfectly clear: you should make the call to the attorney - not the other way around. If an attorney, or anyone, calls you after a collision, you should not hire that person. It is that simple. You may need an attorney. You may not need an attorney. But, only you know that.

So, do not fall prey to these predators. This disgusting behavior should be outlawed in all 50 states. And every decent trial attorney should support that!

New Drivers Education Bill in California Senate

The Sacramento Bee reported on a new bill from Sen. Tom Torlakson of Antioch. (The bill is here.)Sen. Torlakson has decided, correctly, that we are not doing enough to teach teens how to drive. So, he has proposed a bill that would add $10 to the $27 fee that driver spay to take their DMV test. That money would go to someone. Torlakson is not sure who should get it - DMV to update their tests, schools to provide better education, or someone else. But, Torlakson's bill does set up a commission to figure that out.

Is the bill perfect? No. Is it a start? Yes. Teen driving is still as bad as ever, if not worse. Cars go faster, more cars are on the road, and teens are distracted by their iPods, iPhones, and iOtherstuff. At the same time, we all know that the DMV test is not rocket science and does not really test your driving ability. So, I am support Sen. Torlakson's efforts.

Driving Don'ts

While driving around over the last few days, I have seen some really bad driving. And by bad, I mean really, really bad driving that should have people's licenses taken away. So, with that in mind, I am going to give you my "Top 10 Driving Don'ts" from just this last week:

1. Do not eat soup out of a bowl with a spoon while driving. How, exactly, do you hold the bowl, the spoon, and steer at the same time?
2. Along those same lines, do not eat that hot fudge sundae until you get home!
3. Do not turn left from the far right lane. You can always turn right, then make a u-turn and go straight to get to the same point - and it is safer.
4. Do not tailgate the big rig. As his mudflaps say, if you can't see his mirrors, he cannot see you.
5. Do not drive at night with your lights off. How is anyone supposed to see you, Mr. Black Sports Car?
6. The curved freeway on ramp with 1 lane has 1 lane for a reason. Do not pass someone in the shoulder.
7. The police officer who is following the speed limit will pull you over when you pass him going more than 10 mph faster than he is going.
8. This is a special one for the ladies - do not put on your eye makeup while driving. Please?
9. For the guys - do not comb your hair with both hands.
10. Knees were meant for moving your legs, not driving!

If you have any driving don'ts, please share them. I am anxious to hear what you are seeing.

Health Insurance Reimbursement

There is always a question of whether you need to reimburse your health insurer after a collision. The basic scenario: you are struck by another driver. You go to the doctor. Your health insurer pays for your treatment. They then send you a notice saying they are entitled to be reimbursed.

The largest company that handles reimbursements for insurance companies is a company called Ingenix. Ingenix is now being investigated by the NY Attorney General. While the investigation is focusing on what a doctor is reimbursed, it will not surprise me to see a review of the subrogation practices of Ingenix and other health insurers.

I will continue to follow this for you.

Keep Looking on the Bright Side of Death

I wrote previously and posted a few funny cartoons. One was a Blue Cross video on YouTube. Some poor guy was sick and Blue Cross called it a pre-existing condition and denied coverage. Here is the video, if you want to see it again. Really funny!

Well, it may be more true than funny. Blue Cross, according to the LA Times, is sending out applications for new members to the doctor who will treat the member. Blue Cross is asking the doctors to report to report pre-existing conditions. According to the letter "Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately."

Amazingly, Blue Cross wants the doctors to conduct its underwriting. And, it wants them to violate the doctor-patient relationship all in the name of PROFIT. Now, I have nothing wrong with making money, but there is a right way to do it and a wrong way. This, my friends, falls under the wrong way.