Pleasant Law Blog (Insurance Claims, Medical Misakes, and Nursing Home Claims)

Insurance Law: Allstate Would Rather Pay $25,000 PER DAY than Release McKinsey Documents

Insurance Companies Act in Bad Faith When They Set Goals for Cancellations or Pay Bonuses Based on Cutting Claims

The Los Angeles Times recently reported that the State of California fined Health Net Inc. over $1 million for setting goals for its adjusters based on the cancellation of benefits. Apparently, Health Net also paid bonuses at least partly based on how many policy holders were dropped and the money saved as a result. In the insurance law realm, doing this sort of thing is not acceptable, and in most cases, in my opinion, likely constitutes insurance bad faith and may also violate the applicable unfair insurance claims practices laws (in North Carolina and other states). Insurance companies are certainly entitled to make money, but on the claims side, claims adjusters and those with the power to cut benefits cannot be given incentives to stop benefits, reduce coverages, or deny claims. These kinds of incentive programs are not new: California also fined disability insurance giant UNUM Provident several years ago (somewhere around $15 million), in part, I believe, for engaging in some of the same types of activities. This Health Net scandal appears to be more of the same in the way of insurance bad faith and insurance unfair claims practices.

Insurance Unfair Claims Legal Victory Versus Fireman's Fund Insurance

Unfairly Delayed Insurance Claim Payments Can Result in Large Insurance Damages Award

Allstate, Unum, AIG, State Farm, Conseco, Wellpoint, Farmers, United Health, Torchmark, and Liberty Mutual Top Ten Worst Insurance Companies List

Unum Provident Defrauded the Government, Jury Finds

Insurance Claim Tactics Exposed Again by AAJ - Read "Tricks of the trade: How Insurance Companies Deny, Delay, Confuse and Refuse"

Court Confirms Serious Disability Insurance Unfair Claims Practices of Unum and Paul Revere

$1.68 Million Verdict for Correction Officer in California

The December 2007 Law Reporter (Published by the American Association for Justice) outlines the details of a recent disability discrimination case filed by a County Juvenile Detention Facility worker who was awarded $1.68 million in damages related to her employer’s failure to accommodate her wrist disability.  The plaintiff, who had been earning about $43,200.00 per year, came away with damages that high probably for a number of reasons.  First, in employment law cases, future expected income can often be substantial.  In this case, the plaintiff’s future expected lost income was $360,000.00.  Also in employment law cases, generally the plaintiff is able to recover past lost income as of the time of trial; and in this particular case that amount was $69,000.00.  This plaintiff also had lost her health insurance benefits, which were apparently substantial.  Most importantly, probably, were emotional distress damages related to the case.  The employer in this case repeatedly over a number of years failed to accommodate this employee’s disability, which aggravated the injury due to the job duties required.  The worst part, however, is that the employer finally terminated the plaintiff while the plaintiff was on leave for treatment of a breast cancer condition, and only after plaintiff finally complained about her employer’s failure to accommodate her wrist disability.  Most federal employment law protections for employees also contain “anti-retaliation” provisions.  In many cases, even if the employer has not violated the statute itself (e.g., by actually discriminating in violation of the law), but the employer terminates an employee for complaining or “blowing the whistle”,  then the employer is liable for retaliation if it takes any adverse employment action against the employee.  These seem to be some of the best employment law cases.  These retaliation provisions are important to the enforcement of employment law protections for employees and to protecting employees’ rights under the law.  The jury’s verdict in this case demonstrates the importance of employees being able to report or complain about what is perceived to be discriminatory treatment.  Employment law retaliation provisions also pave the way for employees to work with employers to ensure fairness under those laws.