Thomas Pleasant helps people who are being victimized by insurance companies. If you are facing obstacles in getting your insurer to pay a legitimate claim or if your claim has already been denied, Thomas can help you. His areas of special expertise include insurance bad faith cases, long-term disability claims, and property damage and losses as well as personal injury and product liability cases, and situations in which people are being treated unfairly by their employers and as consumers. Thomas represents clients in the Southeast and Mid regions of North Carolina. If you need legal help, contact Thomas today for a free consultation. www.pleasantlaw.com

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Thomas Pleasant helps people who are being victimized by insurance companies. If you are facing obstacles in getting your insurer to pay a legitimate claim or if your claim has already been denied, Thomas can help you. His areas of special expertise include insurance bad faith cases, long-term disability claims, and property damage and losses as well as personal injury and product liability cases, and situations in which people are being treated unfairly by their employers and as consumers. Thomas represents clients in the Southeast and Mid regions of North Carolina. If you need legal help, contact Thomas today for a free consultation. www.pleasantlaw.com

News

Pending: Nursing Home Transparency and Improvement Act of 2008

Congress is looking at what some consider to be the most crucial nursing home law in 20 years. Senator Chuck Grassley of Iowa, Ranking Republican on the Finance Committee, and Senator Herb Kohl of Wisconsin, Chairman of the Special Committee on Aging (Two of Congress’s leading supporters of nursing home reform), have introduced the Nursing Home Transparency and Improvement Act. Read more via this link to the National Citizens Coalition for Nursing Home Reform. Take action to support this bill, so that nursing home victims and nursing home injury, abuse, neglect and wrongful death lawyers can hold the nursing home industry accountable.

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$6 Million Awarded To Family of Patient Killed by Morphine Overdose

The Tuscon Citizen Reports: "A jury awarded a Tucson family $6 million in a lawsuit brought after an ailing 81-year-old relative died of a morphine overdose. Mary Culpepper and two other relatives last month were awarded $2 million each, with the cost to be paid 90 percent by operators of a nursing home, Manor Care Health Services, and 10 percent to be paid by Tucson Medical Center." This event actually happened in a nursing home; but drug overdoses are common medical mistakes made by doctors, nurses, hospitals, and other healthcare providers. Click the link to read the actual article.

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Thomas Pleasant Settles Homeowner Insurance Claim Case. Insurer Pays About Double What It Claimed Was Due For House Repairs

Thomas Waitt Pleasant recently settled a fire insurance unfair claims practices case for a client, getting insurance money in an amount that almost doubled what the insurance company originally claimed was due to the homeowner/policyholder.  The insurance company ended up paying a total of about $253,000.00 just for the home repairs -- an amount about double what the insurance company originally claimed the repairs would cost.

The home of Mr. Pleasant's client burned on Christmas Eve 2005, when a small portable heater tipped over. The house was uninhabitable. There was no allegation of arson. Plaintiff notified the insurer of the claim on Christmas day.   In February 2006, the insurer produced and proposed a dwelling repair estimate from its subcontractor adjuster totaling approximately $123,000.00.  Plaintiff contended that this estimate was inadequate and incomplete, and the insurer later acknowledged thiis.

The insurance company’s subcontractor-adjuster re-inspected the dwelling in May 2006, for the purpose of revising the first estimate.  This subcontractor-adjuster was terminated by the insurer in approximately June 2006, having never revised the estimate. In October 2006, after Plaintiff retained counsel, and over eight months after the loss, the insurer paid the undisputed amount (approximately $123,000.00), based on the first estimate.

The insurer then had a second subcontractor-adjuster inspect the dwelling. This second adjuster produced and proposed a dwelling repair estimate of approximately $124,000.00 (only about $1,000.00 greater than the first estimate).  The insurer took the position that this estimate was accurate, and paid the difference between this new estimate and the undisputed amount previously paid. Mr. Pleasant filed suit on the plaintiff's behalf, claiming damages related primarily to the alleged underpayment on the dwelling claim. Plaintiff alleged breach of contract, unfair and deceptive trade practices, tortious breach of contract/bad faith, and other claims.

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State Farm appeals award

"NEW ORLEANS -- State Farm Fire and Casualty Co. is asking a federal appeals court to throw out a landmark $1 million punitive damages award to a Mississippi couple who sued the insurer for refusing to cover Hurricane Katrina damage to their home." From SunHerald.com

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Insurers playing rough

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Lawyers Guiding Clients Through The Strike Zone

“You won't find them on the picket lines, but it shouldn't come as a surprise that attorneys representing film and television writers are playing a key part in the Writers Guild of America strike, which enters its 12th day Friday. The involvement is certainly not comparable (at least not yet) to the five-month 1988 strike, when noted legal eagle Ken Ziffren took a leading role in resolving the dispute, meeting with union officials, studio heads and the studios' chief negotiator Nick Counter to mediate a settlement. Rather, the role many top industry attorneys say they now find themselves in is that of steady adviser, helping clients to navigate the war rhetoric and complex strike rules without unintentionally angering either side.” Reuters, 11-16-07

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Insurance Industry Stung by $11 Million R-67 Loss

"The insurance industry’s $11 million bellyflop against Referendum 67 was an election bright spot for ruling Democrats, who otherwise took their lumps from a frugal electorate that sent establishment ideas packing. The referendum, which allows triple damages in lawsuits alleging bad faith by insurance companies, spawned a lively campaign pitting the industry against trial lawyers. Supporters said R-67 would give consumers a powerful tool to punish bad actors in the insurance industry. Opponents countered that it was an unnecessary magnet for unfounded lawsuits, and would drive up insurance rates." Curt Woodward, Associated Press, 11-8-07

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Health Insurer Tied Bonuses to Dropping Sick Policyholders

"One of the state’s largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved. Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed." Lisa Girion, Los Angeles Times, 11-9-07

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Employment Discrimination Suit to Test Strength of Arbitration Clause

"The Supreme Judicial Court recently heard arguments in a case that addresses the tension between the right of an individual to a jury trial on her claims of employment discrimination and the strong public policy favoring enforcement of arbitration agreements. In St. Fleur v. WPI Cable Systems/Mutron, SJC No. 09961, the court will decide if an employee waived her right to a jury trial by signing her employer’s arbitration agreement, even where she says she was only presented with the signature page and never saw the entire agreement." David Frank, Massachusetts Lawyers Weekly, 11-13-07

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Sugeon Wins $31 Million in UnumProvident Suit

"A California jury's $31.7 million verdict against UnumProvident, the nation's largest disability insurer, is just one of a number of legal problems the company faces. More than 2,500 policyholders have sued the company accusing it of fraud and breach of contract, there is at least one class-action suit pending and regulators in two states are conducting inquiries."

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AP - Louisiana Couple Beats State Farm in First Federal Katrina Insurance Trial

"An attorney for plaintiffs Michael and Judy Kodrin and a State Farm spokesman estimated the award would be about $350,000. But U.S. District Judge Carl Barbier said he'd have to calculate the amount and did not immediately issue a finding.

'We're just happy it's over, and that the jury was fair and just,' Judy Kodrin said, adding later: 'It never was about the money for us. It was about justice more than anything.'"

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Bad-Faith Treble Damages Win in Wash. Vote

"In a big-bucks lobbying battle that pitted trial lawyers against the insurance industry in Washington state, the attorneys have prevailed.

Voters have approved a referendum upholding a state law passed earlier this year that calls for courts to award treble damages to policyholders when their carriers refuse, in bad faith, to pay claims that are covered under the insurance contract. Although the votes from yesterday's election haven't all been counted, the referendum clearly has passed and insurance carriers have conceded defeat, reports the Associated Press."

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Philadelphia Judge Awards Wal-Mart Workers $62M More

“A Philadelphia judge has awarded an additional $62 million in statutory liquidated damages to 124,506 current and former Pennsylvania employees of retail titan Wal-Mart who a Philadelphia jury found were not properly compensated for off-the-clock work and missed rest breaks. Philadelphia Common Pleas Court Judge Mark I. Bernstein, who presided over the 2006 trial in Hummel v. Wal-Mart and Braun v. Wal-Mart, Wednesday awarded $62,253,000 to the plaintiffs who worked after Jan. 1, 2002. The 12-member jury last year awarded $78.5 million in compensatory damages to 186,000 current and former employees of the retailer. The rest of the class did not qualify for statutory damages because of the time frame in which they worked.” Amaris Elliott-Engel, The Legal Intelligencer, Law.com 10/4/07

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State Bias Claims Against Employers Gain Traction

“The right to sue an employer for discrimination in state courts is gaining momentum, rattling the nerves of employers who fear more lawsuits and costly jury trials. From Oct. 1, Maryland employees for the first time are allowed to sue employers for discrimination in state court and seek a jury trial due to an amendment to the state's anti-discrimination law. In the past, employees were limited to suing in federal court or filing administrative claims with a state agency or the U.S. Equal Employment Opportunity Commission. Illinois employees also have gained similar rights. Starting on Jan. 1, 2008, plaintiffs there will be allowed to pursue workplace claims in state court, rather than be limited to federal court and administrative claims. Illinois and Maryland join 38 other states that allow for workplace disputes to be pursued in state courts.” Tresa Baldas, National Law Journal, Law.com 10/8/07

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Bill Would Streamline Whistleblower Protections (Nov 2, 2007)

FOR IMMEDIATE RELEASE

Contact: Adam Miles, Legislative Representative
Phone: 202.408.0034 ext 132, cell 202.276.2007
Email: adamm@whistleblower.org

Bill Would Streamline Whistleblower Protections
Woolsey Bill Covers Private Sector, State and Municipal Employees

(Washington, D.C.) – The Government Accountability Project (GAP) applauds Rep. Lynn Woolsey (D-CA), Chairwoman of the House Education and Labor Subcommittee on Workforce Protections, and a group of 13 co-sponsors, for introducing the “Private Sector Whistleblower Protection Streamlining Act of 2007” yesterday, November 1. The legislation, H.R. 4047, would for the first time establish a uniform, coherent system of legal protections for all private sector, state and municipal employees who are retaliated against for disclosing threats to public safety or violations of federal law.

“This is a ‘Good Housekeeping,’ good government measure more than 30 years overdue,” said GAP Legal Director Tom Devine. “Whistleblowers are the life blood for the government to enforce consumer protection laws. But the legal system is hopelessly dysfunctional. For too long, whistleblower law at the non-federal government and corporate levels has been a crazy quilt of contradictory, hit or – usually – miss protections tucked into specific public health and safety laws.”

The list of 13 original co-sponsors includes Rep. George Miller (D-CA), Chairman of the Education and Labor Committee, Rep. Robert Andrews (D-NJ), Rep. Tim Bishop (D-NY), Rep. Raul Grijalva (D-AZ), Rep. Phil Hare (D-IL), Rep. Dale Kildee (D-MI), Rep. Dennis Kucinich (D-OH), Rep. Ed Markey (D-MA), Rep. Carolyn McCarthy (D-NY), Rep. Don Payne (D-NJ), Rep. Linda Sanchez (D-CA), Rep. Carol Shea-Porter (D-NH), and Rep. John Tierney (D-MA).

The legislation uniformly adopts “best practices” whistleblower protection models Congress already has passed, or has been considering, on an issue-by-issue basis since last November’s election. To illustrate, in August President Bush signed into law enhanced whistleblower protections for ground transportation employees in the rail, bus, trucking, and public transit industries. The Senate Commerce Committee this week advanced similar pro! tections for employees who blow the whistle on violations of product safety standards. The Senate approved modern, “best practices” whistleblower protections for employees of defense contractors as part of its FY2007 defense bill.

H.R. 4047 applies the modern “best practices” throughout the private sector and for non-federal government employees for enforcement of consumer protection laws in areas including health and health care, environmental protection, food and drug safety, transportation safety, building and construction-related requirements, energy, homeland, and community security, and financial transactions or reporting requirements, including banking, insurance, and securities laws.

“It will benefit labor, management and the public to streamline the 32 disparate federal whistleblower statutes, while filling arbitrary coverage gaps,” GAP Legislative Representative Adam Miles explained. “Currently almost everyone is flying blind about whistleblower rights. Nobody knows what the rules are without a legal specialist.”

To illustrate, an employee at a meat packing plant has whistleblower rights when challenging the release of fecal-contaminated water flowing into a river. But the same employee has no rights when disclosing the shipment of fecal-contaminated meat and poultry to a supermarket’s butcher case. A truck driver is protected for challenging bad tires, but not illegal cargo in his haul. An employee of a pharmaceutical company has protection for disclosing false statements in financial reports to shareholders. But there is no protection for challenging false statements to the government or the public about potentially lethal drug safety hazards.

To see a comprehensive list of the failures of the current system, see Devine’s testimony from a May 15 Workforce Protections Subcommittee hearing at http://edworkforce.house.gov/testimony/
051507TomDevineTestimony.pdf

To watch Tom Devine deliver a s egment of this testimony on You-Tube, go to http://www.youtube.com/watch?v=AtVJLEtGF5U

To read other witnesses’ testimony from the hearing, "Private Sector Whistleblowers: Are There Sufficient Legal Protections?", including tobacco industry whistleblower Jeffrey Wigand, go to http://edworkforce.house.gov/hearings/
wp051507.shtml

To read the legislation, go to http://www.whistleblower.org/doc/2007/
HR_4047.pdf

To read a summary and section-by-section analysis of the legislation from the Education and Workforce Subcommittee, go to http://www.whistleblower.org/doc/2007/
summary%20of%20Private%20Sector%
20Whistleblower%20Protection%20Streamlining%
20Act%20of%202007.pdf

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More Protection for Whistle-Blowers Proposed

"U.S. officials have long retaliated against employees who speak out, burying the dangers they expose. Now, Congress wants to give whistle-blowers greater protection -- but President Bush vows to stop it."

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20/20: Katrina: Where Things Stand: 8/25/06

In an exclusive report on the one-year anniversary of Hurricane Katrina, ABC News chief investigative correspondent Brian Ross investigates allegations of fraud in the handling of Katrina-related damage claims in Mississippi by State Farm Insurance. Speaking publicly for the first time, two State Farm insiders, Cori and Kerri Rigsby, claim supervisors in their Mississippi office demanded that outside engineers change or bury damage reports so that State Farm would not have to pay the claims. The Rigsby sisters, who worked as independent adjustors for State Farm for eight years, have provided thousands of documents to federal and state prosecutors in Mississippi. Their allegations are now a key part of a massive lawsuit against State Farm by policyholders who claim they were cheated. 'Katrina was devastating. But so was State Farm,' says Cori Rigsby. 'Until this storm, we were very proud to work with State Farm,' she says. A lawyer for State Farm, Wayne Drinkwater, says the company paid more than a billion dollars in claims in Mississippi and denies State Farm cheated anyone.

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Washington State Referendum 67 Update

"Ballots for the November general election are arriving in mailboxes around the area that include a lot of statewide issues including Referendum 67, a complex issue regarding insurance company accountability[,]" including unfair insurance claims practice statutes.

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Smithfield Union Suit Claims Racketeering

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From NYT: "Fires’ Cost to Insurers Is in Range of $1 Billion"

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Allstate Bad Faith? Fight to Release McKinsey Documents Continues.

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Protection for Disabled Employees to Continue: ADA Restoration Bill Introduced

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The 'good hands' people make a fist (Houston Chronicle)

"We've known the insurance company game for a long time. We just didn't have any proof. David Berardinelli does."

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Washington State Trial Bar Rolls Up Sleeves for Ref. 67 Fight

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Plaintiffs Await Ruling on Canceled Health Insurance Policies

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AAJ Article: "The Truth About Jones v. Allstate: Customer Service or Charade?"

On January 14, 2000, Washington State superior court Judge Phillip G. Hubbard ruled that Allstate Insurance "engaged in the unauthorized, negligent practice of law" for holding itself out as a legal representative for a claimant family, and for convincing that family that it had no need to contact an attorney. The court also said Allstate was liable for that family's injuries and damages caused by this unauthorized practice of law. Read more at the American Association for Justice website (link below)....

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CNNMoney.com Article: "When your insurer plays hardball"

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Insurance Companies' "Pattern of Greed" Revealed

Follow the link below to read more....

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Allstate Insurance Cannot Hide Claim Practices Information

On August 16, United States District Judge Sarah Vance in New Orleans refused to seal the trial exhibits in Weiss v. Allstate, the case of a New Orleans couple who earlier this year won a $2.8 million verdict against Allstate for illegally refusing a hurricane-related claim. In so ruling, the Court noted that "[p]ublic access serves to enhance the transparency and trustworthiness of the judicial process, to curb judicial abuses, and to allow the public to understand the judicial system better."

In arguing against secrecy, FTCR, which has fought for comprehensive insurance reforms in California and nationwide, says Allstate and other insurance companies have accepted premium payments from customers like the Weisses for years, only to deny or drastically reduce property owners' claims when catastrophe strikes.

The court's order and other related documents can be viewed at the referenced link.

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Lawsuit Accuses Insurers of Defrauding Government

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Home Insurers' Secret Tactics Cheat Fire Victims, Hike Profits

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Study Exposes Allstate's Excessive Prices and Poor Claims Handling

"In recent years, property-casualty insurers have made a number of significant but not always highly visible changes in the way they assess risk, set rates and manage claims. The aftermath of Hurricane Katrina exposed the harmful effects of many of these changes on policyholders, especially lower income and minority consumers." "As CFA [The Consumer Federation of America] has tracked these questionable [insurance claim] practices, one insurance company stood out as a leader in creating and exploiting many of these trends. That insurer is Allstate. As a result, CFA launched a detailed investigation of Allstate’s business practices, which found: 1. Excessive rates and profits... 2. Questionable claims settlement practices... 3. Mistreatment of consumers throughout the country in the aftermath of Hurricane Katrina... 4. Unfair rating and underwriting practices... 5. High consumer complaints... 6. Shifting costs to taxpayers... The entire report is available at the Consumer Federation of America's website, www.consumerfed.org.

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