As I have not blogged lately I decided to start 2012 off with a low controversy issue. Let’s start off with a few definitions:
Pro-Choice is defined by the Oxford Dictionary as those advocating legalized abortion.
Pro-life is defined by the Oxford Dictionary as those opposing abortion.
Abortion is defined by the Oxford Dictionary as the deliberate termination of a human pregnancy.
Choice is defined by the Oxford Dictionary as a range of possibilities from which one or more may be chosen.
This week the U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued a statement detailing the requirement that employers are required to provide insurance coverage including contraceptive drugs including abortion drugs.
The rule will require most health insurance plans to cover preventive services for women including recommended contraceptive services without charging a co-pay, co-insurance or a deductible. Beginning August 1, 2012, most new and renewed health plans will be required to cover these services without cost sharing for women across the country.
Nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until August 1, 2013, to comply with the new law. This additional year will allow these organizations more time and flexibility to adapt to this new rule.
The entire statement can be found at http://www.hhs.gov/news/press/2012pres/01/20120120a.html.
If you are a Pro-Life employer you are understandably upset as the rule would require you to pay for something that you oppose on potentially both moral and religious grounds. If you are Pro-Choice I would think that you would be concerned as it is a clear move by the government to do away with Choice. In this rule they are requiring everyone to either obey the law in violation of their personal belief (religious, moral, etc.) or to violate the law and face the consequences. If the issue is truly one for the women whom it impacts — as espoused by Pro-Choice proponents then why is this decision a government issue which requires those who do not agree to pay for that decision.
The issue of pro-choice v. pro-life is one that is so fundamental to most people that a discussion on it will generally end with whether you consider the embryo to be a baby or not. The issue of paying for terminating the life of a baby is not one that should be forced upon anyone or mandated by the government.
The statement by Secretary Sebelius that an additional year will allow these organizations more time and flexibility to adapt to this new rule is ridiculous. Who is the government to give a person or group a year to adapt to a rule that violates their very moral and/or religious beliefs?
For the purpose of this discussion, I don’t care if you are pro-choice or pro-life. This is an issue of pro freedom from government interference in your life. The very thing that pro-choice advocates claim to have fought to achieve they are now conceding and welcoming because they see it as a benefit to them.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Wednesday, January 25, 2012
Tuesday, July 12, 2011
Court allows Drunks to reduce how much they pay
Texas Supreme Court allows drunk drivers and others who cause car wrecks to reduce how much they will have to pay. Drunk Drivers get benefit of your premiums for health Insurance by getting credit for the negotiated rate.
This should have been front page news in papers across Texas this past week as our Supreme Court issued its opinion in the case Haygood v. Escabedo. Did you see a single paper discuss this ruling? Have you heard any of the radio or TV talk shows discuss this case? Why not? Where is the outrage?
I hear comments from people every month who call me about a workers compensation claim, medical malpractice or other issues. I tell them I can’t handle it because the law has made it almost impossible. They almost invariably tell me that it wasn’t supposed to impact their case only those frivolous ones. When I ask them why they weren’t mad and outraged when the laws were being passed or the Supreme Court was “interpreting” them, they always say it didn’t impact me so I didn’t pay attention. The only outrage about our rights being taken away nationally and in Texas seems to be coming from the trial lawyers. I am proud to be in the outraged group.
So what has the Texas Supreme Court done in its latest piece of judicial activism? Their twists and turns distort the law so much it would make a contortionist envious.
The Court's decision in Haywood v. Escobedo allows the person or company who harms you or your family to benefit from the health insurance you have paid premiums for all these years.
The Court argues there ruling is necessary to prevent a “windfall” to the claimant (that would be the person injured, maimed or killed by the drunk or other reckless driver to us normal people).
They also argue they are just interpreting the law as the Texas legislature wanted. Hard to believe that is the case when the legislature actually tried to repeal the law they are “interpreting” the session after they passed it as they realized what it truly was -- which is a windfall for the drunks, reckless drivers and their insurance companies. However Governor Perry vetoed the repeal of the bill so it is still on the books.
So here we are with an Activist Court that needs to protect the drunks and insurance companies, but how? They have already overturned virtually every jury verdict for any Plaintiff that comes their way. So rather than wait until a jury hears all the evidence and votes to compensate the injured person, they have decided to limit what the jury can hear so the compensation will be even lower and the insurance companies will have to pay less, make more profits and be able to contribute to all the expensive political campaigns.
Here is how the Court accomplished this with their latest decision: Let’s start with a situation where you are hit by a drunk who has a policy of $50,000.00. You are taken by life flight to the hospital where you stay for a week. You then have to go through rehabilitation. After about four months you are mostly better. You missed a month of work and still can’t do everything, but hopefully you will get where you can sleep through the night and play with your kids without having to tell them Daddy needs to rest. You have worked hard for years and paid for your health insurance at the cost of some vacations you wanted to take, but you knew how important it was for you to provide coverage for you and your family in case a situation like this happened. The medical bills were over $100,000.00, but because of your group plan they managed to reduce the total to $35,000.00 and since you met your deductible earlier in the year, you don’t owe anything else.
You send the bills to the drunks’ insurance carrier and ask that they pay the $50,000.00 policy limits because your medical bills alone are over $100k. Pretty straight forward right? You shouldn’t even need to get an attorney to settle this case. The operative word there is shouldn’t.
The reality is the insurance company will tell you we don’t owe $100k in medical because we get to take credit for your health insurance premiums and negotiated rate so all we will owe is $35k and we don’t think all of that is related because we know you hurt your neck 15 years ago when you were putting in fence posts and saw a chiropractor one time so we think all your neck issues are related to that and not this head on collision. So with the paid amount being $35k and us taking out some of the neck issue which we believe is not related (and because we can), we are willing to settle your case for $28,500.00.
What gives them the right to get the benefit of your paying premiums all those years: “Home Office” which is what they consider the Texas Supreme Court. Why shouldn’t they? They have won virtually every case that makes it there. Now the Texas Supreme Court has ruled that the only evidence a jury may consider in determining medical expenses are those amounts which were actually paid or will be owed by the person injured. So all those years of paying premiums and making sacrifices for you and your family to be covered is now benefitting the person who caused the wreck. The jury is not allowed to hear about how the bills were over $100k and because you had insurance it was reduced to $35k. They are not allowed to hear about the premiums you have paid to make that reduction possible. They may not even be allowed to hear about the deductible if it was met before this wreck. All because our Supreme Court has determined that it would be a “windfall”. How is it they never seem to be have a problem when insurance companies have a windfall of profits.
So if you happen to serve on a jury or hear about someone on a jury who talks about how this person was in a wreck but only had xxx in medical you can be fairly certain that it is at least 3x that amount of actual medical charges.
For my lawyer friends we know there are also significant issues regarding how Section 18.001 will be impacted and other battles over what constitutes paid --Is a deductible to be considered? Co-pay?
Some of you may know that I spent my senior year of high school attending gymnasium in Germany (which is the German equivalent of our U.S. high school). One of the things required in history classes was a complete study of the Nazi takeover both in political and military terms, which included the apathy and violence. The rational was if you never forget you will never repeat. If you were to ask someone who lived through that time how they could let it happen they would tell you it was not a sudden change. Rights were taken away one by one and it always was something that didn’t concern them. If someone was complaining about this or that they didn’t care because it didn’t impact them. Until one day it did. Then it was too late. Everyone asked how could “they” let this have happened? And then it became clear they were the “they” who allowed it.
As always I welcome comments.
This should have been front page news in papers across Texas this past week as our Supreme Court issued its opinion in the case Haygood v. Escabedo. Did you see a single paper discuss this ruling? Have you heard any of the radio or TV talk shows discuss this case? Why not? Where is the outrage?
I hear comments from people every month who call me about a workers compensation claim, medical malpractice or other issues. I tell them I can’t handle it because the law has made it almost impossible. They almost invariably tell me that it wasn’t supposed to impact their case only those frivolous ones. When I ask them why they weren’t mad and outraged when the laws were being passed or the Supreme Court was “interpreting” them, they always say it didn’t impact me so I didn’t pay attention. The only outrage about our rights being taken away nationally and in Texas seems to be coming from the trial lawyers. I am proud to be in the outraged group.
So what has the Texas Supreme Court done in its latest piece of judicial activism? Their twists and turns distort the law so much it would make a contortionist envious.
The Court's decision in Haywood v. Escobedo allows the person or company who harms you or your family to benefit from the health insurance you have paid premiums for all these years.
The Court argues there ruling is necessary to prevent a “windfall” to the claimant (that would be the person injured, maimed or killed by the drunk or other reckless driver to us normal people).
They also argue they are just interpreting the law as the Texas legislature wanted. Hard to believe that is the case when the legislature actually tried to repeal the law they are “interpreting” the session after they passed it as they realized what it truly was -- which is a windfall for the drunks, reckless drivers and their insurance companies. However Governor Perry vetoed the repeal of the bill so it is still on the books.
So here we are with an Activist Court that needs to protect the drunks and insurance companies, but how? They have already overturned virtually every jury verdict for any Plaintiff that comes their way. So rather than wait until a jury hears all the evidence and votes to compensate the injured person, they have decided to limit what the jury can hear so the compensation will be even lower and the insurance companies will have to pay less, make more profits and be able to contribute to all the expensive political campaigns.
Here is how the Court accomplished this with their latest decision: Let’s start with a situation where you are hit by a drunk who has a policy of $50,000.00. You are taken by life flight to the hospital where you stay for a week. You then have to go through rehabilitation. After about four months you are mostly better. You missed a month of work and still can’t do everything, but hopefully you will get where you can sleep through the night and play with your kids without having to tell them Daddy needs to rest. You have worked hard for years and paid for your health insurance at the cost of some vacations you wanted to take, but you knew how important it was for you to provide coverage for you and your family in case a situation like this happened. The medical bills were over $100,000.00, but because of your group plan they managed to reduce the total to $35,000.00 and since you met your deductible earlier in the year, you don’t owe anything else.
You send the bills to the drunks’ insurance carrier and ask that they pay the $50,000.00 policy limits because your medical bills alone are over $100k. Pretty straight forward right? You shouldn’t even need to get an attorney to settle this case. The operative word there is shouldn’t.
The reality is the insurance company will tell you we don’t owe $100k in medical because we get to take credit for your health insurance premiums and negotiated rate so all we will owe is $35k and we don’t think all of that is related because we know you hurt your neck 15 years ago when you were putting in fence posts and saw a chiropractor one time so we think all your neck issues are related to that and not this head on collision. So with the paid amount being $35k and us taking out some of the neck issue which we believe is not related (and because we can), we are willing to settle your case for $28,500.00.
What gives them the right to get the benefit of your paying premiums all those years: “Home Office” which is what they consider the Texas Supreme Court. Why shouldn’t they? They have won virtually every case that makes it there. Now the Texas Supreme Court has ruled that the only evidence a jury may consider in determining medical expenses are those amounts which were actually paid or will be owed by the person injured. So all those years of paying premiums and making sacrifices for you and your family to be covered is now benefitting the person who caused the wreck. The jury is not allowed to hear about how the bills were over $100k and because you had insurance it was reduced to $35k. They are not allowed to hear about the premiums you have paid to make that reduction possible. They may not even be allowed to hear about the deductible if it was met before this wreck. All because our Supreme Court has determined that it would be a “windfall”. How is it they never seem to be have a problem when insurance companies have a windfall of profits.
So if you happen to serve on a jury or hear about someone on a jury who talks about how this person was in a wreck but only had xxx in medical you can be fairly certain that it is at least 3x that amount of actual medical charges.
For my lawyer friends we know there are also significant issues regarding how Section 18.001 will be impacted and other battles over what constitutes paid --Is a deductible to be considered? Co-pay?
Some of you may know that I spent my senior year of high school attending gymnasium in Germany (which is the German equivalent of our U.S. high school). One of the things required in history classes was a complete study of the Nazi takeover both in political and military terms, which included the apathy and violence. The rational was if you never forget you will never repeat. If you were to ask someone who lived through that time how they could let it happen they would tell you it was not a sudden change. Rights were taken away one by one and it always was something that didn’t concern them. If someone was complaining about this or that they didn’t care because it didn’t impact them. Until one day it did. Then it was too late. Everyone asked how could “they” let this have happened? And then it became clear they were the “they” who allowed it.
As always I welcome comments.
Thursday, September 30, 2010
Where did our premiums go?
Texas Windstorm Insurance Association (TWIA) is in court in Galveston attempting to convince the Judge to order the Plaintiffs attorneys to turn over the total amount of fees they have made in representing people who had their hurricane claims denied or underpaid. The TWIA has already tried to set the stage against the “greedy” plaintiffs lawyer. There has also been talk about the legislature needing to know the amount of fees so they can possibly do something about them. Here's another crazy idea TWIA -- evaluate the claims fairly and pay them timely and guess what there would be NO attorney fees. What a novel idea. An insurance company actually paying a claim. I realize it is a shock to the insurance world that someone would ever suggest that they do anything other than collect premiums, but normal people actually expect to be covered in exchange for all the money they have paid over the years and they get a little upset when after having their $150,00.00 home destroyed that you want to write them a check for well below the value or that you tell them that the fact that their roof blew off is just a coincidence that it happened after a hurricane.
Sorry I drifted off into the world of how normal people think and not the land of insurance where intelligent life is scarce. So instead of just paying the claims and avoiding the lawsuits and attorney fees completely, the insurance companies whine and moan about how much money the attorneys who are representing their insured’s are making. They want to start an investigation into the amount of fees and make it all public. What they really want to do is create a smoke screen where they can hide. They want to use their same old “greedy lawyers” argument and hope that it gets people to forget that they have made millions (if not billions) of dollars off the people of this state in premiums and then refused to pay the claims.
The only time you generally need insurance is when something bad happens. The only time you generally need a lawyer is when someone has done something they shouldn’t have. I see a correlation here. It does not seem to be apparent to the insurance industry. So why should that surprise us? Instead of hearings on attorney fees paid out, how about hearings and an investigation into how to prevent this type of abuse by the insurance companies in the future. Make the failure of an insurance company to pay a valid claim a claim in which not only can the person who paid their premiums get their attorney fees and the real value of the claim, but punitive damages or an automatic 10x the claim value. Maybe that will get the insurance companies to do what is right in the first place.
I do have some questions of my own: How much did the insurance companies make off of Texans in the last 10 years? How much did they make off of interest in the premiums they have kept and money they have not paid out for the hurricane claims? How much do they pay their lobbyists and others who try and convince our representatives to “protect” them (in other words don’t make us actually pay any claims or worst case let us delay them for years and then only pay the very minimum)? Which representatives received money from the insurance companies and how much?
Sorry I drifted off into the world of how normal people think and not the land of insurance where intelligent life is scarce. So instead of just paying the claims and avoiding the lawsuits and attorney fees completely, the insurance companies whine and moan about how much money the attorneys who are representing their insured’s are making. They want to start an investigation into the amount of fees and make it all public. What they really want to do is create a smoke screen where they can hide. They want to use their same old “greedy lawyers” argument and hope that it gets people to forget that they have made millions (if not billions) of dollars off the people of this state in premiums and then refused to pay the claims.
The only time you generally need insurance is when something bad happens. The only time you generally need a lawyer is when someone has done something they shouldn’t have. I see a correlation here. It does not seem to be apparent to the insurance industry. So why should that surprise us? Instead of hearings on attorney fees paid out, how about hearings and an investigation into how to prevent this type of abuse by the insurance companies in the future. Make the failure of an insurance company to pay a valid claim a claim in which not only can the person who paid their premiums get their attorney fees and the real value of the claim, but punitive damages or an automatic 10x the claim value. Maybe that will get the insurance companies to do what is right in the first place.
I do have some questions of my own: How much did the insurance companies make off of Texans in the last 10 years? How much did they make off of interest in the premiums they have kept and money they have not paid out for the hurricane claims? How much do they pay their lobbyists and others who try and convince our representatives to “protect” them (in other words don’t make us actually pay any claims or worst case let us delay them for years and then only pay the very minimum)? Which representatives received money from the insurance companies and how much?
Tuesday, February 3, 2009
Uninsured/Underinsured Auto Coverage
Did you know that the auto insurance that you have paid for all these years can refuse to pay even if it is clear that you were injured through no fault of your own? Let me give you an example. You are stopped at a light and a drunk hits you. You go to the hospital and everyone knows you are seriously injured. The drunk is arrested and taken to jail for causing the wreck and your medical bills are increasing daily. You learn that the drunk has no insurance, so you make a claim on your insurance under the uninsured portion of your policy. That is why you have been making those payments all these years. You submit all your bills and even send them the police report. You then get a letter stating that they do not have to pay anything until the drunk is found liable and the damages are established. Your medical is now over $40,000.00 and your uninsured coverage is only $50,000.00 clearly they will pay it and not make you hire a lawyer and file a lawsuit right. Wrong. The Texas Supreme Court has expressly permitted this very action and the insurance companies are taking full advantage of it. You may now have to hire a lawyer, file a lawsuit and incur all the cost of filing fees, depositions, etc. to "prove" the drunk was at fault and what your damages are, and once you do all that and get a verdict, you would think you would get the policy limits ($50k in our example), plus your expenses and attorneys fees because you paid those premiums to get treated fairly, but that is not the case. In our example, let's say the jury finds the drunk at fault and awards $150,000.00. The Supreme Court has held that if the policy limits are tendered timely (within 5 days) of the judgment, all they owe is the policy ($50k), no attorneys fees or expenses. So why would an insurance company ever settle an uninsured case for the full value when they know they can make you spend time and money and ultimately will get less. If you think this is wrong, you are right. Let me know your thoughts.
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