Personal Injury and Social Security Disability Blog

Texas Drivers Hit Roadblocks After Filing Auto Insurance Claims

Lawyers who represent victims of auto collisions in Texas have always known that insurance companies will use any legitimate means to deny a liability claim against their insured. But in recent years there has been a disturbing trend among some insurance companies of using means that stretch the boundaries of being legitimate. In fact, in many cases, these denials of coverage are just plain fraudulent.

Now the Dallas Morning News has exposed some of these tactics in an excellent article that identifies the suspect insurance companies by name. I encourage anyone who owns a vehicle to read this article. You do not want insurance with one of these companies. A denial of coverage means that you will be personally responsible for any damages you cause in a car wreck, while your insurance company will keep your premiums and say "tough luck" to you.

Some of these shady tactics include issuing an auto insurance policy in the name of a person who is not the owner of the car, with the owner listed as an "excluded driver." So the vehicle does have insurance coverage (which satisfies the police and keeps the vehicle from being impounded in case of a collision), but the owner of the vehicle is actually uninsured. The result is that if the owner of the car causes a collision, the innocent person he hits is out of luck. Another tactic is to claim the insured person is "refusing to cooperate" with the insurance company's investigation of the collision. This is actually a legitimate reason for denying a claim. But what the sleazy insurance companies do is just never try to contact their insured, and flat out lie when they say their insured is not cooperating. We have seen each of these situations multiple times.

Please read the newspaper article. Here are excerpts:

Pat Taylor of Mesquite was headed home after a typical workday this summer when another car jolted her Toyota Highlander from behind. The damage to her SUV was serious and, she said, the 20-year-old driving the other car clearly was at fault. Police arrived and the other driver showed an insurance card from a company that Taylor figured would cover her losses, estimated at $1,500.

But after several days, she said, the other driver’s insurer — Fred Loya Insurance Co. — told her that the policy was in his mother’s name and that he was excluded from coverage, and that the company would not pay for the damages.

“It was infuriating,” she said of the accident along U.S. Highway 80. The insurance card from Loya “let him get his annual inspections and license renewals. But when he got into an accident, all of a sudden he had no insurance coverage.”

Taylor’s case is not an isolated example for drivers in North Texas and across the state after accidents involving Loya or Old American County Mutual Insurance — two major companies at the top of the state’s complaint list for auto insurers.

The Texas Department of Insurance says Loya, which collected $271 million in premiums last year, had a “complaint index” of 2.4, nearly 21/2times the state average. The larger Old American, which had premiums of $575 million, had a complaint index of 3.96 — nearly four times the state average.

House Insurance Committee Chairman John Smithee, R-Amarillo, said he has had growing concerns about certain insurers who regularly refuse to pay claims in which their policyholders are at fault.

Typically, Smithee said, an adjuster for the company tells the injured party that if the claim isn’t paid, the person will have to hire a lawyer and will probably wind up with little money for the trouble. At that point, the driver feels forced to take 50 percent or less of the claim for damages. “It has been hard to make some of these companies behave,” he said.

Last year, consumers filed more than 6,600 complaints against auto insurers in Texas. More than half were filed by drivers who said they were not at fault in an accident but had trouble getting an insurer to pay their claims.

Alex Winslow of Texas Watch, a consumer group active in insurance issues, said unethical companies have an advantage because they undercut regular insurers on price largely because of the claims payment practices.

“The business model is they drag their feet and make it as difficult as possible for the claimant to collect in hopes they will take a low-ball offer or give up,” he said.

“I’m concerned the Insurance Department is not being aggressive in policing market conduct. They should be exercising more authority over these companies that are using questionable practices.”

AT A GLANCE: Complaints filed with state

HIGHER THAN AVERAGE

These Texas insurers had an above-average number of complaints in 2010, based on Insurance Department complaint index*:

AAA Texas County Mutual 2.06

ACCC Insurance 1.28

Allstate Fire and Casualty 1.16

Allstate Indemnity 1.29

Colonial County Mutual 1.64

Geico Indemnity 1.36

Home State County Mutual 1.58

Liberty County Mutual 1.33

Fred Loya Insurance 2.4

Old American County Mutual 3.96

Southern County Mutual 1.95

*The average index for all companies is 1.0; a higher number would indicate the insurer has more complaints than average filed with the state. A company with an index of 3.0 has three times as many complaints as the typical company. Eleven of 25 insurers with more than 100,000 policies in Texas had an above-average complaint index.

 

SOURCE: Texas Department of Insurance

Featured Link — Council for Disability Awareness

The Council for Disability Awareness is essentially a group of long-term care insurance companies, but their Web site does contain some helpful information about disability in general, and some disturbing statistics about the likelihood of becoming disabled. Here is the mission statement from the site:

The CDA is a non-profit organization committed to informing and educating the American public about the widespread and growing frequency of disability, and the financial impact it can have.

Since it began in 2005, the Council for Disability Awareness has engaged in communications, research and education about disability. A large part of our mission is providing helpful resources and information to wage earners, their families, the media, employers and anyone concerned about disability and the devastating impact it can have on the finances and lifestyle of American families.

Our mission is:

• To expand public awareness of the growing likelihood of disability occurring among the working population;
• To increase public knowledge about the financial hardship that disability can have on wage earners and their families;
• To demonstrate the value of planning responsibly in the event disability prevents one from earning a living.

Doctor Gaps in Texas Persist Despite Perry's Stats

It's no great surprise to many of us that the medical malpractice "tort reform" legislation of several years ago has not brought about the benefits promised by its supporters, such as the big insurance companies. One of those benefits was supposed to be more physicians in under-served areas of the state. But this simply has not happened, as reported by the Associated Press. Here are excerpts from the article:

Presidio County is bigger than Delaware and has just one practicing physician who doesn't deliver babies or treat emergencies. It's the kind of underserved region that Gov. Rick Perry suggested would benefit when he proposed a crackdown on medical malpractice lawsuits in 2003.

Now running for president, Perry says his tort reform plan proved the wisdom of his business-friendly policies by expanding health care across the state.

Yet none of the 23,000 doctors Perry says Texas has newly licensed have come this way.

"Some patients, when they find out they're pregnant, bam — they're out of here," said Dr. Darrell Parsons, whose practice in Presidio is just across the Rio Grande from Ojinaga, Mexico.

An analysis of Perry's tort reform initiative in Texas reveals a more complicated bottom line than his campaign rhetoric on the issue would suggest. State medical data show that the number of physicians practicing in Texas has increased since the initiative passed in 2003, though by considerably less than the total Perry cites. And the bulk of that influx has come in larger cities where health care was already abundant, leaving large rural swaths of Texas still without doctors.

Discussing his malpractice reforms in a speech in Georgia in September, Perry said, "Pregnant women have better access to OB-GYNs. People in need of trauma care have better access to neurosurgeons and other specialists. That's what tort reform is really all about. About how to give better access to the people of my home state. We need to spread lawsuit reform across all economic sectors of this country."

However, medical records in Texas show that of the state's 254 counties, only 106 have an obstetrician/gynecologist — just six more than in 2003. In Presidio County, which has 8,000 residents and is growing, some of Parsons' patients move 240 miles away to live with relatives in Odessa or Midland when they become pregnant.

Overall, the increase in physicians in Texas roughly tracked the state's population growth. Medical rolls increased by 24 percent since 2003, while Texas' population was soaring by 20 percent during the decade. Texas also saw rapid growth of physicians per capita before tort reform, according to the Texas Department of State Health Services.

The statistic Perry most often cites — 23,000 newly licensed doctors after tort reform — includes about 10,000 who sought licenses in Texas but took jobs elsewhere and physicians practicing telemedicine in other states.

Perry made access to health care a major argument for tort reform in the initiative's advertising campaign in 2003, saying the state was hemorrhaging doctors because of lawsuits and malpractice insurance costs. The ballot issue, Proposition 12, became the most expensive campaign ever waged to amend the Texas Constitution. More than $15 million was spent in the showdown between trial lawyers and health care interests.

In a speech to the conservative Heritage Foundation that year, Perry told a New York audience how three out of five Texas counties lacked an obstetrician.

"That's a hardship for many pregnant women in certain areas of our state, but especially women with high-risk pregnancies," Perry said.

Eight years later, that ratio is the same.

History of Veterans Day

Today is, of course, Veterans Day in the United States. Please take a few minutes to thank the veterans you know for their service to our country.

Here is the history of Veterans Day from the official Web site of the Department of Veterans Affairs:

History of Veterans Day

World War I – known at the time as “The Great War” - officially ended when the Treaty of Versailles was signed on June 28, 1919, in the Palace of Versailles outside the town of Versailles, France. However, fighting ceased seven months earlier when an armistice, or temporary cessation of hostilities, between the Allied nations and Germany went into effect on the eleventh hour of the eleventh day of the eleventh month. For that reason, November 11, 1918, is generally regarded as the end of “the war to end all wars.”

Soldiers of the 353rd Infantry near a church at Stenay, Meuse in France, wait for the end of hostilities. This photo was taken at 10:58 a.m., on November 11, 1918, two minutes before the armistice ending World War I went into effect

In November 1919, President Wilson proclaimed November 11 as the first commemoration of Armistice Day with the following words: "To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations…"

The original concept for the celebration was for a day observed with parades and public meetings and a brief suspension of business beginning at 11:00 a.m.

The United States Congress officially recognized the end of World War I when it passed a concurrent resolution on June 4, 1926, with these words:

Whereas the 11th of November 1918, marked the cessation of the most destructive, sanguinary, and far reaching war in human annals and the resumption by the people of the United States of peaceful relations with other nations, which we hope may never again be severed, and

Whereas it is fitting that the recurring anniversary of this date should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations; and

Whereas the legislatures of twenty-seven of our States have already declared November 11 to be a legal holiday: Therefore be it Resolved by the Senate (the House of Representatives concurring), that the President of the United States is requested to issue a proclamation calling upon the officials to display the flag of the United States on all Government buildings on November 11 and inviting the people of the United States to observe the day in schools and churches, or other suitable places, with appropriate ceremonies of friendly relations with all other peoples.

An Act (52 Stat. 351; 5 U. S. Code, Sec. 87a) approved May 13, 1938, made the 11th of November in each year a legal holiday—a day to be dedicated to the cause of world peace and to be thereafter celebrated and known as "Armistice Day." Armistice Day was primarily a day set aside to honor veterans of World War I, but in 1954, after World War II had required the greatest mobilization of soldiers, sailors, Marines and airmen in the Nation’s history; after American forces had fought aggression in Korea, the 83rd Congress, at the urging of the veterans service organizations, amended the Act of 1938 by striking out the word "Armistice" and inserting in its place the word "Veterans." With the approval of this legislation (Public Law 380) on June 1, 1954, November 11th became a day to honor American veterans of all wars.

Later that same year, on October 8th, President Dwight D. Eisenhower issued the first "Veterans Day Proclamation" which stated: "In order to insure proper and widespread observance of this anniversary, all veterans, all veterans' organizations, and the entire citizenry will wish to join hands in the common purpose. Toward this end, I am designating the Administrator of Veterans' Affairs as Chairman of a Veterans Day National Committee, which shall include such other persons as the Chairman may select, and which will coordinate at the national level necessary planning for the observance. I am also requesting the heads of all departments and agencies of the Executive branch of the Government to assist the National Committee in every way possible."

President Eisenhower signing HR7786, changing Armistice Day to Veterans Day. From left: Alvin J. King, Wayne Richards, Arthur J. Connell, John T. Nation, Edward Rees, Richard L. Trombla, Howard W. Watts.

On that same day, President Eisenhower sent a letter to the Honorable Harvey V. Higley, Administrator of Veterans' Affairs (VA), designating him as Chairman of the Veterans Day National Committee.

In 1958, the White House advised VA's General Counsel that the 1954 designation of the VA Administrator as Chairman of the Veterans Day National Committee applied to all subsequent VA Administrators. Since March 1989 when VA was elevated to a cabinet level department, the Secretary of Veterans Affairs has served as the committee's chairman.

The Uniform Holiday Bill (Public Law 90-363 (82 Stat. 250)) was signed on June 28, 1968, and was intended to ensure three-day weekends for Federal employees by celebrating four national holidays on Mondays: Washington's Birthday, Memorial Day, Veterans Day, and Columbus Day. It was thought that these extended weekends would encourage travel, recreational and cultural activities and stimulate greater industrial and commercial production. Many states did not agree with this decision and continued to celebrate the holidays on their original dates.

The first Veterans Day under the new law was observed with much confusion on October 25, 1971. It was quite apparent that the commemoration of this day was a matter of historic and patriotic significance to a great number of our citizens, and so on September 20th, 1975, President Gerald R. Ford signed Public Law 94-97 (89 Stat. 479), which returned the annual observance of Veterans Day to its original date of November 11, beginning in 1978. This action supported the desires of the overwhelming majority of state legislatures, all major veterans service organizations and the American people.

Veterans Day continues to be observed on November 11, regardless of what day of the week on which it falls. The restoration of the observance of Veterans Day to November 11 not only preserves the historical significance of the date, but helps focus attention on the important purpose of Veterans Day: A celebration to honor America's veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good.

Friday Fun

Here's another of those incredible building projections:

Health Insurance Carrier Removes Coverage for Avastin Breast Cancer Drug

The New York Times reported, "Blue Shield of California will no longer pay for the use of the drug Avastin to treat breast cancer, a sign that support for the widely debated and expensive treatment may be eroding among health plans." The Times notes, "Blue Shield, with 3.2 million members, is apparently the first large insurance company to end payments since a federal advisory committee unanimously recommended in June that the Food and Drug Administration rescind Avastin's approval as a treatment for breast cancer, saying the drug did not really help patients. Shortly after the F.D.A. advisory committee's negative vote, a panel of breast cancer doctors convened by the National Comprehensive Cancer Network, an organization of major cancer hospitals, reaffirmed that Avastin was 'an appropriate therapeutic option for metastatic breast cancer'...important because Medicare and UnitedHealthcare are supposed to pay for drugs listed in the cancer network's guidelines."

From the American Association for Justice news release.

 

Study Suggests Chantix May Be Linked To Increased Suicide Risk

The quit-smoking drug Chantix (varenicline), has had a reputation of causing serious side-effects, including suicidal thoughts. Now, according to Reuters, a new study seems to confirm these suspicions. Here are excerpts from the story:

Pfizer's smoking cessation drug Chantix carries too many risks and should only be tried when other treatments fail, researchers said.

Chantix was eight times more likely to be linked with a reported case of suicidal behavior or depression than other nicotine replacement products, such as the nicotine patch, they said.

The findings contradict two studies released last month by the Food and Drug Administration that showed Chantix (sold as Champix outside the United States) did not increase the risk of being hospitalized for psychiatric problems such as depression.

The agency at the time acknowledged that those studies were flawed because they were too small to identify rare events and they only captured cases that were severe enough to land people in the hospital

"Our study contradicts the implications of a recent review by the FDA showing no difference in psychiatric hospitalizations between varenicline and nicotine replacement patches," said Dr. Curt Furberg, professor of Public Health Sciences at Wake Forest Baptist Medical Center, co-author of the study published online in the Public Library of Science journal PLoS One.

"The FDA hospitalization studies were flawed because they could not capture most of the serious psychiatric side effects, including suicide, depression, aggression and assaults. These can be catastrophic events but do not normally result in hospitalization," Furberg said in a statement.

CHANTIX VS ZYBAN

The new study relies on adverse events from the FDA's Adverse Event Reporting System from 1998 through September 2010. They analyzed 3,249 reports of serious self-injury or depression linked to Chantix (varenicline), GlaxoSmithKline's Zyban (bupropion) antidepressant that was approved for smoking cessation and nicotine replacement products.

They found that 2,925 cases, or 90 percent, of suicidal behavior or depression reported to the FDA were related to Chantix, even though the drug was only approved for four of the nearly 13 years of data included in the study.

By comparison, there were 229 cases of suicidal behavior or depression related to bupropion and 95 cases related to nicotine replacement products.

"We found that Chantix is associated with more suicidal behavior reports than any other smoking-cessation drug on the U.S. market. The risks simply outweigh the benefits," Furberg said.

Prior studies by Furberg and colleagues have shown Chantix increases the risk of heart problems, unprovoked aggression, and sudden blackouts.

"There were reports of people driving cars and blacking out," said Furberg. He and fellow researchers were so concerned about this side effect that they took their findings to the Federal Aviation Administration, which banned pilots from using Chantix in 2008.

Of course, tobacco use also has serious risks. It is responsible for one in five deaths in the United States each year and adds $193 billion to health care costs.

Trial Lawyers Take Issue With Depiction Of Legal Reform As Jobs Legislation

Gary M. Paul is president of the American Association for Justice, formerly the Association of Trial Lawyers of America. He wrote this opinion piece for Roll Call.

On Wednesday, Speaker John Boehner (R-Ohio) addressed the U.S. Chamber of Commerce and its Institute for Legal Reform — the leading front group for multinational corporations seeking to limit Americans’ access to the courts.

And in its typical self-serving fashion, ILR has seized on the hardships of millions of unemployed Americans, claiming that this country needs “jobs, not lawsuits,” despite no actual evidence to bolster its nonsensical claims.

ILR’s board members run the gamut of industries — from chemical makers and drug companies to Wall Street banks. And they have more in common than just their commitment to closing the courthouse door on injured Americans. The corporations that finance ILR have long, storied histories of using the courts for their own agendas — to gain the upper hand against their competitors, customers and even each other.

One ILR board member, Caterpillar Inc., sued the Walt Disney Co. because it felt the depiction of bulldozers in the straight-to-video movie “George of the Jungle 2” was overly villainous. FedEx Corp., another stalwart board member, took a “stand for justice” by suing a man for making a chair out of FedEx boxes. Johnson & Johnson used the civil justice system to take on a most unlikely foe — the Red Cross.

These corporations certainly have the right to seek justice through the legal system. What makes their actions shameful is that they are members of ILR’s board for the sole purpose of denying American workers and consumers that very same right. This ultimate hypocrisy not only undermines that ridiculous jobs argument but also highlights their real motivations: obtaining immunity when they injure or kill American workers and consumers.

Every company that holds a seat on ILR’s board or participates as a member stands to gain monetarily from the organization’s agenda of blocking the courthouse doors. For instance, in return for being an ILR board member, Honeywell International has received lobbying and public relations help when its negligence has been uncovered. Days after an Illinois jury delivered a multimillion-dollar verdict against Honeywell for conspiring to hide the dangers of asbestos, the Madison County Record, an Illinois-based propaganda-as-news outlet fully owned by ILR, featured an opinion piece headlined, “McLean County Continues Inching Closer to Becoming a ‘Judicial Hellhole.’”

America’s civil justice system gives people a fair chance to hold wrongdoers accountable. The civil justice system has uncovered countless examples of corporate negligence, and as a result, things we take for granted — whether it is cars, medicines or the workplace — are all safer. Our legal system also serves as a powerful deterrent, making corporations think twice before putting profits ahead of people. Thousands of lives are saved because the civil justice system gives corporations the needed incentive to make better products, instead of ones that are cheaper but more dangerous.

When faced with abusive corporate practices, the courts are often the last resort for everyday Americans to seek justice. ILR board members know a jury verdict is one of the few things they cannot buy and control, but with ILR’s assistance, they have found a willing partner to simply whine to Congress for more immunity instead.

We cannot allow self-serving corporations — let alone their front groups — to just slap a “jobs creation” sticker on legislation that has absolutely nothing to do with jobs, in order to finally check off items on their wish list. There is a difference between providing incentives to employers to hire more workers and giving handouts to corporations that simply want to skirt the law and avoid accountability. While we doubt the chamber will ever learn the difference, we certainly hope lawmakers will.

How to Prevent Workplace Injuries

This guest post is from Evan Fischer.

It’s all fun and games until you’re dancing on the conference table on margarita Friday and you fall off and break a hip.  Okay, so most end-of-the-week “team building” exercises don’t go quite this far, but when it comes to workplace injuries, they’re probably best avoided.  Not only do most people want to keep their bodies intact, but do you really want to explain to your boss (and the workers compensation commission) just exactly what you were doing dancing on a table, three sheets to the wind?  Or more likely, why you were pulling a fifty pound box of paper off a high shelf while using a wheeled office chair as a stepstool?  Even lifting something, if done improperly, could result in a back injury that not only hurts like the dickens, but makes you feel like a fool, as well (everyone knows you should lift with your legs, not with your back).  The point is, you don’t want to deal with it in the first place.  So here are a few tips to help you prevent these injuries from occurring.

First, you should probably make an honest assessment of your physical abilities.  Many accidents and injuries in the workplace occur during simple tasks like lifting because people either aren’t paying attention to what they’re doing or they mistakenly overestimate their abilities.  One of the most common causes of workplace injury is falling.  This could result from climbing something in order to get at items that are high up or it could occur because you walked right past the wet floor sign without so much as a glance.  So you need to assess each situation for danger, pay attention to your surroundings, and ask for help if you need it.  You may be embarrassed to ask the young guy in the cubicle next to you to pull down a box from a high shelf, but you’ll be a lot redder in the face if you have to go to the hospital because you fell off the ladder and the box landed on you.

Of course, many people also experience repetitive motion injuries.  These are extremely common in office workers, in particular, because small motions like typing and using a mouse are often performed all day, every day.  In addition, many people who sit at a desk all day don’t realize that holding poor posture for extended periods can lead to aches, pains, and even serious injuries over time.  Before this happens, talk to your office manager about securing ergonomic devices meant to protect your body.  There are chairs and keyboards that will help to correct your posture and positioning in order to avoid injury (and they’ll cost a lot less than physical therapy).  As for staving off pain from repetitive motion, consider using stiff, padded wrist guards that will limit your range of motion.

And always practice safety first.  There are likely guidelines and policies in place to protect workers in every profession, especially those that are prone to hazard.  So make sure that you always follow safety regulations.  When in doubt, take the time to check and double check that you’re doing everything you can to avoid accident and injury – and don’t be too proud to ask for help since you’re the only one who will suffer from the decision not to (unless you happen to fall on a co-worker).

Friday Fun

This is a very old video of dogs drinking soda water, but I never get tired of watching it.