SOURCE: American Lawyer Media, LLC. [Get a temp password here for sites below]
State Farm wrote to the California Supreme Court on Feb. 16, urging the justices to again consider depublishing a damaging Second District ruling. In 1997, State Farm convinced a court to re-seal a former employee's sworn statements accusing the company of routinely defrauding its policyholders. The declarations.
SOURCE: American Lawyer Media, LLC. [Get a temp password here for sites below]
The Ninth Circuit affirmed a private right of action under California's Earthquake Insurance Act, reinstating bad faith claims against State Farm Fire & Casualty Co. The opinion.
September 27, 1998
Suit Contests Insurers' Insistence on Generic Car Parts
[WITH COMMENTARY by WCH] and Supreme Court Follow Up
By MATTHEW L. WALD
WASHINGTON -- When Mark Covington drives his 1992 Chevy Cavalier
at night, the beam of the left headlight wobbles across the road,
and in daylight, the red paint on the hood shows an odd ridge on
the left side.
He blames his insurance company: After his wife crashed the car
into the back of a pickup in April, he said, he took the car to one
of the best body shops in Laurel, Miss., but the shop had to use
generic parts.
"State Farm just absolutely refused to put GM parts on it,"
Covington said. Instead, the insurance company insisted on
"imitation parts."
"They said that by using those, it would restore our vehicle to the
original condition and value, which it did not do," Covington said.
Lawyers are seeking to add him to a large class-action suit against
State Farm. But the suit has alarmed consumer advocates, including
Public Citizen, which Ralph Nader founded as part of his
auto-safety crusades, and the attorneys general of New York,
Massachusetts, Pennsylvania and Nevada, along with the National
Association of State Insurance Commissioners. They have all filed
briefs at the Supreme Court supporting State Farm and opposing
people like Covington.
[PUBLIC CITIZEN? - I WONDER WHO BOUGHT THEM OFF?
NAIC IS FUNDED BY THE INSURANCE INDUSTRY! - DUH!
STATE INSURANCE COMMISSIONERS ARE ALMOST ALL BOUGHT BY THE INSURANCE
INDUSTRY. ONE CAN ONLY GUESS ABOUT ATTORNEYS GENERAL.]
The court could announce as early as Monday whether it will hear
arguments in the case.
Plaintiffs say the case involves 5 million drivers and could cost
State Farm $2 billion, but their opponents say it would drive up
insurance rates nationwide.
[WHICH EXACTLY WHAT INSURANCE COMPANIES ALWAYS SAY - SURE WE
WOULDN'T WANT THESE *VERY* RICH BABIES ACTUALLY TO PAY A CLAIM
NOW - IT JUST MIGHT DRIVE UP INSURANCE RATES. A LITTLE REALITY:
How do insurance rates get "driven up"? With consent of the
State regulatory agencies which are already in consort with the
insurance companies, and are as stated, agencies of the State
government. Even if given individuals have not been bribed,
to assent to this robbery, the interesting twist is that the
State governments get to tax the insurance companies and by
increasing the profit of insurance companies a State government
increases its own revenue. State governments have decided that it
is good for you to have insurance and so - you must by law. The
State has a weapon at your head and you are forced to pay.
Your paying is indirect proportion to the revenue the State
receives as an indirect tax on you, in addition to federal
income tax, state income tax, sales taxes imposed by this and
that level of government. Insurance rates may raise only because
it is profitable to your State government, which revenue it
seems cannot be used to support the court systems by which you
are supposed to be able to gain redress of grievance against
the the insurance companies by which you have benn defrauded.
IT IS IN THE INTEREST OF SELF SERVING GOVERNMENTAL MONSTERS TO
SEE TO IT THAT YOU ARE TAXED AND DEFRAUDED TO DEATH - GREED
BLINDS THESE BUREACRATIC MINDS TO THE ULTIMATE CONSEQUENCE
WHICH IS THE DEATH AND DESTRUCTION OF THEIR CASH COWS.
IT IS FAR SOUNDER, ECONOMICALLY, TO ALLOW FRAUDULENCE TO BE
PUNISHED. AT LEAST THIS STATISTICALLY INSURES THE VIABLITY
OF CASH COWS. "Bulls make money; Bears make money; Pigs
loose money." - Stock Market Advice from John Baiardi.
We haven't got government with the common intelligence of
a goldfish.
]
Lawyers who filed the class-action suit quote a study done for
General Motors that says that cars repaired with generic parts lose
$1,670 in resale value, and that some generic parts can be
dangerous. Insurance companies dispute both ideas.
[INSURANCE COMPANIES DISPUTE THAT A MAN WITH NO HEART BEAT
IS DIASABLED - SO DO THEIR MEDICAL WHORES.]
Both sides agree that if the class-action suit succeeds, it will
affect nearly all drivers around the country. It could also
overturn insurance regulations or state laws in New York,
Massachusetts and Hawaii, among other places.
[SOME LAWS NEED OVERTURNING.]
According to consumer advocates and the insurance companies, what
State Farm calls "quality replacement parts," and others call
"after-market parts" meet the same standards for fit and finish,
corrosion resistance, strength and durability as the ones produced
by GM, Ford or Toyota. The after-market parts have broken a
longstanding monopoly of the auto companies on replacement fenders,
hoods, bumpers and other parts, consumer advocates say.
[IF ANY WANTS THEM, LET THEM BUY THEM - NO PROBLEM.]
The insurance companies say they have a good reason for demanding
generic replacements. "They are one of the factors that contributes
to our being able to keep our premiums as low as we can," said
David Hurst, a spokesman for State Farm. When an insured driver has
an accident, everyone is better off if replacement parts cost less,
he said.
[AND AGAIN:
WHICH EXACTLY WHAT INSURANCE COMPANIES ALWAYS SAY - SURE WE
WOULDN'T WANT THESE *VERY* RICH BABIES ACTUALLY TO PAY A CLAIM
NOW - IT JUST MIGHT DRIVE UP INSURANCE RATES.]
And manufacturers' parts are expensive. The Alliance of American
Insurers calculated that building a 1996 Chevy Lumina from GM parts
would cost $72,600, more than triple the sticker price of the car.
GM, on the other hand, has advertised that generic parts are not as
durable and can cause safety problems.
[BUT, WE'RE NOT BUILDING A WHOLE CAR, ARE WE?
ALLIANCE OF AMERICAN INSURERS? - JUST A LARGER COLLECTION OF LIARS.
ON INFORMATION AND BELIEF, I'LL BELIEVE GM, THANK YOU.]
The dispute is one of the longest-running in the car business.
"I've never seen two industries more dependent on each other that
hate each other more," said Jack Gillis, chief spokesman at the
Consumer Federation of America, referring to insurers and
collision-repair companies. "There's no respect, no trust, no
nothing."
[WHY, ON EARTH, SHOULD ANYONE HAVE TRUST IN OR RESPECT FOR AN
INSURANCE COMPANY? - UNLESS THERE IS A DAMN GOOD REASON.]
Part of the animosity, he said, comes from repair shops' billing
insurance companies for original manufacturer parts and then using
the cheaper generic ones, a practice that most consumers could not
discern. The body shops sometimes do this to spare car owners the
cost of their deductibles, or sometimes they do it so they can
pocket the difference.
[CAN YOU SPELL D-I-V-E-R-S-I-O-N ?]
Gillis, who is also the author of an annual buying guide called The
Car Book, is not completely neutral; he is also the executive
director of a nonprofit organization established by the insurance
industry, the Certified Auto Parts Association, to evaluate generic
parts.
["Certified Auto Parts Association"!? - FUNDED BY WHO?!
GIVE ME A BREAK!]
Gillis said parts that carried his organization's seal were just as
good as parts from GM and other manufacturers, a contention that
will be an issue in the class-action trial. But he added that only
about 3 percent of the parts used in collision repairs were
certified by his group. Five percent, he said, come from junkyards,
12 percent are noncertified generic parts, and 80 percent come from
auto manufacturers.
[GILLIS WILL SAY ANYTHING HE'S TOLD TO SAY.]
The class-action lawyers, who brought suit in Marion, Ill., in July
1997, say the use of generic parts constitutes fraud under Illinois
law. "They breach their contract every time they put these flimsy,
imitation parts on a vehicle," said Don Barrett, one of the
class-action lawyers, in Lexington, Miss.
[FRAUD? - BY AN INSURANCE COMPANY? - THIS IS NEWS?]
But many consumer advocates disagree. "All things being equal, the
generic product is going to be cheaper," said Brian Wolfman, a
lawyer at Public Citizen, which filed a brief in the case. "I'm not
suggesting all things are always equal, but sometimes they are
equal. You ought not create barriers to introduction of these
generic products."
[WHOSE CREATING BARRIERS? HOW ABOUT BEING ALLOWED TO HAVE WHAT
YOU WANT? CAR OF YOUR CHOICE - PARTS OF YOUR CHOICE - PHYSICIAN
OF YOUR CHOICE - IT SEEMS WE HAVE ALL THIS FREEDOM AND LOOSING
ALL OF OUR CHOICES. GOVERNMENT PUTS A GUN TO OUR HEADS TO FORCE
PURCHASE OF INSURANCE AND THEN AIDS AND ABBETS THE FRAUD, EXTORTION
AND RACKETERRING COMMITTED BY INSURANCE COMPANIES.
PRAY TELL THEN, JUST WHAT IS FREEDOM?]
Such products are not only cheaper than the ones made by car
companies, but the competition helps drive down the cost of
car-company parts, too, consumer advocates say.
[OH NOT ALL CONSUMER ADVOCATES SAY THAT - AND OF COURSE, THEY
ARE CHEAPER, NOT LESS EXPENSIVE, CHEAPER - WHICH IS EXACTLY
WHAT ALL CONSUMERS ARE SUPPOSED ACCEPT AND PUT UP WITH, EVEN
IF IT KILLS THEM - IT'S THE LAW!]
The insurance commissioners and attorneys general see another
issue, which State Farm asked the Supreme Court to review: Should a
court in Illinois be allowed to make what amounts to a national
rule on insurance? (The class includes drivers in all states but
Arkansas and Tennessee, where separate class-action suits have been
filed.)
[CHIKEN KAKA -
CAN YOU SPELL D-I-V-E-R-S-I-O-N ?]
Insurance regulations in New York encourage the use of generic
parts when equal-quality parts are available; a law in
Massachusetts requires their use. Hawaii, according to documents in
the case, permits the use of manufacturers' parts only if the car
owner pays the difference.
[BUT, OF COURSE: INSURANCE COMPANIES HAVE BOUGHT THE STATE
LEGISLATURES - WHAT DO YOU THINK THEY DOO WITH ALL THAT MONEY
THEY TAKE FROM YOU? PAY CLAIMS?]
Opponents of generic parts cite safety. In an incident that the
class-action lawyers intend to introduce in the trial, which is
scheduled to begin next April unless the Supreme Court intervenes,
Daniel Della Rova was driving his 1988 Honda Accord on a four-lane
state highway near Reading, Pa., to his job as an electronics
engineer at Lucent Technologies on Jan. 2. He pulled into the left
lane to pass a truck, when his hood slammed into his windshield.
The hood blocked the view to the front completely, he said, leaving
him to navigate by sticking his head out the window.
Della Rova had bought the Honda used. The car's original owner,
Della Rova said, explained that when the Accord was new, he had
accidentally backed into it with his other vehicle, a truck,
puncturing the hood. The first owner repaired the car with a
generic part.
An auto body expert, Charles Barone, who heard about the accident
and later retrieved the Honda from a junkyard, said that on the
after-market hood, the "striker," the piece of metal that descends
and hooks into the latch on the car, was spot-welded inadequately.
One weld showed signs of rust, he said. On Honda hoods, he said,
the striker is a sturdy metal shaft that passes through several
small holes and is then smashed into a mushroom shape, so it cannot
come loose.
Barone, a former body shop owner whom the class-action lawyers
expect to call as a witness, said, "We all know what junk these
parts are. They are approximations at best."
[YES - BUT THEY CAN PAY 100,000 BODY SHOP PEOPLE TO SAY
OTHERWISE - DING! - YOU LOSE - BUT THANK YOU FOR PLAYING ANYHOW.]
Many insurance companies specify generic parts.
At Allstate, the second-largest auto insurer, Raleigh Floyd, a
spokesman, said his company recommended them but would pay for
original manufacturer parts if the policy holder wanted.
[ALLSTATE !!!!????? - THE JOKE OF THE YEAR.
CF. You're In Bad Hands With Allstate]
"The whole reason for going into generic parts is it reduces cost,
but it also comes down to peace of mind," he said. Cars can be
restored to what the industry calls "pre-loss condition" with
generic parts, he said, but in the car owner's mind, "that may mean
the part came out of a Toyota plant."
[UH HUH - SURE - RIGHT - AND I'M ALEXANDER THE GREAT.]
Followup:
Insurance News Network - State Farm denied by U.S. Supreme Court
_________________________________________________________________
Based on an article, Copyright 1998 The New York Times Company
_________________________________________________________________
Subject: State Farm's Secret $100 million dollar deal
I'm sure some of you have seen this, but I've also found the news
doesn't always get around, thanks to court sealing, Vacatur, and a very
spotty media. Although we normally cover Allstate, this is a very good
example of how huge decisions are hidden by court sealing, so that most
of the public continues to think insurers are like kindly old uncles.
And of course, Allstate does the same sort of hiding.
Jim & Paula
=========================================
Thursday, June 11, 1998
State Farm Pays $100 Million to Settle Quake Suit Insurance:
Secret agreement involved 117 policyholders alleging that coverage was
unfairly lowered before Northridge temblor.
Firm denies wrongdoing.
By KENNETH REICH, SOLOMON MOORE, JEFF LEEDS, Times Staff Writers
State Farm Insurance Co. secretly has paid $100 million to 117
policyholders to settle a lawsuit alleging that the company unfairly cut
their earthquake coverage before the devastating 1994 Northridge
temblor. The settlement, hammered out before a retired state Supreme
Court justice working as a private mediator and filed under a seal of
"deepest confidentiality," marks the largest known single payout by an
insurer involved in post-earthquake claims. Lawyers for the homeowners
said the case could also expose State Farm, the nation's richest
insurance company, to claims by thousands of other policyholders whose
insurance was covertly pared years before the Northridge quake. In a
September 1984 internal memo obtained by The Times, State Farm
executives considered sending their policyholders a written
clarification of their earthquake coverage. But the executives, Rob
Kelley, John Rosenstock and J.P. De Cicco, decided against the idea,
saying that it would "appear inconsistent with our marketing philosophy
since we don't want to sell the coverage." The company did restructure
the policies available to customers, however. It replaced two insurance
plans with a less costly "combined limit policy" and eliminated the
notion of "guaranteed replacement," the idea that it would pay to
replace homes destroyed by an earthquake even if the cost exceeded a
homeowner's coverage limit. "There were a lot more people that were
victims of State Farm's marketing ploy," said George Kehrer, founder of
the nonprofit homeowners group that advised most of the plaintiffs.
Nonetheless, Kehrer said he felt "a great sense of relief and
satisfaction that a wrong had been made right." Northridge resident
Irene Allegro and 116 other homeowners alleged that State Farm secretly
restructured their policies in 1985 to limit the amount of money they
could recover if their homes were damaged in an earthquake. The
homeowners said State Farm concealed the true nature of the changes by
sending notices that described the coverage as "new" or "different,"
without disclosing that it also amounted to less. State Farm had been
under pressure to settle the case since May 1997, when a Superior Court
judge found that the company had "failed to give specific notice in
'clear and understandable language,' " as required under state law. The
company appealed that ruling, but settled before the appellate court
could decide the case. Lawyers for Allegro and the other homeowners said
that about 25,000 other policyholders were similarly misled and could
sue the company based on the Superior Court's ruling. State Farm
officials declined to discuss the potential for future litigation, but
noted that the company admitted no wrongdoing in the settlement.
"Ultimately, settlement, although a bitter pill, is the best way to go,"
said company spokesman Bill Sirola. "There are business considerations
that must be weighed."
Lawyers for the plaintiffs and other advocates, however, said the case
could pave the way for numerous lawsuits by other property owners, who
purchased insurance before 1985. "The fact that State Farm paid a
$100-million settlement to more than 100 people indicates that there was
massive fraud and wrongdoing and that there are many other policyholders
entitled to money as well," said Harvey Rosenfield, founder of the Santa
Monica-based Proposition 103 Enforcement Project. But even if other
homeowners file new lawsuits, experts said, they would have to navigate
particularly murky territory in insurance law, and prove that they had
not missed a one-year statute of limitations that insurance companies
believe has been established by California court decisions. While
insurance companies like State Farm make it their business to assess
risk, the unpredictability of earthquakes has been a source of anxiety
in the industry for more than a decade.
Companies Sought to Limit Liability
Before 1984, insurance companies tried to limit their potential
liability in disaster-prone states like California by capping sales of
certain policies. Under a state law that became effective that year,
however, insurance companies were required to offer earthquake coverage
to people who had homeowners' insurance. "They didn't perceive that
earthquake insurance would be a profitable enough line of business,"
said Keith Crocker, who holds a teaching chair at the University of
Michigan. "Once they were required to offer earthquake insurance, they
may well indeed have tried to figure out how to reduce their exposure to
a risk that they never wanted to take in the first place." Policyholder
Jerry Yandell, 58, didn't know about the change in his coverage until it
was too late. He had insured eight rental properties and his Chatsworth
townhouse before 1985, and hoped to retire on the rental income before
the Northridge quake shook his dream to the ground. State Farm
eventually offered a settlement equal to his coverage limit, $641,000,
although the damage to all his properties was estimated at more than $1
million. "We went to our agent and I said: 'I know the damage is more
than [our policy limit], but I have guaranteed replacement,' " Yandell
said. "The agent looked at me and told me: 'No, you don't.' I could have
just fallen off my chair." Yandell said he filed his claim just before
the one-year time limit expired, and was unsure whether others who tried
to file now would be successful even if they are armed with a Superior
Court decision. State Farm officials said they believe that had the
Allegro case continued to the appellate level, they would have
prevailed. Michael J. Bidart, the plaintiffs' lawyer, disagreed. "We
thought our odds were good," he said. "That's what makes cases settle."
* SECRECY ISSUES: Columnist Kenneth Reich questions secret settlement.
B5
Copyright Los Angeles Times
BUSINESS NEWS
Homeowners said State Farm sent them notices that described different
coverage, without disclosing that it amounted to less coverage.
The Associated Press L O S A N G E L E S, June 11 State Farm Insurance
Co. said today it settled claims of more than 100 policyholders who
accused the company of trimming coverage about a decade before the 1994
Northridge earthquake. The Bloomington, Ill.-based insurer would not
confirm a newspaper report that the policyholders received $100 million
to drop their lawsuit, or divulge other details of the agreement reached
last November. "The settlement amount is confidential, as agreed to by
all parties, but represents a small part of the more than $3 billion
paid by State Farm to more than 117,000 policyholders whose property was
damaged," a company statement said. The settlement is the largest known
single payout by an insurer involved in post-earthquake claims, the Los
Angeles Times reported. According to an internal company memo in
September 1984, executives considered informing policyholders about
restructuring plans but decided against it because it would "appear
inconsistent with our marketing philosophy."
Company Used Muddled Terms The lawsuit said two insurance plans were
ultimately replaced by a less expensive policy, and the company
eliminated the notion of "guaranteed replacement," which would require
the insurer to replace homes destroyed by a quake even if the cost
surpassed a policyholder's coverage limit. Instead, State Farm sent
policyholders notices that described the coverage as "new" or different"
without disclosing that it amounted to less coverage, according to the
lawsuit filed by 117 homeowners. In May 1997, a Superior Court judge
ruled that the company failed to give notice in "clear and
understandable language,"' as required under state law. State Farm's
appeal of the ruling was pending when the settlement was reached.
"Ultimately, settlement, although a bitter pill, is the best way to go,"
said Bill Sirola, a company spokesman. The magnitude 6.7 earthquake in
Northridge, in Los Angeles' San Fernando Valley, killed 72, injured
thousands and caused more than $40 billion in damage and economic
losses.
Copyright 1998 Associated Press.
--
Come To "You're In Bad Hands With Allstate" (and others)
at http://www.insurancejustice.com/
and find out why you're NOT insured.
-------------------------------------------------------------------
Subject: Re: Amicus Anapolis
Well I'm gratified to see that DESPITE the amicus briefs of the AG's
that the Supreme Court has decided to let the Justice system run it's
course as our forefathers desired. When you said the AG of
Massachusetts submitted a brief, were you referring to Scott Harshbarger
who is named in my lawsuit for collusion and dereliction of duties for
not investigating UNUM. I recieved another "blow-off" from his office
yesterday (the Regulated Industried Division), claiming that since I had
filed a lawsuit, their office did not have to DO anything. Since when
do CRIMINALS get off the hook just because a CIVIL lawsuit is filed?
Judydoc
Paula Moran wrote:
>
> On Oct 5, the Supreme Court refused to decertify a nationwide class
> action against State Farm, for their forcing auto repairers to use fake
> parts. Of interest is not the suit itself, but the "friends" of State
> Farm who filed Amicus briefs in support of this poor little
> multi-billion dollar company, which, according to our studies, is nearly
> as bad as Allstate when it comes to cheating citizens.
>
> Amicus breifs in support of State Farm were filed by the attorneys
> general of the following states, who should be either removed from or
> voted out of office. Even if SF were not nearly as rotten as Allstate,
> we feel it is improper for our government officials to fly to the
> defense of a giant insurance company which has a proven record of
> maltreating citizens. The states which are a better friend to the
> insurers than to the voters are: New York, Massachusetts, Nevada,
> Pennsylvania, and Texas.
>
> Worse, yet, although we have previously mentioned that Nader's group is
> now a captive of the insurers, Public Citizen, the Consumer Federation
> of America, and the Public Interest Research Group also sided with the
> giant insurer. We will look at their claims of "consumerism" with a
> much more jaundiced eye in the future. Few "consumer" organizations can
> have failed to receive tons of mail from insurance company victims --
> heck, we're much smaller than they are and we do. Someone at these
> organizations is either blind or knows what side their bread is buttered
> on.
>
> Other Items: Some of you are no doubt aware of this utility, but we just
> received the application for the Pacer system, which allows any citizen
> with a PC and a modem to access case records of the several federal
> district courts. The fee is sixty cents a minute (although in our
> opinion it should be free, since we as taxpayers have already paid for
> the system.) Still, this is cheap as databases go, and the time will
> mostly be spent on searching, since downloading is quick. And you may
> find some shockers as regards insurance companies. For some odd reason
> you have to apply by postal mail. You can get the application form by
> calling 1 800 676-6856, or by emailing pacer@aottsd.uscourts.gov
> or postal mail to PACER Service Center, PO Box 780549, San Antonio, TX
> 78278-0549
>
> Finally, the Amicus Curiae information was compiled by Sheila Loftus,
> publisher of Hammer and Dolly, a trade publication for the collision
> industry which often has information on insurance company skulduggery,
> since they have a great impact on the collision industry. She can be
> reached at dolly@aol.com or by phone at 202 244-0178
>
> Yours,
>
> Jim & Paula
>
> --
> Come To "You're In Bad Hands With Allstate" (and others)
> at http://www.insurancejustice.com/
> and find out why you're NOT insured.
----------------------------------------------------------------------
From kana@fcol.comWed Nov 25 02:23:45 1998
Date: Sun, 22 Nov 1998 12:37:37 -0500
From: Jim & Paula
Subject: New SF Class Action
First Item: New Class Action Against State Farm
"State Farm faces another class action suit. While it's limited to Ohio
at this point, it may bear watching. This one takes issue with SF's
methodology for calculating 'cost of repair.' The impetus for the suit
is two insureds whose estimates were rejected by State Farm. The suit
alleges that SF has an internal "secret" definition for "competitive
bid," which requires that it reject any truly competitive bids submitted
by its policyholders. This leads to the issue of reference surveys
which, the suit alleges, do not result in competitive prices. Calling
the surveys 'bogus,' the suit details why they do not lead to prevailing
competitive pricing. A lawyer for the plaintiff said the survey isn't
for price at all, but for a 'prevailing competitive labor rate.' The
underlying charges are breach of contract, breach of duty of good faith
and fair dealing, and breach of fiduciary duty.
(Reprinted from CRASH Network bulletin -- which contains a lot of info
on the autobody industry and insurance company malfeasance. Contact
Sheila Loftus at dolly@aol.com for content and subscription info.)
Oddly enough, the dentist's case also involves some sort of secret
list. Secrets seem a real motif with the insurance industry.
--
Come "You're In Bad Hands With Allstate" (and others)
at http://www.insurancejustice.com/
and find out why you're NOT insured
---------------------------------------------------------------------
Insurance News Network - States
State Farm being sued over medical examiner
One of State Farm's customers is suing the auto insurance giant,
claiming that the company flew in a biased doctor to perform an
independent medical review. Tracy Shaw, a resident of East Aurora,
N.Y., filed suit against State Farm Automobile Insurance Co. in
December 1998. She claims that the company paid for Dr. Carl Valvo to
fly from Yonkers to Buffalo in order to have him recommend that the
company deny her claim for medical benefits.
Shaw was hit by a pickup truck in March 1997 and was receiving
treatment for a back injury resulting from the accident. She claims
that she had to see her own chiropractor to repair the damage caused
by Dr. Valvo during his examination, and that she suffered emotional
trauma from his subsequent report to State Farm.
Insurance companies routinely employ doctors to conduct these exams to
determine whether someone filing a claim actually needs medical
benefits. They're called independent examiners because they have no
prior relationship with the patient.
Impartial doctor or hired henchman?
State Farm insists that it uses Dr. Valvo because he is the chairman
of the New York State Board for Chiropractic. "We use him because he
has a reputation for being objective and because of his high
credentials," says Heather Thomson, a spokeswoman for State Farm's
northeast region.
But Shaw's attorney tells a different story. "There are two sets of
fact patterns indicative of a bias," says Christopher O'Brien of
Ballow, Braised, O'Brien & Rusin, a law firm in Williamsville, N.Y.
"There's the fact that they're flying in Dr. Valvo from Yonkers even
though there are over 100 chiropractors in the western New York area,
and in fact State Farm uses some of these other chiropractors on their
cases."
O'Brien also points to the wording of a notice that State Farm sends
out notifying people that they need to attend an independent medical
exam. He claims that the notice leads people to believe it's their
responsibility to procure medical records and take them to the exam
appointment, when in fact it's the responsibility of the insurance
company. "One of the most basic regulations is that an insurance
company should not treat their insured as an adversary," O'Brien tells
INN. And he believes that sending out such a notice constitutes
adversarial treatment. State Farm officials decline to comment on the
wording of the notice because it's part of the documentation involved
in the lawsuit.
New York state law doesn't allow private citizens to sue insurance
companies for unfair claims practices, so Shaw and her attorney are
bringing suit against State Farm for fraudulent business practices.
Shaw is seeking $50,000 in compensatory damages and $250,000 in
punitive damages. O'Brien says that they are seeking punitive damages
because they're dealing with one of the largest insurance companies in
the nation. "If you don't ask for punitive damages, they're not going
to pay attention," he explains.
He says that Shaw would be willing to drop the suit if State Farm
would agree to stop flying Dr. Valvo around and to change the wording
of its medical-examination notice. State Farm's lawyers have not yet
responded to the suit.
Last updated Jan. 8, 1999
--------------------------------------------------------------------
THE DIRTY TRICKS DEPARTMENT: EVEN WHEN YOU WIN - YOU LOSE!
JUST S.O.P. FRON STATE FARM AND THE INSURANCE CARTEL
February 12, 1999
Lawyers Appeal State Farm Settlement
______________________________________________________________
Filed at 6:29 p.m. EST
By The Associated Press
BLOOMINGTON, Ill. (AP) -- A lawyer for six people in a class-action
lawsuit accusing State Farm Insurance Co. of fraudulent sales
practices said Friday he will appeal a $238 million settlement
agreement.
Under the agreement, State Farm would make varying payments --
averaging about $1,300 -- to every one of the 3 million customers
represented by the class action. However, those entitled to a
larger award must undergo what lawyer Kenneth Nelson described as a
confusing claim process.
``We believe that will have the effect of discriminating against
policy holders who are poor, disabled, elderly, unsophisticated --
in other words, the easiest targets for fraud,'' said Nelson, of
Kansas City, Mo.
Any appeal would only serve to stall State Farm's payments, said
Tom Schneider, a State Farm lawyer.
McLean County Judge Ronald Dozier approved the settlement on
Thursday. The lawsuit contended that State Farm cheated people
while selling them whole life and universal life insurance policies
from January 1982 to December 1997.
In August, State Farm agreed to settle the lawsuit in order to
avoid a protracted trial. In Thursday's agreement, the company does
not admit to any wrongdoing.
Each member of the class will get the initial payment. Others who
allege they are entitled to more must apply to an independent
company. That neutral firm will determine the size of the
additional award using an intricate scoring system.
However, State Farm expects as few as 5 percent of those eligible
for a larger award will apply.
``The fact of the matter is, of the 3 million, only a handful are
going to actually follow the claim relief procedure,'' said Robert
Cummins, a Chicago lawyer who also objects to the settlement.
``And that's only if the folks step through the hoops correctly.
But my goodness, the folks in the complaints are elderly,
unsophisticated people,'' Cummins said.
It is common for complicated, legalistic notices to deter members
of a class-action from filing for a claim, said Robert Hunter,
director of insurance for the Consumer Federation of America.
``You get a big, 65-page document, or 50 pages or something, and
it's just incredibly intimidating,'' Hunter said. ``First of all,
are you going to read it? And if you are, can you understand it?''
The lawsuit accused State Farm of duping policy holders to switch
policies and lose value; promising unrealistic returns on cash
value policies; inflating dividend projections; and soliciting
sales by referring to life insurance policies as ``investments''
and ``retirement plans.''
_________________________________________________________________
Copyright 1999 The New York Times Company
The information contained in this AP Online news report
may not be republished or redistributed
without the prior written authority of The Associated Press.
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