RICO laws in litigation againsy insurance companies.">

HMO, ERISA, Insurance and Court News

  1. Court Overturns Disablity Time Limit
  2. A few new items from New York Times and LA Times
  3. Class Action Against UNUM Insurance Company
  4. Testimony before Nevada legislature about HMO care
  5. Punitive Damages awarded under ERISA
  6. Credit Checks by Insurance Companies (Yang v Geico)

Court Overturns Disablity Time Limit

   From judydoc@the-spa.comThu Jul 23 18:15:05 1998
   Date: Tue, 21 Jul 1998 09:53:00 -0400
   From: judy morris 
   To: judydoc@the-spa.com
   Subject: Re: Court Overturns Disablity Time Limit
   The following is from Florida Agent, July 1998,a publication for
   insurance agents.
   A long term disability insurance policy limiting benefits for mental
   but not physical illness violates the Americans with Disabilities
   Act, a federal judge ruled.
   Judge Leonie M. Brinkema of the U.S. District Court in Alexandria,
   Va. ordered Kmart to resume paying Harold Lewis disability benefits
   until he turns 65.
   Disabilities rights activists hailed the decision as a victory.
   The matter is hardly settled since two U.S. Appeals courts have
   ruled the other way.
   The judge ruled that for Kmart to win they would have to show that
   its offer of lesser mental health benefits was based on " sound
   actuarial principles". The company fail to do that.

A few new items from New York Times and LA Times

   Date: Wed, 22 Jul 1998 00:45:49 -0400
   From: judy morris 
   Subject: A few new items from New York Times and LA Times
   July 21, 1998
   Hold H.M.O.'s Liable for Bad Care
   To the Editor: 
   The only reason that health maintenance organizations are signing on to
   legislation regulating their industry is because they are
   trying to avoid the one piece of legislation that would truly protect
   the public (editorial, July 17). The only way to crack down on
   the H.M.O.'s and to stop their widespread abuse of patients is to make
   it clear that when they dictate medical decisions, they are
   practicing medcine without a license. 
   Any legislation that Congress passes to protect the American people must
   include provisions that hold H.M.O.'s and their
   executives personally accountable for such actions and allow for civil
   remedies and punitive damages against them. H.M.O.'s
   favor what they call independent appeal panels, but with these managed
   care companies controlling doctors' lives, no such panel
   could be independent. 
   Great Neck, N.Y., July 17, 1998 
   To the Editor: 
   The H.M.O. Group, a coalition of 25 health maintenance organizations,
   opposes legislation that would allow consumers to sue
   insurance companies when benefits are improperly denied (editorial, July
   Paradoxically, the Employee Retirement Income Security Act, the law that
   shields H.M.O.'s from liability suits, was instituted as a
   safeguard for the consumer, whose hands it now ties. The H.M.O. Group
   claims that being subjected to lawsuits would increase
   consumer costs, because it would increase industry spending. Yet the
   insurance industry is not shy about spending millions of
   dollars on public relations campaigns, which increases in consumer costs
   no doubt help finance. 
   If the managed care industry were honest about its good intentions, it
   would subject itself to legal scrutiny. 
   Chicago, July 17, 1998 
   To the Editor: 
   It is disappointing to see President Clinton and his Democratic
   colleagues champion the right to sue ahead of all other patients'
   rights enumerated in proposed managed care legislation (news article,
   July 17). As both political parties weigh in with proposals
   for such legislation, the right to sue stands out as a divisive issue
   that could kill any chance for meaningful reform. 
   Of course managed care plans should have to pay when their decision to
   deny care results in physical or economic injury. 
   The most expedient means toward that end is to amend the Employee
   Retirement Income Security Act, which was intended to
   regulate pension plans, so that it no longer regulates employee benefit
   Chicago, July 17, 1998 
   To the Editor: 
   It is not surprising that health maintenance organizations seem ready to
   accept many of the tenets of the proposed patients' bill
   of rights but remain opposed to being held liable for their decisions
   (editorial, July 17). The concessions they are willing to make
   are small stuff compared with real accountability. 
   For example, if a psychiatrist wishes to hospitalize a suicidal patient,
   approval must be obtained from an H.M.O. or managed care
   group. If approval is denied, it is the psychiatrist who is forced to
   indemnify the H.M.O. or managed care group for its decision
   should there be an adverse outcome. 
   H.M.O.'s say it isn't good when government plays doctor by writing laws
   governing their practices. Neither should citizens accept
   a status quo that gives license to H.M.O.'s to make clinical decisions
   unless they are held liable for those decisions. 
   Garden City, N.Y., July 17, 1998 
   The writer is vice president, New York State Psychiatric Association.
   To the Editor 
   It is paradoxical that Senator Edward M. Kennedy is among those leading
   the charge against health maintenance organizations
   (front page, July 16). Five years ago he supported a national health
   insurance plan that amounted to a Government-run H.M.O. In
   an effort to revive his dream, he would now decry the horrors of private
   health maintenance organizations' deciding how much
   health care we may have. 
   The Democrats complain that we cannot sue H.M.O.'s if they commit
   malpractice. But will their plan allow us to sue the
   Government if it commits malpractice? Granted, H.M.O.'s have not solved
   the health care problem, but neither will more
   government. Why not a supply-side solution -- increase the number of
   doctors and drive down the price through competition? 
   Winter Park, Fla., July 17, 1998 
   (Copyright 1998, The New York Times. This article reproduced for
   educational purposes only.)
Class Action Against UNUM Insurance Company

   Date: Wed, 22 Jul 1998 20:51:39 -0400
   From: judy morris 
   Subject: Re: Class Action Against UNUM Insurance Company
   Here's a law firm interested in a Class Action against UNUM.  Please
   spread the word.  As usual I can't vouch for the integrity of any lawyer
   or law firm, but I know Robert Perez is on the "right" side.  You can
   read some of what he's written about ERISA on the Web Site
   He wrote something called Fundamentals of ERISA Litigation.  He's been
   receiving my posts and has gotten his law firm interested in this issue.
   Let's show them just how BAD UNUM is! Spread the word on the newsgroups
   and support groups.  I'm sure there are still plenty of unrepresented
   victims out there.
   > Thank you for your interest in our investigation of Unum's practices. We
   > are intereseted in examining denials of claimants who are not represented
   > by attorneys and have not filed suit. These people are potential class
   > action plaintiffs. We would like to see the insurance certificates and
   > all of the correspondence to and from Unum. My address is
   >	Robert Perez, The Perez Law Firm Co. L.P.A.
   >	7672 Montgomery Rd.
   >	Cincinnati, OH 45236
   >	Tele 513-891-8777
Testimony before Nevada legislature about HMO care

   Date: Thu, 23 Jul 1998 11:11:17 -0400
   From: judy morris 
   Subject: Testimony before Nevada legislature about HMO care
   More HMO Horror stories exposed to the public.  I really think that even
   if RICO wasn't working before, the tide is turning.  NONE of the laws
   that the insurance companies spout to defeat lawsuits in State Court OR
   RICO WAS INTENDED to give insurance companies or ANYONE carte blanche to
   engage in widescale Constructive Fraud, deceit and manslaughter.
   As one of the people testifying in Nevada said, during the process of
   selling him the insurance there were NO communications problems.  All
   the problems occurred AFTER the claims were filed.  How can a company be
   so GOOD at selling insurance and collecting premiums, but the same
   company has such a hard time paying legitimate claims, that they'll only
   pay when the patient threatens to go to the PRESS or the Government (and
   as my case has clearly shown, in some cases, that doesn't even help).
   I want to know how long the insurance companies can keep using the SAME
   deceit, and manslaughter, all the while RAISING PREMIUMS ANYWAY?
   david wrote:
> Howdy,
> One of our more literate allies has drawn to my attention Mr. Christopher
> Hitchens' wonderfully HMO-skewering "Bitter Medicine", in the August isssue
> of VANITY FAIR. One of the main foci of the lengthy (but very readable)
> article is the testimony presented to the Nevada state legislature on their
> patients rights bill. Also included is a brief (and enlightening) history
> of managed care and "HMO's" (which term Mr. Hitchens rightly points out is
> a misnomer).
> Sadly, the article is not available online, but it's well worth a trip to
> your local newsstand, library, dentist's office, or recycle bin.
> Happily, on the other hand, a summary (also lengthy but readable once you
> get past the boilerplate) of the Nevada hearings on A.B. 156 ("Minutes of
> the Assembly Committee on Health and Human Services", Feb 22, 1997) is
> available online at the (yes, also lengthy, but you do have cut-and-paste,
> don't you?) URL:
>      Nevada Hearings Summary
>     http://www.leg.state.nv.us/97minutes/AM/HH/am2-22HH.htm"
> Enough to get you through an afternoon at the beach, and certainly much
> scarier than a Stephen King novel.
> Carry on,
> David

Testimony before Nevada legislature about HMO care

   Date: Thu, 23 Jul 1998 15:14:53 -0400
   From: judy morris 
   Subject: Something to look into re:
            a case where punitive damages were awarded under ERISA
   > From: Broncorudy 
   > Newsgroups: alt.med.cfs
   > Date: Thursday, July 23, 1998 1:23 AM
   > Subject: Re: Disability Insurance- Metlife
   > in my research of CFIDS cases and Fibromyalgia cases, there have been
   > legal > fees that have been awarded to the winning party. It is not
   > true that "punitive" damages can't be awarded, but it is rare.
   > In Godfrey V Bell South Telecommunications the court noted,
   > "Under ERISA Section 502(a)(3), 29 U.S.C. 1132(a)(3),
   > the court has the power to grant equitable relief to redress
   > violations of ERISA or violations of the benefit plan."
   > Rudy

Credit Checks by Insurance Companies

Date: Mon, 24 Aug 1998 21:13:53 -0400

Here's recent appelate court decision that
even INSURANCE DON'T have carte blanche to order credit checks on people.

Yang v Geico


I'll analyze this case with quotes later.

Date: Thu, 10 Sep 1998 10:53:15 -0400

Subject: FCRA - Fair Credit Reporting Act

Case Yang v. Geico  DC Docket No. 1:95-CV-3287-JOF

I believe, although this case has extremely circular logic, that the
point is being made that although Geico claims the report in question is
NOT a credit report and therefore not subject to FCRA because it wasn't
USED for an approved purpose, that the court found that the report was
indeed covered under FCRA because it was PREPARED by Equifax to be USED

The report  sought by Geico after an insurance claim was filed is called
an IAR (inquiry Activity Report) and was computer generated by something
called ARCO (Automated Credit Reporting On-Line).

I think we have a case against these Credit Reporting Companies to ensure
that the reports they are generating are NOT used for unapproved purposes
by insurance companies (as a means of  harrassment and finding out
information they have no right to) and also because everytime a report is
REQUESTED from the agencies, the fact that a request was made gets put
into the reports, and some institutions consider the LENGTH of a credit
report as an indication of a lack of credit worthiness.

Geico's reasons for requesting this report were, of course, pure
defamatory BS, as I'm sure we will find in many of our UNUM cases where
reports are "routinely" requested.



Date: Mon, 24 Aug 1998 21:13:53 -0400

This is the latest from Steve Russell and Lee Hoffman.  They are the
ones who got the Arizona Supreme Court Decision that UNUM must produce
documentation concerning all lawsuits filed for denial of disability
benefits since 1994.  UNUM has been ordered to produce all of the
documents by the 31st of August or they are in contempt of the Arizona
Supreme Court.

Attorney Hoffman also invites any attorneys with lawsuits against UNUM
to come to his office and review the case file.  Here's how to contact
him: 	(602) 254-5341	HSSlaw@aol.com


It is now well past the August 31, 1998 deadline and UNUM has defied
the Order of the Supreme Court of Arizona to produce the documents, and
therefore UNUM is in potential contempt.

   Date: Wed, 16 Sep 1998 18:56:53 -0400
    Listmember wrote:
   The los angeles times today, sept 16, 1998 on page one of the front
   section published an article entitled "Pressure Mounts to let consumers
   sue HMO's"  The article sets forth several matters in which people were
   denied healthcare treatment under their employee sponsored HMO's which
   led to their deaths.  Because ERISA controlled, they and their survivors
   could not collect damages.  I will write to the staff writers and alert
   them to the issues involving disability policies.

   My response:
   judy morris wrote:

   As Dick Van Dyke said on his show Diagnosis Murder when HMO red tape led
   to the death of a child and the delayed diagnosis of cancer in another
   person "It's MURDER."
   And it is - it's Premeditated Negligent Homicide. (i.e. murder)

   By denying benefits that the court rules SHOULD have been given, and
   knowing the consequences could be death, but thinking they are protected
   by ERISA, it's PREMEDITATED MURDER.  I want to know when people are
   going to wake up and realize the insurance industry (at least some of
   it, the biggest companies) have DECLARED WAR ON THE AMERICAN PEOPLE.
   It's a Class War - the rich against the poor (although ironically in
   this case - the poorest, those with NO health insurance are better off.
   At least they are not PAYING for the Privelege of BEING MURDERED.)

   It's PREMEDITATED, it's malicious, and the PATTERNS of abuse are
   becoming VERY clear even without an insider "confessing." Although we
   already have Dr. Linda Peeno and her courageous battle that the
   government is WILLFULLY ignoring.
   Just as what's going on in Bosnia is still a war, and each death is
   still a murder, no matter how much they claim it's just "ethnic
   What's going on in this country is still war, it's still premeditated,
   and it's about nothing but MONEY.  There aren't even any higher
   principles involved here.  The insurance companies after all supposedly
   have lots of DOCTORS acting as executives and medical directors who
   SHOULD KNOW that denial of certain treatments MAY result in death or
   injury and they have lots of lawyers who KNOW OR SHOULD KNOW that some
   of these denied benefits are CLEARLY COVERED by the policies.

   As reported in the Miami Herald 
   The brilliant 34 year old psychologist daughter of Joan E. Childs, a
   social worker and her physician (ex?) husband jumped 15 stories to her
   death in July after a struggle of several years not only against her
   neurobiologial (i.e.mental) illness, bipolar disease, but also years of
   battling for proper treatment with her HMO.  Her parents lost not only
   their daughter, but their trust in ANY promise any one might make, just
   as I have, thanks to the repetitive broken ones of our corporate
   By the way, to those of you who still think I'm too hard on the
   insurance industry because SOME people manage to get SOME care.  How
   about the analogy of a parent who manages to feed and cloth his
   daughter, gives her the best money can buy, but sexually abuses and/or
   beats her on the side.  This person is no more a wonderful parent than
   is an insurance company who promises protection and then abuses 10% (or
   ANY percent) of it's claimants is worthy of ANY accolades.

Insurance Page

Uncivilization and its Discontents

Home Page

Email Judy Morris
at: judydoc AT the-spa DOT com

Email me
at: bhammel AT graham DOT main DOT nc DOT us

The URL for this document is:
Created: July 24, 1997
Last Updated: May 28, 2000