RICO laws in litigation againsy insurance companies.">
From judydoc@the-spa.comThu Jul 23 18:15:05 1998 Date: Tue, 21 Jul 1998 09:53:00 -0400 From: judy morrisTo: 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. ------------------------------------------------------------------------
Date: Wed, 22 Jul 1998 00:45:49 -0400 From: judy morrisSubject: 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. HARVEY F. WACHSMAN, M.D. 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 17). 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. TAMARA CLAMAN 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 plans. COLLEEN C. BUTLER 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. BARRY B. PERLMAN, M.D. 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? DAVID E. PETERSON Winter Park, Fla., July 17, 1998 (Copyright 1998, The New York Times. This article reproduced for educational purposes only.) -----------------------------------------------------------------------
Date: Wed, 22 Jul 1998 20:51:39 -0400 From: judy morrisSubject: 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 HARP.org 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. Judydoc > 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 -----------------------------------------------------------------------
Date: Thu, 23 Jul 1998 11:11:17 -0400 From: judy morrisSubject: 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 OLD EXCUSE OF INCREASED INSURANCE PREMIUMS as an excuse for fraud, deceit, and manslaughter, all the while RAISING PREMIUMS ANYWAY? Is ANYONE ACTUALLY BELIEVING THIS BESIDES TRENT LOTT? Judydoc 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
Date: Thu, 23 Jul 1998 15:14:53 -0400 From: judy morrisSubject: Something to look into re: a case where punitive damages were awarded under ERISA > From: Broncorudy > Newsgroups: alt.med.cfs > To: CFS-L@MAELSTROM.STJOHNS.EDU > 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
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 http://caselaw.findlaw.com/scripts/getcase.pl?navby=search&case=/ data2/circs/11th/978432opn.html 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 ONLY FOR APPROVED purposes. 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 UNUM ORDERED BY COURT TO PRODUCE DOCUMENTS BY AUGUST 31, 1998 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 Update: 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 cleansing." 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 "benefactors." 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.
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