Articles Posted in Bad Faith Insurance Practices

According to the Courier Journal, apparently, Jewish Hospital & St. Mary’s Healthcare is not playing by the rules. The Louisville hospital group has reached an agreement with the U.S. government to pay $435,502 resulting from alleged overbilling Medicare for outpatient wound care. The alleged overbilling was due to the hospitals charging for procedures that were never performed, according the U.S. Attorney’s Office in Louisville. The “double-billing” took place between January 2006 and February 2010. According to both sides, there will be no admission of wrongdoing on the part of the hospitals. The allegations against Jewish come on the heels of allegations against Baptist Healthcare System and Hardin Memorial Hospital involving significantly larger amounts of alleged overbilling, close to $9 million.

Frankly, it is not clear to me why these entities who are supposed to be caring for the public and are entrusted with handling the fair and proper billing associated with their care should simply be allowed to pay back the money with no further penalty. There is no indication that these overbillings were accidental. At a time when one of our country’s largest deficit problems relates directly to the cost of healthcare and the viability of Medicaid and Medicare, I would think that the public would like an explanation as to why these hospitals tried to overbill the government or bill them for services that were not even performed. I know I would like an explanation.

Anyone who rents an apartment should talk with an insurance agent about getting Renter’s Insurance. It’s a simple process that takes less than 15 minutes of questions to be answered in the application process, and the costs are very cheap.

The cost of Renters Insurance runs about $10.00 to $15.00 per month. It usually affords renters $100,000.00 of liability insurance to cover liability that may arise from you or your guests’ actions. The policies usually afford medical cover for injuries, and most importantly the policies afford coverage for your personally property, in the event of fire, theft, or other loss. Additionally, most policies provide coverage if you have to relocate from your apartment due to a fire or other catastrophic loss.

When an apartment in an apartment complex or building has a fire, all the apartments in the building are impacted. Not only the unit that caught on fire, but the other unit’s suffer fire damage, smoke damage, and water damage (from the efforts to fight the fire). This usually results in a total loss for all the people living in the building.

If a person were to consider everything that can go wrong or cause problems for them in their home, and then multiply those problems by the number of other people occupying the same complex or building, the risks are enormous. Those risks can be offset cheaply by having Renters Insurance.

Anyone who owns or owned a deferred annuity from American Investors Life Insurance Company or AmerUs Insurance Company (n/k/a Aviva Life and Annuity Company) that was issued from Jan. 1, 1998 to July 28, 2009 needs to know there is a pending class action settlement involving these companies with an opt date requiring a postmark no later than Oct. 13, 2009.

Those wishing for more information on this issue can email Louisville, Kentucky attorney Will Nefzger by clicking on this link: e-mail Will.

Federal prosecutors, capping an 18-month investigation, are preparing to impanel a grand jury in Brooklyn, N.Y., to consider an indictment of a former senior American International Group Inc. executive, according to people familiar with the matter.

The Justice Department and the Securities and Exchange Commission have been investigating whether Joseph Cassano, whose AIG Financial Products unit nearly brought down the insurer a year ago, committed securities fraud in allegedly misleading investors by overstating the value of mortgage-related contracts and failing to disclose material facts about them to AIG’s outside auditor, the people said.

Insurance claims from the August 4, 2009 flood in Louisville, Kentucky are sure to be pouring due to some of the heaviest short-period rainfall and worst flooding in decades. These claims will be for property damage to businesses, homes and autos for the most part.

A Kentucky law known as the Unfair Claims Settlement Practices Act requires insurance companies to adjust claims and treat people fairly and protects consumers from bad fatih practices. Louisville, Kentucky bad faith insurance practices attorney Will Nefzger of Bahe Cook Cantley & Nefzger, who is experienced in handling cases where insurance companies violate this law and act in bad faith said that consumers who make claims that are delayed or denied unfairly should not hesitate to hold their insurance company accountable.

A Louisville, Kentucky jury awarded a woman in an insurance company bad faith lawsuit $3.8 million from American Physician Assurance Corporations for their bad faith and unreasonable delay in settling her claim. Deborah Daniels had an unconventional procedure performed on her that her doctor described as a “modified abdominoplasty.” The surgical procedure, performed by Dr. David Grimes, left Ms. Daniels unable to work again and required multiple and lengthy hospital visits.

Ms. Daniels filed a medical malpractice lawsuit in June 2004. AP Assurance was told by their own medical consultant that the surgical procedure performed on her was “inexcusable and indefensible.” AP Assurance did not make an effort to settle this case until July and August of 2006. By this time Ms. Daniels was told she would never work again after twenty years as a respiratory therapist and had been without an income for two years. In substantial financial distress, Ms. Daniels was offered only $75,000 of the $1 million policy limit.

After great delay and emotional stress Ms. Daniels settled with the doctor for far less then the policy limits. Her Louisville personal injury lawyer, Hans Poppe then filed a suit against AP Assurance directly for their bad faith in settling the insurance claim and in violation of the Kentucky Unfair Claims Settlement Practices Act. Mr. Poppe hired Ken Friedman to try the case as Mr. Poppe would have to be a witness against the AP Assurance. At trial, it became apparent that the policy in handling cases used by AP Assurance was designed to pay less to the injured person and push claims to trial rather than settlement.

The jury saw the bad faith in handling insurance claims used by AP Assurance. They awarded Ms. Daniel $350,000 in compensatory damages as well as $3,479,277 in punitive damages. The amount of punitive damages is the exact amount the claim adjuster was told to cut from her claims in 2006. This sends a message to insurance companies in Kentucky that they are required to use good faith and fair dealings in handling valid claims.