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    <title>Alaska Injury Law Blog</title>
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   <id>tag:www.alaskainjurylawblog.com,2008://163</id>
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    <updated>2008-06-10T23:50:55Z</updated>
    
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<entry>
    <title>Metabolife CEO Headed To Prison</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/06/metabolife_ceo_headed_to_priso_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=19140" title="Metabolife CEO Headed To Prison" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.19140</id>
    
    <published>2008-06-10T22:31:29Z</published>
    <updated>2008-06-10T23:50:55Z</updated>
    
    <summary>The Alaska Personal Injury Law Group has long been involved in the analysis of defective products sold by the diet supplement industry. (Talbert v. E&apos;ola Products, Inc., http://www.alaskainjurylawgroup.com/lawyer-attorney-1286823.html). We have watched this industry repeatedly use unqualified personnel to design and...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Diet Supplement, OTC, Pharmaceutical Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>The Alaska Personal Injury Law Group has long been involved in the analysis of defective products sold by the diet supplement industry.  (Talbert v. E'ola Products, Inc., http://www.alaskainjurylawgroup.com/lawyer-attorney-1286823.html).  We have watched this industry repeatedly use unqualified personnel to design and sell products that are, in a word, dangerous.  The industry has run amuck with virturally no regulatory oversight, and the consumer is repeatedly defrauded or hurt by exposure to the rapacious and dangerous practices of this industry.  </p>

<p><strong>It is thus with some appreciation of the legal and karmic forces at work in the universe to read today's news that Michael Ellis, former CEO of Metabolife, was sentenced to prison </strong>for 6 months based on pleading guilty to a single count of lying to the FDA about the effects of Metabolife 356 and its notorious ingredient, ephedra.   Despite the millions the company relieved consumers of, he was fined just $20,000. In 2005, William Bradley, who was Ellis’ partner in Metabolife, pleaded guilty to seven felonies, including tax evasion, and sentenced the following year to six months in custody.</p>

<p>Metabolife and Ellis had sent letters to the FDA stating that they had “never received a notice from a consumer that any serious adverse health event has occurred because of the ingestion of Metabolife 356.”   Metabolife's own documents, however, showed that it had received many reports from consumers of strokes, heart attacks, seizures, and other serious illnesses.  The company ultimately turned over the reports of 14,000 ephedra-related adverse events that the company had previously not disclosed to the FDA, which ultimately was a key factor in the FDA's ban on ephedra imposed on the industry in 2004. </p>

<p>Metabolife became the target of hundreds of lawsuits, and to outrun the posse, went into Chapter 11 bankruptcy in 2005.  We have seen this bankruptcy ploy used by a number of diet supplement companies wanting to "hide out while on the lam."  <br />
<strong><br />
Source:</strong></p>

<p><a href="http://www.usdoj.gov/usao/cas//press/cas71105-Metabolife.pdf">www.usdoj.gov/usao/cas//press/cas71105-Metabolife.pdf</a></p>

<p><a href="http://www.signonsandiego.com/news/business/20080610-9999-1b10metabo.html">http://www.signonsandiego.com/news/business/20080610-9999-1b10metabo.html</a></p>

<p><br />
</p>]]>
        
    </content>
</entry>
<entry>
    <title>13 Hurt In Charter Bus Crash</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/06/13_hurt_in_charter_bus_crash.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=19124" title="13 Hurt In Charter Bus Crash" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.19124</id>
    
    <published>2008-06-09T20:07:39Z</published>
    <updated>2008-06-10T22:31:13Z</updated>
    
    <summary>On Monday, June 9, 2008, a chartered tour bus carrying Korean tourists traveling to Fairbanks crashed when the bus left the highway and rolled. The cause of the accident is unknown, but the initial scene investigation indicated that the bus...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Legal News" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>On Monday, June 9, 2008,  a chartered tour bus carrying Korean tourists traveling to Fairbanks crashed when the bus left the highway and rolled.  The cause of the accident is unknown, but the initial scene investigation indicated that the bus hit a ditch, went airborne, and rolled at least once.  Thirteen of the passengers were hurt, three of them critically.</p>

<p>The accident occurred on the Richardson Highway, approximately 175 miles northeast of Anchorage.  Five Alaska State Troopers responded to the scene, and the critically injured were medivaced by Army Black Hawk helicopters.</p>

<p>The 54 seat tour bus was being operated by the Luxury Coach Line, a California-based corporation operating charter tours.<br />
<strong><br />
Source: Alaska State Troopers</strong>,<br />
<a href="http://www.dps.state.ak.us/PIO/dispatch/Trooper%20Dispatches%20of%2006-10-2008.20080610.txt">http://www.dps.state.ak.us/PIO/dispatch/Trooper%20Dispatches%20of%2006-10-2008.20080610.txt</a></p>]]>
        
    </content>
</entry>
<entry>
    <title>Getting All The Evidence Is Key To Successful Insurance Claims </title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/05/getting_all_the_evidence_is_ke_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=18475" title="Getting All The Evidence Is Key To Successful Insurance Claims " />
    <id>tag:www.alaskainjurylawblog.com,2008://163.18475</id>
    
    <published>2008-05-30T22:44:51Z</published>
    <updated>2008-06-15T02:39:34Z</updated>
    
    <summary>Alaska Personal Injury Law Group attorneys have waged many legal battles to force Allstate to produce documents that are relevant to insurance &quot;bad faith&quot; claims against the insurer by injured Alaskans. These claims have alleged that Allstate unfairly and unreasonably...</summary>
    <author>
        <name>Neil T. O&apos;Donnell</name>
        
    </author>
            <category term="Automobile Injuries" />
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>Alaska Personal Injury Law Group attorneys have waged many legal battles to force Allstate to produce documents that are relevant to insurance "bad faith" claims against the insurer by injured Alaskans.  These claims have alleged that Allstate unfairly and unreasonably delayed and "low balled" their personal injury insurance claims.  Significantly, the Florida Department of Insurance, Office of Insurance Regulation (OIR) recently suspended Allstate's license to write new insurance in that state because Allstate refused to produce documents requested by the Office of Insurance Regulation (OIR) regarding Allstate's claim practices.  That suspension order was recently affirmed by the Florida Court of Appeals, which wrote that "Allstate's willful, indeed potentially criminal, failure to comply with its disclosure obligations has prevented OIR from adequately investigating its reasoned belief that Allstate is systematically defrauding its policyholders."  Allstate Floridian, et. al. v. Office of Insurance Regulation, 2008 WL 2048349 (Fla. App., May 14, 2008)  Forcing the insurer to produce the relevant documents is key to any successful insurance "bad faith" case.  We have often gone back to court repeatedly to ensure that we get the evidence injured insureds need to prove their claim.  We are encouraged by the Florida court's firm stance on this issue.    </p>]]>
        
    </content>
</entry>
<entry>
    <title>ERA Helicopters Sheep Mountain Helicopter Crash--4 Killed, Boy Survives</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/04/era_aviation_sheep_mountain_he.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=13932" title="ERA Helicopters Sheep Mountain Helicopter Crash--4 Killed, Boy Survives" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.13932</id>
    
    <published>2008-04-17T19:07:05Z</published>
    <updated>2008-06-15T02:37:41Z</updated>
    
    <summary>An ERA Helicopters Eurocopter Arrow Star 350 B2 helicopter crashed in heavy weather conditions near Sheep Mountain on April 15, 2008, killing four people, and seriously injuring a 14-year-old boy. Killed in the crash were the pilot, Benoit Pin, and...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Aviation Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>An ERA Helicopters Eurocopter Arrow Star 350 B2 helicopter crashed in heavy weather conditions near Sheep Mountain on April 15,  2008, killing four people, and seriously injuring a 14-year-old boy.  Killed in the crash were the pilot, Benoit Pin, and three employees of the Alaska Department of Administration, Michael D. Seward, Thomas E.Middleton, and Joseph C. O’Donnell.  The flight was en route to a state telecommunications tower near Tahneta Pass when the crash occurred.  The 14-year-old boy, Quinn Ellington, was found alive on Wednesday morning.  Weather hampered the search for the craft, whose emergency locator transmitter went off  on Tuesday at 1625 hours.  An HC-130 and pararescue personnel on snow machines searched through the night until the crash site was located Wednesday morning approximately 120 miles northeast of Anchorage.</p>

<p>The NTSB is investigating the crash.  The circumstances are similar to another crash of an ERA Aviation helicopter near Fire Island in October 2001, which occurred in heavy snow conditions. (Richard Vollertsen, of the Alaska Personal Injury Law Group, was lead counsel in that crash investigation: <a href="http://www.alaskainjurylawgroup.com/lawyer-attorney-1286823.html)">www.alaskainjurylawgroup.com/lawyer-attorney-1286823.html)</a>  The weather at the time of the Sheep Mountain crash included snow, rain and fog, and rescuers called it “blizzard conditions.”  State of Alaska personnel have not yet explained why Ellington, Michael Seward’s stepson, was a passenger on a flight where state personnnel were performing maintenance on a transmission tower.  The pilot, Benoit Pin, obtained his commercial helicopter license in 2001.</p>

<p>Source: <br />
<strong>Federal Aviation Administration:</strong><br />
<a href="http://www.faa.gov/data_statistics/accident_incident/preliminary_data/media/K_0417_N.txt">www.faa.gov/data_statistics/accident_incident/preliminary_data/media/K_0417_N.txt</a></p>

<p><strong>Eurocopter Arrow Star 350:</strong><br />
<a href="http://www.eurocopterusa.com/Product/as350/as350.asp">www.eurocopterusa.com/Product/as350/as350.asp</a></p>

<p><strong>Alaska State Troopers:</strong><br />
<a href="http://www.dps.state.ak.us/pio/dispatch/Trooper%20Dispatches%20of%2004-17-2008.20080417.txt">www.dps.state.ak.us/pio/dispatch/Trooper%20Dispatches%20of%2004-17-2008.20080417.txt</a></p>

<p><strong>Anchorage Daily News: </strong><br />
<a href="http://www.adn.com">www.adn.com</a></p>]]>
        
    </content>
</entry>
<entry>
    <title>Allstate Finally Releases Development Documents For Its &quot;Boxing Gloves&quot; Claims Adjusting Program</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/04/allstate_finally_releases_deve.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=13453" title="Allstate Finally Releases Development Documents For Its &quot;Boxing Gloves&quot; Claims Adjusting Program" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.13453</id>
    
    <published>2008-04-09T00:01:49Z</published>
    <updated>2008-04-09T00:36:07Z</updated>
    
    <summary>Allstate has finally made public its controversial &quot;McKinsey Documents&quot; which describe the development of its self-described &quot;radical&quot; claims handling program. Allstate made these documents public just days after a Florida court affirmed an order from the Florida Division of Insurance...</summary>
    <author>
        <name>Neil T. O&apos;Donnell</name>
        
    </author>
            <category term="Automobile Injuries" />
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>Allstate has finally made public its controversial "McKinsey Documents" which describe the development of its self-described "radical" claims handling program.  Allstate made these documents public just days after a Florida court affirmed an order from the Florida Division of Insurance prohibiting Allstate from writing any new business in that state until it produced those documents to the Division of Insurance there.   <a href="http://www.alaskainjurylawblog.com/91423.pdf">Download file</a>   The Alaska Personal Injury Law Group already has a copy of many of the McKinsey Documents, having obtained a court order requiring Allstate to produce them in litigation pending in Alaska.  From these documents and other sources, the Alaska Personal Injury Law group is familiar with Allstate's self-described "radical" claims program designed by the international business consulting firm McKinsey & Company.  According to Allstate records, this program has generated hundreds of millions of dollars in additional profit for Allstate's shareholders and executives.  The program, called Claims Core Process Redesign or "CCPR," had three key components: (1) discouraging claimants from hiring attorneys because McKinsey's extensive closed-claim study showed that represented claimants, even after adjusting for the same type of claim, were paid far more than unrepresented claimants; (2) arbitrarily and systematically depressing claim valuations through a centrally "tuned" claims evaluation computer program with the not-so-friendly name of "Colossus;" and (3) vigorously litigating against claimants who did not submit to Allstate's new arbitrarily-lowered claim valuations (candidly called the "Boxing Gloves" treatment by McKinsey and Allstate, as contrasted with the "Good Hands" treatment given to claimants who agreed to Allstate's valuations).  For the last 10 years, Allstate has doggedly refused to produce the McKinsey Documents in cases alleging bad faith claims handling.  In the few cases in which courts have ordered Allstate to produce the McKinsey Documents (like one currently being handled by the Alaska Personal Injury Law Group), the court imposed strict confidentially rules based on Allstate's claim that the documents were allegedly important trade secrets.  Allstate produced 12,929 pages of McKinsey Documents to the Alaska Personal Injury Law Group under protective order.  The Alaska Injury Law Group is now looking forward to using these documents without the burdensome confidentiality restrictions previously advocated by Allstate.   </p>]]>
        
    </content>
</entry>
<entry>
    <title>Health Insurer Punished for Bad Faith Cancellation of Policy of Insured Undergoing Cancer Treatment</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/health_insurer_punished_for_ba_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=11212" title="Health Insurer Punished for Bad Faith Cancellation of Policy of Insured Undergoing Cancer Treatment" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.11212</id>
    
    <published>2008-02-28T00:45:41Z</published>
    <updated>2008-02-28T02:21:16Z</updated>
    
    <summary>In an insurance bad faith case, a retired judge, sitting as an arbitrator, has found a willful scheme to cheat the insured and imposed punitive damages against a health insurer for post-claim underwriting. Post-claim underwriting is a scheme where an...</summary>
    <author>
        <name>W. Michael Moody</name>
        
    </author>
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>In an insurance bad faith case, a retired judge, sitting as an arbitrator, has found a willful scheme to cheat the insured and imposed punitive damages against a health insurer for post-claim underwriting.  Post-claim underwriting is a scheme where an insurer facing a claim for benefits “investigates” the policy application and rescinds the policy on the ground that some important information was not disclosed by the insured.  Post-claim underwriting is discussed in more detail in an <a href="http://www.alaskainjurylawblog.com/2008/02/insurers_bad_faith_postclaim_u.html">earlier article</a> by the Alaska Personal Injury Law Group.</p>

<p>In the <a href="http://www.calendarlive.com/media/acrobat/2008-02/35955051.pdf" target= "_blank">case reported</a> upon here, the insured incurred medical bills of more than $125,000 for breast cancer treatment.  While she was still being treated, the health insurance company did its post-claim underwriting and cancelled her policy.  The poor insured was left facing not only a life-threatening event, but also huge medical bills with no way to pay them.</p>

<p>The ultimate unfairness was that this policy had been sold to her to replace a policy that unquestionably would have covered these bills.  She did not need this new, replacement policy but the insurance company’s agent sold it to her anyway.  The most likely reasons were to generate new business for the company and a commission for himself.  It was the insurance company’s own agent, not the insured, who had filled out the application that the insurance company later used to cancel the coverage.  None of that caused the insurance company to hesitate in the least when it came time to save $125,000 by canceling the policy.</p>

<p>Fortunately, the insured found a lawyer experienced in insurance bad faith cases.  That bad faith insurance claims attorney uncovered evidence that the insurance company employees who do the post-claim underwriting <strong>were paid bonuses based in part on how many policies they cancelled</strong>.  Those same employees were given goals for how many rescissions they were expected to make.  One year, an employee was to rescind 15 policies a month.  The next year that same person was to rescind 25 policies a month, 300 rescissions for the year.  In following years, the goals were stated in terms of an annual goal of money the employee was expected to save the company by rescinding policies after claim were made.  One employee's target goal was $6 million of savings one year, $6.5 million the next.  Of course, those savings were to come at the expense of the insureds who had faithfully paid the insurance company for the health insurance they now drastically needed.</p>

<p>The arbitrator clearly explained what a nefarious scheme this was.  The insurance company’s scam attacked the insureds when they were most defenseless and most in need of the insurance benefits they had paid for.  He found that the insurance company was in bad faith because it paid no attention to its own guidelines when it came to rescinding these policies.  The insurer also acted in bad faith by ignoring state statutes that explicitly prohibited post-claim underwriting.  The arbitrator also believed some of the insurance company’s bad faith actions rose to the level of criminal conduct.  Based on all this wrongdoing, he awarded the insured almost $130,000 for the medical bills that had not been paid, $750,000 in compensatory damages for what the insurer had put her through by wrongfully canceling her coverage, and $8,400,000 in punitive damages.</p>

<p>Fortunately, that is not the end of the story.  The Los Angeles City Attorney is <a href="http://www.latimes.com/features/health/la-fi-insure23feb23,1,6273385,full.story?ctrack=5&cset=true" target= "_blank">investigating criminal charges</a> arising out of this scheme.  I say fortunately, because insurance companies generally treat such scams as an economic game.  Insurance companies who engage in such bad faith practices may get caught occasionally, but they play the odds.  They fight such claims tooth and nail.  If they ultimately lose and have to pay, it is just a minor offset against the huge profits they make by using these bad faith schemes against many insureds all across the country.  The insurance company that gets caught has to pay a little bit, like the Las Vegas casino paying off the few winners, but it knows it typically will not get caught and that the odds overwhelmingly favor the house.  Even $8.4 million in punitive damages pales in comparison to the profits generated by such bad faith insurance company scams.  Maybe potential criminal liability will make insurers hesitate before cheating the insureds most in need of the protection they purchased.</p>]]>
        
    </content>
</entry>
<entry>
    <title>Insurers’ Bad Faith Post-Claim Underwriting Rejected by Court</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/insurers_bad_faith_postclaim_u.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=10043" title="Insurers’ Bad Faith Post-Claim Underwriting Rejected by Court" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.10043</id>
    
    <published>2008-02-26T18:50:16Z</published>
    <updated>2008-02-26T23:43:39Z</updated>
    
    <summary>Wouldn’t it be great if you could get paid for making a promise to do something in the future, but when the time came to keep your side of the bargain you could cancel the contract and not have to...</summary>
    <author>
        <name>W. Michael Moody</name>
        
    </author>
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>Wouldn’t it be great if you could get paid for making a promise to do something in the future, but when the time came to keep your side of the bargain you could cancel the contract and not have to pay?  The person you made the promises to might be upset at paying you for all those years for nothing, but you get free money!  Ignoring the moral and ethical flaws with the scheme, it would be a great way to improve your financial position.  Of course, that’s how insurance companies often operate these days.  One tool they use is “post-claim underwriting.”  It is a terrible, dishonest practice that reneges on the insurer’s promises when the insured most needs the benefits promised in the insurance policy.</p>

<p>What is post-claim underwriting?  In its simplest form, an insurance company takes a cursory look at your application, sells you a policy, collects premiums until you make a claim, and then does an “investigation” to determine that they should not have sold you the policy in the first place.  Instead of doing a true underwriting analysis before issuing the policy, the insurer waits until after you make a claim and then decides you tricked them into insuring you.  The insurance company then rescinds the policy, claiming you misrepresented something or failed to disclose something on your application for the insurance.</p>

<p>From the insurer’s perspective, it’s the perfect scam.  The insurer gets to collect premiums on a policy, but does not have to pay the benefits promised.  Of course, it is also a bad faith practice, a flagrant breach of the covenant of good faith and fair dealing that is part of every insurance policy, and may be a crime.  Unfortunately, those problems will not deter an insurer who cares more about its bottom line than for the rights and interests of its insureds.</p>

<p>Unlike Alaska, some states have a statute that expressly prohibits post-claim underwriting.   California has such a <a href="http://law.justia.com/california/codes/hsc/1389.1-1389.3.html" target= "_blank">statute</a>, but that did not stop health insurers from doing post-claim underwriting.  The language of the statute is very explicit—it requires an insurer to complete its underwriting investigation before issuing the policy, not wait until after a claim is made.  Might seem like a common sense requirement to you as an insurance consumer, but not to an insurance company who wants to cancel a policy.  This is illustrated by the recent case of <a href="http://www.alaskainjurylawblog.com/g035579.pdf" target= "_blank">Hailey v. California Physician’s Service</a>, 158 Cal.App.4th 452 (Ct. App. 4th Div 2007).  Blue Shield contended that the statute requiring it “to complete medical underwriting” before issuing the policy really meant it could just look at the application, assign values to the risks disclosed, and issue a policy.  Although it had a medical release from the prospective insured, it did no underwriting investigation to determine if it should insure the person.  Blue Shield argued it could then do a “postclaim investigation” after a claim was made, and rescind the policy.  The California court rejected that assertion, viewing the “postclaim investigation” as basically the same thing as “postclaim underwriting.”  The court ruled that the insurer must do a reasonable underwriting investigation before issuing the policy or it will lose its ability to rescind the policy later, unless the insured willfully misrepresented something in the application.  A wonderful rule to protect insurance consumers.</p>

<p>Beware that post-claim underwriting is not limited to health insurance.  Insurance companies use it to avoid paying benefits under many forms of insurance.  Post-claim underwriting is common in disability insurance, a policy that pays when a person is unable to work.  Insurance companies even use post-claim underwriting to try to avoid liability on automobile policies.</p>

<p>The Alaska legislature should follow California’s lead and enact an express prohibition against post-claim underwriting.  Although the California case shows that even a statute will not prevent this terrible, bad faith practice, an Alaska statute would at least give the insured a valuable tool to use to obtain some justice when her policy is wrongly rescinded.  Even if the Alaska legislature fails to act, post-claim underwriting can be challenged in Alaska under common law principles.  If you believe you are a victim of wrongful rescission of your policy, talk to an attorney at the Alaska Personal Injury Law Group experienced in insurance bad faith claims.  We will gladly help you fight this reprehensible insurance practice.<br />
</p>]]>
        
    </content>
</entry>
<entry>
    <title>Smilin&apos; Bob Ain&apos;t Smilin&apos; No More: Herbal Company President Convicted</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/smilin_bob_aint_smilin_no_more_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9915" title="Smilin' Bob Ain't Smilin' No More: Herbal Company President Convicted" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9915</id>
    
    <published>2008-02-23T02:05:04Z</published>
    <updated>2008-03-06T14:55:34Z</updated>
    
    <summary>A federal jury today convicted the president of Berkeley Nutraceuticals, Steve Warshak, on charges of conspiracy to commit mail fraud, bank fraud, and money laundering. Warshak’s mother, Harriett Warshak, was also convicted. They now face more than 20 years in...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Diet Supplement, OTC, Pharmaceutical Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p><strong>A federal jury today convicted the president of Berkeley Nutraceuticals</strong>, Steve Warshak, on charges of conspiracy to commit mail fraud, bank fraud, and money laundering.  Warshak’s mother, Harriett Warshak, was also convicted. They now face more than 20 years in prison, and the company could be forced to forfeit tens of millions of dollars.  Seven former company officials pled guilty to conspiracy charges before the trial began. </p>

<p>The company bilked thousands of customers out of millions of dollars using fake product warranties, fake medical spokesmen, and fake credit card transactions.  The company's main product, Enzyte, was advertised as a "natural male enhancement" and was hawked on TV ads by a constantly grinning character nicknamed Smiling Bob.</p>

<p><strong>We suspect that Bob isn't smiling anymore.</strong></p>

<p><strong>Source: AP Wire, February 22, 2008:  </strong> <br />
<a href="http://ap.google.com/article/ALeqM5gk4wBhEIdtWWF7hvr9C3Jl7pZ1XQD8UVNMKG0"target="_blank" >http://ap.google.com/article/ALeqM5gk4wBhEIdtWWF7hvr9C3Jl7pZ1XQD8UVNMKG0</a><br />
</p>]]>
        
    </content>
</entry>
<entry>
    <title>Diet Supplement Glucosamine No Better Than Placebo</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/diet_supplement_glucosamine_no_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9773" title="Diet Supplement Glucosamine No Better Than Placebo" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9773</id>
    
    <published>2008-02-20T19:54:12Z</published>
    <updated>2008-02-19T20:51:55Z</updated>
    
    <summary>Under the dubiously named Dietary Supplement Health and Education Act (DSHEA), diet supplements and herbal preparations are not approved by the Food and Drug Administration for medical use in humans. Thus, safety and formulation are solely the responsibility of the...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Diet Supplement, OTC, Pharmaceutical Claims" />
            <category term="Health Alerts" />
            <category term="Orthopedic Injuries" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>Under the dubiously named Dietary Supplement Health and Education Act (DSHEA), diet supplements and herbal preparations are not approved by the Food and Drug Administration for medical use in humans. Thus, safety and formulation are solely the responsibility of the manufacturer; evidence of safety and efficacy is not required as long as they are not advertised as a treatment for a medical condition.  As we have seen in diet supplement litigation (Talbert v. E'ola Products, Inc.), diet supplement manufacturers often promise the moon in selling their products to the consumer, while having little other than anecdotes to show when it comes to providing data for the safety or effectiveness of their products.  <strong>Even assuming that the products are not adulterated (because of shoddy manufacturing protocols), have not been spiked (pharmaceutical drugs intentionally put into the supplement), and actually contain the ingredient at the levels claimed (often the “active” ingredient is missing or varies wildly),  it is the exception, not the rule, that the manufacturer will have evidence that the supplement is safe for human consumption and actually works. </strong> With pharmaceutical drugs, the manufacturer foots the bill for such research.  In the world of diet supplements, however, it is often independent researchers or the government (read: the taxpayer) that is burdened with the duty and cost of proving the safety and efficacy of a particular diet supplement.   </p>

<p>At the Alaska Personal Injury Law Group, we are frequently asked to help those with serious orthopedic injuries.  And our clients commonly face the debilitating consequences of arthritic changes that come from these injuries.<strong>  So a discussion about glucosamine is in order.</strong>  Luckily, unlike ephedra and other more dangerous diet supplements, glucosamine has not had a string of serious adverse events (it is not without side effects, however, so you need to read carefully before using glucosamine).  But <strong>does it work</strong>?  </p>

<p>Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent of glycoaminoglycans in cartilage matrix and synovial fluid (this is the “hydraulic” fluid in your joints).   It is believed that the sulfate moiety provides clinical benefit in the synovial fluid by strengthening cartilage and aiding glycosaminoglycan synthesis.  The question is, if you take the supplements, will the body put the critical compounds into your blood stream and use them where the arthritis lies?   There have been multiple clinical trials of glucosamine as a medical therapy for osteoarthritis, but the results have been conflicting. Early clinical trials sponsored by a European patentholder, as expected, demonstrated a benefit from glucosamine. However, these studies were of poor quality due to shortcomings in their methods, including small size, short duration, poor analysis of drop-outs, and unclear procedures for blinding.  <strong>Subsequent independent studies did not detect any benefit of glucosamine. </strong> This situation led the National Institutes of Health (yes, you the taxpayer) to fund a large, multicenter clinical trial studying reported pain in osteoarthritis of the knee, comparing groups treated with chondroitin sulfate, glucosamine, and the combination, as well as both placebo and celecoxib (Celebrex). The results of this 6-month trial found that patients taking glucosamine HCl, chondroitin sulfate, or a combination of the two had <strong>no statistically significant improvement in their symptoms compared to patients taking a placebo.</strong></p>

<p><strong>Today’s news is that the Annals of Internal Medicine has just published a study</strong> concerning the effect of glucosamine sulfate on the symptoms and structural progression of hip arthritis.  Following 222 patients over a 2-year period, the researchers evaluated the patients’ pain, function and stiffness at regular intervals in the 2-year period.  They concluded that <strong>“glucosamine sulfate was no better than placebo in reducing symptoms and progression of hip osteoarthritis.”  Translation: glucosamine supplements will do nothing for the pain in your hip—the pain is likely coming from what the cost of the supplements did to your wallet.  </strong></p>

<p><strong>Source: Annals of Internal Medicine</strong>, <em>Effect of Glucosamine Sulfate On Hip Osteoarthritis</em>, 19 February 2008, Volume 148 Issue 4, at 268-277, <a href="http://www.annals.org/cgi/content/abstract/148/4/268"target="_blank"<br />
>http://www.annals.org/cgi/content/abstract/148/4/268</a>.</p>

<p><strong>Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT)</strong>, <a href="http://www.clinicaltrials.gov/show/NCT00032890"target="_blank" >http://www.clinicaltrials.gov/show/NCT00032890</a>; AND   <a href="http://www.ncbi.nlm.nih.gov/pubmed/16495392"target="_blank" >http://www.ncbi.nlm.nih.gov/pubmed/16495392</a>.</p>]]>
        
    </content>
</entry>
<entry>
    <title>Alaska Personal Injury Law Group Attorney Selected By Benchmark:Litigation</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/alaska_personal_injury_law_gro.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9724" title="Alaska Personal Injury Law Group Attorney Selected By Benchmark:Litigation" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9724</id>
    
    <published>2008-02-19T22:10:21Z</published>
    <updated>2008-02-18T22:56:14Z</updated>
    
    <summary>Alaska Personal Injury Law Group member, Richard E. Vollertsen, has been selected for inclusion in the 2008 edition of America’s Leading Litigation Firms and Attorneys. Those selected are identified by Benchmark’s research team, which conducts extensive face-to-face and telephone interviews...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Firm News" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>Alaska Personal Injury Law Group member, <strong>Richard E. Vollertsen</strong>, has been selected for inclusion in the 2008 edition of <em>America’s Leading Litigation Firms and Attorneys.</em>  Those selected are identified by Benchmark’s research team, which conducts extensive face-to-face and telephone interviews with the nation's leading private practice lawyers and in-house counsel in the preceding 12 month period.  The purpose of the ranking is to identify those firms and attorneys best able to handle complex litigation matters.  The rankings include identification of "local litigation stars" for each state, reflecting only those individuals who were recommended consistently as incontrovertible stars by clients and peers. Mr. Vollertsen was identified in this ranking as a “local litigation star”.  </p>

<p>The research results for law firms were also broken down into “highly recommended” and “recommended” categories.  All listed firms were consistently mentioned by peers and clients, but the "highly recommended" firms received the most mentions, and were held up as being definitively dominant in their particular jurisdiction.  <strong>Atkinson, Conway & Gagnon, Inc., of which the Alaska Personal Injury Law Group is a division, was identified as “highly recommended” in this ranking, as well.  Atkinson, Conway & Gagnon, Inc. was one of only 3 firms in Alaska selected as "highly recommended."</strong></p>

<p><br />
<strong>Source: Benchmark: Litigation,</strong> <em>America's Leading Litigation Firms and Attorneys,</em> 2008, <a href="http://www.benchmarklitigation.com"target="_blank" <br />
>www.benchmarklitigation.com</a></p>]]>
        
    </content>
</entry>
<entry>
    <title>Returning Soldiers: Advancing Medicine After Sacrifice In Battle</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/returning_soldiers_advancing_m.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9722" title="Returning Soldiers: Advancing Medicine After Sacrifice In Battle" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9722</id>
    
    <published>2008-02-18T21:22:21Z</published>
    <updated>2008-02-18T23:10:31Z</updated>
    
    <summary>If the march of history has shown us anything, it is that technological advances are often the result of armed conflict. We have seen that in striking detail in the Iraq and Afghanistan conflicts. One of the most unfortunate consequences...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Brain &amp; Spinal Cord Injuries" />
            <category term="Psychological Injuries" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>If the march of history has shown us anything, it is that technological advances are often the result of armed conflict.  We have seen that in striking detail in the Iraq and Afghanistan conflicts.  One of the most unfortunate consequences of these conflicts is that they have dramatically highlighted the armed services’ inability to effectively screen and treat traumatic brain injury (TBI) and post traumatic stress disorder (PTSD) in returning soldiers.  Another consequence is that the fact that soldiers have suffered TBI and PTSD in ever increasing numbers has forced research forward concerning these intractable disorders.  In recent weeks, several articles of note crossed our desks here at the Alaska Personal Injury Law Group.</p>

<p>The <strong>Government Accounting Office (GAO)</strong> just released a report that underscored the Dept. of Veteran’s Affairs’ (VA) continuing inability to identify and provide services to affected veterans.  This is true despite a pledge by the VA Secretary, Jim Nicholson, last April to promote new screenings for brain injury and a personal promise to see the changes through.  The GAO reviewed nine VA medical centers, and found that there were problems in securing follow-up appointments after the veterans initially tested positive under the VA’s TBI screening tool.  Two of the medical centers did not follow the screening tools protocol because they failed to use the symptom checklist, which they said was because they didn’t know the checklist existed or because they had inadequate staffing.  The GAO also identified poor rural access to services resulting in a 50% decrease in the ability to provide care.  It is estimated that as many as 20% of US combat troops who fought in Iraq and Afghanistan are believed to leave with signs of TBI.</p>

<p>At the end of January, the <strong>New England Journal of Medicine </strong>published a study submitted by  specialists at the Walter Reed Army Institute of Research that added further to the controversy about how veterans should be screened and treated upon their return.  Studying outcomes for over 2500 soldiers, the researchers found that soldiers with mild traumatic brain injury, particularly those who had suffered loss of consciousness, were significantly more likely to report poor general health, missed workdays, medical visits, and a high number of somatic and post-concussive symptoms than were soldiers with other injuries.  After the data was adjusted, the researchers concluded that mild traumatic brain injury with loss of consciousness was strongly associated with PTSD and depression.   Over 43% of soldiers reporting TBI with loss of consciousness met criteria for PTSD, compared with 27% of those with the lesser brain injury from an altered mental status following their injury.  TBI with loss of consciousness was also significantly associated with major depression.  The difficulties the soldiers faced may therefore be more attributable to the result of intense psychiatric reactions to battlefield events, rather than a structural injury to the brain.  This may be good news in that there are treatments for PTSD and depression, and very few medical treatments available to those who have suffered a structural injury to the brain.</p>

<p>Finally, the February issue of  the <strong>Journal of Nervous and Mental Disease</strong> published research concerning the link between PTSD and chronic inflammation and early death.  Studying veterans diagnosed with PTSD after the Vietnam conflict, the researchers found high erythrocyte sedimentation rates (ESR), white cell counts (WBC), and cortisol/dehydroepiandrosterone sulfate ratios (DHEA-s).  Death rates between the comparison groups was 13.6% among those suffering from PTSD and 5% for those without the diagnosis.  In addition to PTSD predicting an increased all-cause mortality rate, PTSD and a high erythrocyte sedimentation rate were also associated with increased death rates from cardiovascular conditions.  Thus, having PTSD, a high ESR, a high WBC count, and a high cortisol/DHEA-s ratio were associated with all-cause disease mortality. These study results suggest that physicians treating veterans should routinely screen for PTSD and these associated increased risks.  The article provided further scientific explanation as to why the archaic mind-body duality relied upon by the law is medically unsupportable.  This is simply because, if one’s mind (PTSD) is affected, one body will surely suffer consequence, as well. </p>

<p><br />
<strong>Source:</strong></p>

<p><strong>VA Health Care: Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans, but Challenges Remain,</strong> GAO-08-276  February 8, 2008; <a href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-08-276"target="_blank" >http://www.gao.gov/docsearch/abstract.php?rptno=GAO-08-276</a>. </p>

<p><strong><br />
Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq, </strong> New England Journal of Medicine, Volume 358:453-463  January 31, 2008  Number 5; <a href="http://content.nejm.org/cgi/content/full/358/5/453"target="_blank" >http://content.nejm.org/cgi/content/full/358/5/453</a>. </p>

<p><br />
<strong>Psychobiologic Predictors of Disease Mortality After Psychological Trauma: Implications for Research and Clinical Surveillance,</strong><br />
Journal of Nervous & Mental Disease. 196(2):100-107, February 2008.</p>]]>
        
    </content>
</entry>
<entry>
    <title>Medical Research: How Can You Trust The Data If The Doctor Has Financial Ties To The Manufacturer?</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/medical_research_how_can_you_t.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9625" title="Medical Research: How Can You Trust The Data If The Doctor Has Financial Ties To The Manufacturer?" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9625</id>
    
    <published>2008-02-16T01:34:19Z</published>
    <updated>2008-02-18T19:46:16Z</updated>
    
    <summary>When we represent clients at the Alaska Personal Injury Law Group, we do our homework. When serious injuries occur, we have to become experts ourselves in the particular medicine being used to treat our clients. We thus comb through and...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Health Alerts" />
            <category term="Orthopedic Injuries" />
            <category term="Product Liability &amp; Design Defect Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>When we represent clients at the Alaska Personal Injury Law Group, we do our homework.  When serious injuries occur, we have to become experts ourselves in the particular medicine being used to treat our clients.  We thus comb through and rely extensively on medical literature in virtually every case we handle.  We use it in our work with the medical experts we engage to help our clients, and we also share it with our clients.</p>

<p><strong>And whether you realize it or not, you rely on medical literature every time you see a doctor or take any medication.</strong>  This is because the engine of medicine runs on the data from medical literature.  That data is what the FDA uses to decide whether to allow a medication or medical device to be sold, and what your doctor relies on to decide if a treatment, medical device, or medication will help you.  Extraordinary rules and guidelines are put in place to make sure that the scientific findings in a particular study are objective and scientifically verified.  </p>

<p><strong>So it is always shocking when we learn that a manufacturer has taken liberties with the research data to make it appear that their product works when it really doesn’t. </strong> (We saw this repeatedly in the litigation against diet supplement manufacturers:  <em>Talbert v. E'ola Products, Inc.)  </em>We know why this happens: millions and sometimes billions of dollars are made by manufacturers in these endeavors, and greed can be a powerful motivator.  Every time we learn about one of these situations, it reaffirms the need to vigilantly enforce the principles that guide regulators and researchers who develop research data.  Western medicine is so profoundly effective because it is "evidence-based medicine".  <strong>If we allow clinical researchers to get into bed with the manufacturers, how can we trust that the research data they create for the manufacturers is valid, objective and truly "evidence-based"?</strong></p>

<p><strong>Today’s when-the-cat’s-away lesson involves Synthes, the manufacturer of an artificial spinal disc called the Prodisc.</strong>  It turns out that doctors at about half of the medical facilities conducting clinical trials, i.e.,  performing surgeries, using the Prodisc stand to profit handsomely if the Prodisc is approved by the FDA.  For example, 12 of the surgeons involved in the study had also invested in Synthes.  The concern is that the study results submitted by the manufacturer to the FDA did not contain data about a large number of patients, some of whom said they had poor outcomes.  Those critical of this conflict of interest suggest that the data casts the Prodisc, scientifically speaking, in “an overly flattering light.”  Was it because surgeons in the study were also investors in the device?  We can’t know for sure, but we do know that <strong>the research data is now tainted because of this impropriety. </strong></p>

<p><strong>This situation gives us yet another example of how conflicts of interest can distort scientific data and why the FDA and other gatekeepers should vigilantly eradicate them.  The FDA should not accept data from clinical trials conducted by those who would profit from market approval of the device or medication being studied.  The hospitals and universities conducting such trials should not permit their researchers and physicians to financially benefit from the studies being conducted.  As professionals, the physicians themselves should recognize such conflicts of interest and refuse to participate as researchers or investors—attorneys, for example, are ethically barred from representing clients when such conflicts exist and are professionally bound to recognize when a conflict exists and refuse to represent a client when a conflict is present.</strong></p>

<p>This situation with Synthes is also remarkable because these issues have actually come to light—most such conflicts of interest do not.  Until the clinical data on the Prodisc is substantiated by objective researchers, surgeons and potential patients should steer clear of this device.  <strong>If you can’t trust your doctor, who can you trust?</strong></p>

<p><strong>Source: N.Y. Times: </strong><br />
<a href="http://www.nytimes.com/2008/01/30/business/30spine.html"target="_blank" >http://www.nytimes.com/2008/01/30/business/30spine.html</a>;<br />
<strong>Association for Ethics in Spine Surgery:</strong><br />
<a href="http://ethicalspinesurgeon.org/">http://ethicalspinesurgeon.org/</a></p>

<p><br />
</p>]]>
        
    </content>
</entry>
<entry>
    <title>Institutional Bad Faith 101 -- How Allstate&apos;s DOLF Program Works</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/institutional_bad_faith_progra.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9455" title="Institutional Bad Faith 101 -- How Allstate's DOLF Program Works" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9455</id>
    
    <published>2008-02-15T02:36:10Z</published>
    <updated>2008-02-15T22:56:48Z</updated>
    
    <summary>We recently reported on the CNN study that found insurers like Allstate and State Farm have systematic programs to force their insureds to settle for less insurance proceeds than the insurance company promised them in their insurance policies. CNN concluded...</summary>
    <author>
        <name>W. Michael Moody</name>
        
    </author>
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>We <a href="http://www.alaskainjurylawblog.com/2008/02/study_finds_institutional_bad.html">recently reported</a> on the CNN study that found insurers like Allstate and State Farm have systematic programs to force their insureds to settle for less insurance proceeds than the insurance company promised them in their insurance policies.  CNN concluded that these programs have resulted in billions of dollars of excess profits for insurance companies.  Allstate alone has given <a href="http://www.alaskainjurylawblog.com/2008/02/allstate_officials_tout_profit.html">$23 billion of profits</a> to its shareholders in only twelve years of using such a program.</p>

<p>How do those programs work?  Let's look at Allstate's program, which it calls DOLF -- Defense of Litigated Files.  Allstate makes the insured a lowball offer.  If the insured refuses to settle for less than the insurance benefits she bought, the claim will be litigated.  In fact, Allstate will send a letter telling the insured that this is the only offer they are going to get and that, if the lowball offer is not accepted, Allstate will vigorously litigate the claim.  So, instead of the insurance benefits she paid for, the injured insured is threatened with years of litigation to get what she was promised and deserves.</p>

<p>There is a theoretical possibility that Allstate will increase its offer, but only if the insured provides documentation of some "value changing event."  An example would be a doctor's report that the insured needs surgery.  But even if there is a significant change, the system is tilted against you.  In one case, Allstate representatives testified at trial that new information about a significant value changing event did not go back to the original adjuster.  Instead, it went from the Allstate defense lawyer to the "gatekeeper" in the Allstate claim office.  The gatekeeper decided the adjuster did not need to know about the new information.  That made it impossible for the adjuster to reevaluate the claim on the basis of the new evidence.  Such a reevaluation was required by the insurer’s duty of good faith and by state claim handling regulations.</p>

<p>Some of you may wonder if that "gatekeeper" just made a mistake.  No, he did not.  He played his role just as Allstate intended.  The job title of the "gatekeeper" is Evaluation Consultant.  Any value changing information was supposed to be reported to the Evaluation Consultant, who was to decide if it was important enough to pass on to the adjuster.  One of the key functions of the Evaluation Consultant is to ensure that adjusters do not weaken and pay more than Allstate's lowball offer.  The best way to do that is to keep them out of the loop in DOLFed cases.  In that case, the adjuster was still assigned to the file, but was not even told of a court-ordered settlement conference—Allstate sent someone else, who knew very little about the file, in his place.</p>

<p>By the way, this was not a case where Allstate's liability was in question.  The insured had been injured by a drunk driver who ran a stop sign and then fled the scene of the wreck.  This was a claim under the Allstate underinsured motorist (UIM) coverage.  You would think that if anyone deserved the <em>good hands</em> treatment, it would be a young girl injured by a drunk driver.  Obviously, Allstate did not.  Do Allstate actions towards this poor girl sound like the caring, good hands treatment you hear about in all those fancy television ads where Allstate wants you to buy their policies?<br />
</p>]]>
        
    </content>
</entry>
<entry>
    <title>Health Insurer Pushes Itself Into Doctors&apos; Exam Rooms</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/health_insurer_pushes_itself_i_1.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9535" title="Health Insurer Pushes Itself Into Doctors' Exam Rooms" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9535</id>
    
    <published>2008-02-13T22:02:54Z</published>
    <updated>2008-02-14T01:01:24Z</updated>
    
    <summary>We at the Alaska Personal Injury Group have seen it again and again with insurers, and have documented the practices in this blog: insurers mercilessly attempting to reduce costs by withholding policy benefits owed to policyholders, all the while justifying...</summary>
    <author>
        <name>Richard E. Vollertsen</name>
        
    </author>
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>We at the Alaska Personal Injury Group have seen it again and again with insurers, and have documented the practices in this blog: insurers mercilessly attempting to reduce costs by withholding policy benefits owed to policyholders, all the while justifying outlandish premium rate hikes by claiming that costs are too high.  As insureds, we have almost become jaded to the extraordinary level of intrusion by insurers into our personal lives as they wage this campaign.  For example, we think nothing of having to wrestle with an insurer who challenges our physician’s prescription for medication—the insurer intrudes into our relationships with our physicians as if it belongs in the room with us and our physician, challenging the physician's choice of medication, the length of prescription, and even whether we should have the medication at all.</p>

<p><strong>One of the most outrageous moves by health insurers yet</strong> is a letter Blue Cross of California recently sent to physicians asking them to “rat out” (my wording) their patients who might have preexisting medical conditions, which, of course, would then allow Blue Cross to cancel the patient’s coverage for the treatment sought from the physician.  WellPoint, Inc., the Indianapolis-based company that owns Blue Cross of California justified the move because it was (and where have we heard this before?) trying to hold down costs.  This is apparently a justification for intruding upon one of the most sacred of relationships, that of physician and patient.</p>

<p><strong>Blue Cross is actually forwarding to the physician the patient's insurance application (!) along with the letter instructing that:“Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately.” </strong> To its credit, the California Medical Association contacted California insurance regulators immediately, explaining that the maneuver by Blue Cross was “deeply disturbing, unlawful, and interferes with the physician-patient relationship.”</p>

<p>The move by Blue Cross was its answer to <strong>recent fines imposed on it because of a systematic pattern of terminating policies when claims were made</strong>—it would accept applications and premiums from policyholders, but later cancel the policy based on mistakes in the applications, minor inconsistencies, and a poor application form designed to create the supposed failure to disclose preexisting conditions.  (In the industry, this word for terminating the coverage is “rescission,” which hardly serves to capture the malice inherent in this practice.)  Once a policyholder was terminated, the insured would be unable to obtain a new policy for the current illness because any other insurer would see the problem as a preexisting condition and would refuse to insure.  Thus, those with serious illnesses like cancer were unable to obtain treatment or they faced financial ruin trying to pay for the necessary care out of pocket.</p>

<p>Another way for Blue Cross to have handled the problem, of course, is to have examined the applicant’s medical history <strong>at the time of the application</strong> to determine whether to accept the applicant as an insured.  This process of analyzing the risk is called “underwriting,” and <strong>it is the insurer’s job to do this at the time the policy is sold.</strong>  <strong>What Blue Cross is doing here is trying to force physicians to do their underwriting job for them</strong>, and to look for ways to keep from paying the costs of medical care long after it has already agreed to underwrite the risk and has already been paid its premiums by the policyholder for that very risk.  </p>

<p>And another way for Blue Cross to cut costs is perhaps to cut executive salaries.  Its outgoing CEO received in 2005 <strong>salary and bonus of $5.2m and a restricted stock award of $3.1m</strong>.  Upon retirement, he received <strong>a lump sum of $31m, which did not include $55m in unexercised stock options </strong>he also received.  <br />
<strong><br />
The physician’s job is to care for the patient, often at a time when that person is at their most vulnerable.  The  physician must be free to inquire about all medical history that might be relevant to care, and the patient must be free to trust the physician with that information.  To make the physician an agent of the insurer so the insurer can, yet again, maximize profits at the expense of the insured who has already paid for their policy, is to destroy the foundation of the physician-patient relationship and ultimately to prevent the insured from getting effective medical care.  Essentially, the physicians are being shanghaied by Blue Cross to help it defraud its own insureds.</strong></p>

<p>This maneuver by Blue Cross is unconscionable.  An insurer does not belong in the exam room with the physician and the patient.  That relationship is sacrosanct and must remain so.  Any physician worth his salt will tell Blue Cross this.  And the California Department of Managed Health Care should let them have it with both barrels.</p>

<p></p>

<p></p>

<p><strong>Source: Los Angeles Times:<</strong><br />
<a href="http://www.latimes.com/news/printedition/front/la-fi-bluecross12feb12,1,7937098.story"target="_blank" >http://www.latimes.com/news/printedition/front/la-fi-bluecross12feb12,1,7937098.story</a>; <br />
<strong>Blue Cross Letter:<</strong><br />
<a href="http://www.calendarlive.com/media/acrobat/2008-02/35508226.pdf"target="_blank" >http://www.calendarlive.com/media/acrobat/2008-02/35508226.pdf</a>;<br />
<strong>WellPoint Salaries:</strong><br />
<a href="http://www.signonsandiego.com/news/business/20070226-1336-wellpoint-glasscockretires.html"target="_blank" >http://www.signonsandiego.com/news/business/20070226-1336-wellpoint-glasscockretires.html</a></p>]]>
        
    </content>
</entry>
<entry>
    <title>Study Finds Institutional Bad Faith at Allstate, State Farm and Other Major Insurers</title>
    <link rel="alternate" type="text/html" href="http://www.alaskainjurylawblog.com/2008/02/study_finds_institutional_bad.html" />
    <link rel="service.edit" type="application/atom+xml" href="http://www.alaskainjurylawblog.com/cgi-bin/mt-atom.cgi/weblog/blog_id=163/entry_id=9453" title="Study Finds Institutional Bad Faith at Allstate, State Farm and Other Major Insurers" />
    <id>tag:www.alaskainjurylawblog.com,2008://163.9453</id>
    
    <published>2008-02-13T02:03:47Z</published>
    <updated>2008-02-12T19:53:22Z</updated>
    
    <summary>An 18-month study by CNN has confirmed that most of the major insurers, lead by Allstate and State Farm, are engaging in institutional bad faith claim practices. The study found that insurers, including Allstate and State Farm, have not been...</summary>
    <author>
        <name>W. Michael Moody</name>
        
    </author>
            <category term="Insurance &amp; Bad Faith Claims" />
    
    <content type="html" xml:lang="en-us" xml:base="http://www.alaskainjurylawblog.com/">
        <![CDATA[<p>An 18-month <a href="http://www.cnn.com/2007/US/02/09/insurance.hardball/index.html?iref=newssearch">study</a> by CNN has confirmed that most of the major insurers, lead by Allstate and State Farm, are engaging in institutional bad faith claim practices.  The study found that insurers, including Allstate and State Farm, have not been treating their insureds fairly.  Instead of fair treatment for insureds, they follow a strategy of "deny, delay, defend."   Deny the claim, do whatever they can to delay the claim, and defend the resulting lawsuit to the hilt.  </p>

<p>The CNN findings focused on cases involving soft tissue injury and minor impact.  Insurers have their own euphemisms for this type of claim, such as Allstate's MIST, which stands for Minor Impact Soft Tissue.  The personal injury attorneys at the Alaska Personal Injury Law Group do not handle MIST cases, but we have seen the same tactics employed in Alaska in cases that are neither minor impact nor soft tissue cases.  We also handle bad faith cases that arise when insurers like Allstate and State Farm break the promises they made when they took the insured's hard-earned premium dollars.</p>

<p>CNN's investigation found that the insurers' hardball approach to claims is the result of programs developed for insurers like Allstate and State Farm by The McKinsey Company.  The Alaska Personal Injury Law Group and other lawyers throughout the country have been trying to get Allstate's McKinsey documents into the hands of the public, but Allstate has been successful in obtaining orders that keep the documents hidden.  As we <a href="http://www.alaskainjurylawblog.com/2008/01/insurance_commissioner_suspend.html">reported earlier</a>, insurance regulators in Florida may be the public's best hope of seeing the McKinsey documents.  CNN did confirm, however, the existence of the formal program where the <em>good hands</em> people at Allstate are told to use <a href="http://www.alaskainjurylawblog.com/2008/01/games_insurance_companies_play_1.html">boxing gloves </a>on the insureds who refuse to accept Allstate's lowball offers.</p>

<p>This Allstate program has nothing to do with justice or fairness.  It is all about profits resulting from economic warfare against insureds.  Allstate documents in the public domain show that it is also motivated by the insurance company's desire to prevent personal injury attorneys from trying to help the victims of these lowball take-it-or-leave-it offers.  The insureds and the lawyers who help them get bludgeoned by one of the largest financial powerhouses in the world.  As the CNN study shows, after Allstate and State Farm started using the McKinsey scheme against their insureds, other insurers followed.</p>

<p>That take-it-or-leave-it approach and the resulting lowball settlements have lead to soaring profits, while insurers pay out far less in claims but continue to charge higher premiums.  Insurance rates are theoretically, but poorly, regulated by the states, so if Allstate is paying out less in losses, they should have to reduce premium rates.  Instead, they are generating <a href="http://www.alaskainjurylawblog.com/2008/02/allstate_officials_tout_profit.html">phenomonal profits</a>.</p>]]>
        
    </content>
</entry>

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