Plaintiffs Get Settlement in Long-Term Care Insurance Lawsuit

Kansas City, MO: Consumers who purchased long term care insurance are now fighting back against policies that they say are unfair and unreasonable. Some consumers are fighting back by filing long term care insurance lawsuits, alleging their insurance provider misled them or denied their claims on a questionable basis. Recently, 1 class action lawsuit, filed against 3 companies, resulted in a settlement.

The lawsuit was filed against American Heritage Life Insurance Co. and Wakely and Associates Inc., who sold the policies, and Mutual of Omaha Insurance Company, who co-insured the policies. The class action lawsuit, filed on behalf of people who purchased long term care insurance from American Heritage or Wakely, alleged that the defendants set low premiums for the policies but did not tell policyholders that they planned to raise the rates dramatically.

The suit was settled for approximately $15 million, with American Heritage and Mutual of Omaha paying $11 million in insurance and benefits while Wakely will pay $4 million. All of the defendants deny any wrongdoing in the sale of the insurance policies. According to a lawyer for the plaintiffs, many of the policyholders will receive $35,000 to $40,000 in long term care benefits without paying any more for their premiums.

If you think your long term care rates will not dramatically increase, you may be wrong. An article in the Federal Times reports that up to 155,000 civilian and military employees enrolled in the federal long term care insurance programs will see their premiums increase by as much as 25 percent in the coming months. The increase will affect people enrolled in the “automatic compound inflation protection” option, with the premium increases determined by the age an enrollee first signed up for coverage. Whoever purchased the policy at 65 years or younger face an increase of 25 percent.

The office of Personnel Management, overseer of the program, said that the premium increase is necessary to cover the costs of running the program.

Long term care insurance is designed to help a policyholder should she become in some way incapacitated or unable to take care of herself. While most people do not want to consider that a possibility, the truth is that there are many ways that people can become incapacitated as they age, and, in fact, some people need long term care well before they hit age 65.

Long term care insurance policies vary depending on the contract, but they can include nursing home care, institutional settings, in-home health care or managed care. They do not cover hospital stays or medical treatment.

Of course, given the recent controversy surrounding long term care insurance, some people may wonder if they will ever access the benefits they were promised when they signed up for their policy. After all, long term care insurance providers have been accused in the past couple of years of using unfair tactics to deny claims. Such tactics allegedly include sending people the wrong paperwork, questioning their need for care (even when the claimant is diagnosed with early-stage dementia) and not updating policies to include changes in assisted living, meaning that newer types of assisted living homes are not covered in the policy.

The list of grievances against some long term care insurance providers is long, and has resulted in action being taken against some of those providers in the form of lawsuits.

Long term care insurance can be a vital part of a person’s life-long care plan as well as her financial plan. Unfortunately, when premiums rise suddenly or when claims are denied for questionable reasons, they can have a serious effect on a person’s financial and physical well-being.

Medical Device Safety Act Update

On May 12, 2009, the House Energy and Commerce Subcommittee on Health held a hearing on the Medical Device Safety Act of 2009.  HR 1346 would overturn the February 2008 Supreme Court decision that, for the first time, denied patients the right to sue device makers for compensation when injured by certain medical devices.  Read more  …

At least one county in Alabama has low level of tolerance

A Walker County jury returned a verdict of $3 million against a physician who was alleged to have engaged in a sexual relationship with the Plaintiff and prescribed him pain medication that ultimately led to a long battle with addiction. The Plaintiff’s lawyer, Garve Ivey, Jr. believes the verdict indicates that area citizens are tired of the negative impacts of recklessly prescribed drugs, especially when those prescriptions result in addiction. Ivey noted that his filing of more than a dozen cases against local doctors was not an indictment on the medical community at large and that only a handful of doctors in Walker County are guilty of such charges.

Medical Malpractice – You Must Disclose Experts!

In Cobb v. Fisher, No. 1071501 (Ala. April 3, 2009), the Alabama Supreme Court affirmed the trial court’s grant of summary judgment to Fisher, a doctor who performed bilateral knee surgery on Cobb, where Cobb failed to disclose her expert’s identity during discovery. 

After the surgery, Cobb experienced pain in her left knee and difficulty walking.  During a second surgery four months later, bone fragments and cement were found and removed.  Cobb sued Dr. Fisher and Russellville Hospital  making claims of medical malpractice, breach of fiduciary duty, and the tort of outrage based on res ipsa loquitor and respondeat superior.  However, Cobb never disclosed the identity of an expert as required by the Alabama Medical Liability Act (“AMLA”).  Both parties filed for summary judgment, and Cobb attached an expert’s affidavit with her motion wherein the expert opined that Fisher and the hospital staff deviated from the applicable standards of care.  Cobb additionally argued that her claims fell within an exception to the AMLA and that expert testimony to support her medical malpractice claim was not required because of the foreign instrumentality found in her knee.  Fisher and the hospital moved the court to strike the expert’s affidavit because the identity of said expert was not previously disclosed as required.  The trial court granted both of Fisher’s and the hospital’s motions. 

The Supreme Court agreed with the trial court.  First, Cobb’s claim did not fall within the AMLA’s exception to the general rule requiring expert testimony because the cement found in her knee was not like an instrument that should have been removed.  Rather, the placement of cement in her knee required expert testimony.  Second, the trial court had authority to impose sanctions for Cobb’s failure to disclose her expert within the timelines established by the scheduling order and even though striking her expert’s testimony nullified Cobb’s claims,  such sanction was appropriate under the circumstances. 

Read the full case here. 

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Why Should You Hire An Attorney?

Automobile accidents are the single largest source of personal injury in America. Personal injury can describe anything from a pinched nerve to an amputated limb. A personal injury suit can also be filed if someone is killed in an auto accident.

The legal term for a personal injury is a “tort” and laws are in place to protect you from harm by another person. If you or your loved ones are harmed in an auto accident, your best recourse will be to consult with an attorney specializing in tort law.

Why Should You Hire An Attorney?
Medical bills, death expenses, lost wages, hired help, and other unexpected expenses will come out of your pocket―even if you were not at fault in the accident.  Insurance companies may not be your best friend while trying to recover damages after an accident. They may try to get you to settle for less than you should.  A personal injury attorney will help protect your rights. He/she will fight with the insurance companies so you won’t have to do it while you are recovering.

You may be entitled to collect damages for more than the insurance company is willing to pay. An experienced attorney will know whether to sue the insurance company, the driver, or his/her employer. An experienced attorney will also be able to help you build a strong case for your claim.

Questions To Ask The Attorney
When you meet with your personal injury attorney for the first time, here are some questions you should ask:

• What fees do you charge?

• What percentage will you take from the money I am awarded?

• What if I lose my case? How much will I owe you then?

• Will you settle out of court?

• How long do you expect this to take?

• Will I be told of all offers to settle out of court?

• How will you communicate with me the progress of my case?

If you would like a free evaluation of your personal injury case, please give me a call today.  Remember, there are time limits within which a persoanl injury claim must be filed.

Exams of Injured Workers Fuel Mutual Mistrust

Doctors hired by insurers to examine injured workers are called independent examiners, but there are questions about how truly independent they are.  Read the full story . . .

Yamaha Rhino Recall

Yamaha Motor Corp. issued a recall of more than 120,000 Yahama Rhino ATVs on March 31, 2009. All Rhino 450 and 660 model vehicles are being recalled for repairs intended to prevent accidents that have resulted in 46 confirmed deaths and hundreds of injuries. These Yamaha Rhinos suffer from inherent design flaws that make them unstable and susceptible to low-speed rollovers.  Read more . . .