Jan 24, 2012 | Insurance, Uncategorized
As I have not blogged lately I decided to start 2012 off with a low controversy issue. Let’s start off with a few definitions:
Pro-Choice is defined by the Oxford Dictionary as those advocating legalized abortion.
Pro-life is defined by the Oxford Dictionary as those opposing abortion.
Abortion is defined by the Oxford Dictionary as the deliberate termination of a human pregnancy.
Choice is defined by the Oxford Dictionary as a range of possibilities from which one or more may be chosen.
This week the U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued a statement detailing the requirement that employers are required to provide insurance coverage including contraceptive drugs including abortion drugs.
The rule will require most health insurance plans to cover preventive services for women including recommended contraceptive services without charging a co-pay, co-insurance or a deductible. Beginning August 1, 2012, most new and renewed health plans will be required to cover these services without cost sharing for women across the country.
Nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until August 1, 2013, to comply with the new law. This additional year will allow these organizations more time and flexibility to adapt to this new rule.
The entire statement can be found at http://hhs.gov/news/press/2012pres/01/20120120a.html.
If you are a Pro-Life employer you are understandably upset as the rule would require you to pay for something that you oppose on potentially both moral and religious grounds. If you are Pro-Choice I would think that you would be concerned as it is a clear move by the government to do away with Choice. In this rule they are requiring everyone to either obey the law in violation of their personal belief (religious, moral, etc.) or to violate the law and face the consequences. If the issue is truly one for the women whom it impacts — as espoused by Pro-Choice proponents then why is this decision a government issue which requires those who do not agree to pay for that decision.
The issue of pro-choice v. pro-life is one that is so fundamental to most people that a discussion on it will generally end with whether you consider the embryo to be a baby or not. The issue of paying for terminating the life of a baby is not one that should be forced upon anyone or mandated by the government.
The statement by Secretary Sebelius that an additional year will allow these organizations more time and flexibility to adapt to this new rule is ridiculous. Who is the government to give a person or group a year to adapt to a rule that violates their very moral and/or religious beliefs?
For the purpose of this discussion, I don’t care if you are pro-choice or pro-life. This is an issue of pro freedom from government interference in your life. The very thing that pro-choice advocates claim to have fought to achieve they are now conceding and welcoming because they see it as a benefit to them.
Oct 25, 2011 | car crash, Frivolous, health care, Insurance, personal injury, taxes; death; estate, Tort Reform, trial attorney, Uncategorized
Wal-Mart announces reduction in medical coverage due to continuing rise of cost of coverage. Premiums continue to climb while benefits drop. Auto, Home and Business insurance premiums continue to rise. It must be those lawsuits right? What about those trial lawyers they must be the cause. All those frivolous lawsuits keep driving up the cost for everyone. Great tag lines but as the old commercial says “Where’s the Beef?” The insurance industry has done a great job of advertising and obfuscating. They have convinced people that if only tort reform was passed then everyone’s insurance rates would drop. Texas has had tort reform for almost a decade. Have any of your rates dropped? I didn’t think so. Every year it is the same story, well the reforms didn’t go far enough.
Over the next few weeks I will go through some of the different legislative and judicial edicts that form our current Texas law and much ballyhooed Tort Reform. Why don’t we start with the newest fair haired tort reform -known affectionately as loser pays (if you are the one who is injured that is) which allows the Courts to dismiss frivolous cases. That is a great idea. That is probably why we have had that procedure in place for pretty much since the inception of laws in Texas.
The Courts have always had the power to dismiss a frivolous case upon request by either party. So why the need for the new law and why is it that the loser only pays if it is the person bringing the case and not the person who caused the injury. Could it be that the insurance companies defending the person causing wrecks and injuries are trying to intimidate people into not making valid claims? What a strange idea. So here we are with a whole new set of laws designed to reduce the ability to recover for injuries caused by others actions.
Even if it is an unintended (:>)) result at least the overall benefit is for the good of us all — right. Let’s look at that starting with loser pays. Sounds great, but who is the loser who is going to pay? Suppose that a driver, Rich causes a wreck and Joan is injured. Joan is taken to hospital and gets treated. She doesn’t have health insurance so who is going to pay the hospital bills? Well if she doesn’t have health insurance she probably has Medicare or Medicaid maybe — maybe not. If she does then one of those entities pays and has a right to recover all their money. So why if there is a chance of having to pay the person who caused the wrecks attorney fees and expenses would you take the risk? I mean everyone knows juries are crazy right. That is what we always hear as a reason why they shouldn’t be allowed to determine damages in an injury case which could impact a person’s life (but they are great for deciding life in death in a criminal case – but I digress), so why would an attorney agree to represent Joan if he or she has to spend months fighting with Medicare/Medicaid just to get an answer as to how much is owed, invest significant time and money out of his/her own pocket to try and recover the damages for her. It may be that the determination is that it is not worth it so no lawyer, no lawsuit.
Great tort reform works. Oh Wait.
What about the hospital bills that Medicare/Medicaid paid on behalf of Joan. Well you and I paid those bills, after all isn’t Medicare/Medicaid essentially a tax funded insurance plan. But wait there’s more (I love infomercials) and since the hospital didn’t get the full value of their services they raise their charges to offset the loss which causes the cost to go up for everyone else. So now you and I are paying for the injuries caused by Rich. So when we hear loser pays we need to just admit that you and I are paying and Rich gets a free ride for his actions. Next time we will discuss the Court Decision I affectionately call Brainless.
The opinions in this blog, as always, are mine and not necessarily those of the firm.
Oct 20, 2011 | Uncategorized
As you no doubt noticed, I have not blogged in a while. The reasons aren’t really important, but they include work and general indecision on what to blog about. I could have written about Escobedo, Loser Pays, Mandatory arbitration, or a host of other legal issues which have generally sickened me as to the state of law and accountability in Texas, but just decided to take a break and come back with a rant on these topics next time. During my break I became one of those Ipad people. I, of course justified it by stating how it would make me more productive, it would be easier to travel, etc. etc. I sent out e-mails asking for favorite apps for work and fun and then loaded them on my trusty Ipad2. Now I have dropbox, iannotate, goodreader, blackjack, facebook, etc. all loaded and ready, but still don’t understand how they all work. I am writing this blog on my laptop as I am nowhere near as fast on the Ipad. So here are my question and request: What is your favorite apps, why, what the heck do they do and how do you work them? I would really appreciate it if each reader could send at least one suggestion, even it is already mentioned.
Jul 13, 2011 | Uncategorized
Below is a link to the Haygood opinion.
http://scholar.google.com/scholar_case?case=8478677452372294245&hl=en&as_sdt=2&as_vis=1&oi=scholarr
Jul 12, 2011 | Uncategorized
Texas Supreme Court allows drunk drivers and others who cause car wrecks to reduce how much they will have to pay. Drunk Drivers get benefit of your premiums for health Insurance by getting credit for the negotiated rate.
This should have been front page news in papers across Texas this past week as our Supreme Court issued its opinion in the case Haygood v. Escabedo. Did you see a single paper discuss this ruling? Have you heard any of the radio or TV talk shows discuss this case? Why not? Where is the outrage?
I hear comments from people every month who call me about a workers compensation claim, medical malpractice or other issues. I tell them I can’t handle it because the law has made it almost impossible. They almost invariably tell me that it wasn’t supposed to impact their case only those frivolous ones. When I ask them why they weren’t mad and outraged when the laws were being passed or the Supreme Court was “interpreting” them, they always say it didn’t impact me so I didn’t pay attention. The only outrage about our rights being taken away nationally and in Texas seems to be coming from the trial lawyers. I am proud to be in the outraged group.
So what has the Texas Supreme Court done in its latest piece of judicial activism? Their twists and turns distort the law so much it would make a contortionist envious.
The Court’s decision in Haywood v. Escobedo allows the person or company who harms you or your family to benefit from the health insurance you have paid premiums for all these years.
The Court argues there ruling is necessary to prevent a “windfall” to the claimant (that would be the person injured, maimed or killed by the drunk or other reckless driver to us normal people).
They also argue they are just interpreting the law as the Texas legislature wanted. Hard to believe that is the case when the legislature actually tried to repeal the law they are “interpreting” the session after they passed it as they realized what it truly was — which is a windfall for the drunks, reckless drivers and their insurance companies. However Governor Perry vetoed the repeal of the bill so it is still on the books.
So here we are with an Activist Court that needs to protect the drunks and insurance companies, but how? They have already overturned virtually every jury verdict for any Plaintiff that comes their way. So rather than wait until a jury hears all the evidence and votes to compensate the injured person, they have decided to limit what the jury can hear so the compensation will be even lower and the insurance companies will have to pay less, make more profits and be able to contribute to all the expensive political campaigns.
Here is how the Court accomplished this with their latest decision: Let’s start with a situation where you are hit by a drunk who has a policy of $50,000.00. You are taken by life flight to the hospital where you stay for a week. You then have to go through rehabilitation. After about four months you are mostly better. You missed a month of work and still can’t do everything, but hopefully you will get where you can sleep through the night and play with your kids without having to tell them Daddy needs to rest. You have worked hard for years and paid for your health insurance at the cost of some vacations you wanted to take, but you knew how important it was for you to provide coverage for you and your family in case a situation like this happened. The medical bills were over $100,000.00, but because of your group plan they managed to reduce the total to $35,000.00 and since you met your deductible earlier in the year, you don’t owe anything else.
You send the bills to the drunks’ insurance carrier and ask that they pay the $50,000.00 policy limits because your medical bills alone are over $100k. Pretty straight forward right? You shouldn’t even need to get an attorney to settle this case. The operative word there is shouldn’t.
The reality is the insurance company will tell you we don’t owe $100k in medical because we get to take credit for your health insurance premiums and negotiated rate so all we will owe is $35k and we don’t think all of that is related because we know you hurt your neck 15 years ago when you were putting in fence posts and saw a chiropractor one time so we think all your neck issues are related to that and not this head on collision. So with the paid amount being $35k and us taking out some of the neck issue which we believe is not related (and because we can), we are willing to settle your case for $28,500.00.
What gives them the right to get the benefit of your paying premiums all those years: “Home Office” which is what they consider the Texas Supreme Court. Why shouldn’t they? They have won virtually every case that makes it there. Now the Texas Supreme Court has ruled that the only evidence a jury may consider in determining medical expenses are those amounts which were actually paid or will be owed by the person injured. So all those years of paying premiums and making sacrifices for you and your family to be covered is now benefitting the person who caused the wreck. The jury is not allowed to hear about how the bills were over $100k and because you had insurance it was reduced to $35k. They are not allowed to hear about the premiums you have paid to make that reduction possible. They may not even be allowed to hear about the deductible if it was met before this wreck. All because our Supreme Court has determined that it would be a “windfall”. How is it they never seem to be have a problem when insurance companies have a windfall of profits.
So if you happen to serve on a jury or hear about someone on a jury who talks about how this person was in a wreck but only had xxx in medical you can be fairly certain that it is at least 3x that amount of actual medical charges.
For my lawyer friends we know there are also significant issues regarding how Section 18.001 will be impacted and other battles over what constitutes paid –Is a deductible to be considered? Co-pay?
Some of you may know that I spent my senior year of high school attending gymnasium in Germany (which is the German equivalent of our U.S. high school). One of the things required in history classes was a complete study of the Nazi takeover both in political and military terms, which included the apathy and violence. The rational was if you never forget you will never repeat. If you were to ask someone who lived through that time how they could let it happen they would tell you it was not a sudden change. Rights were taken away one by one and it always was something that didn’t concern them. If someone was complaining about this or that they didn’t care because it didn’t impact them. Until one day it did. Then it was too late. Everyone asked how could “they” let this have happened? And then it became clear they were the “they” who allowed it.
As always I welcome comments.
