Georgia Injury Lawyer Blog

Our Atlanta attorneys frequently receive calls from Georgia citizens seeking help when a large health insurance company denies benefits for a procedure or test their doctor has ordered. Many times these decisions are made by nonqualified employees of the insurer who have never even seen the patient. Doctors routinely complain about this second guessing by health insurance companies.

Healthcare reform is a controversial topic today. In almost all of the proposed bills the actions of these large health insurers in second guessing doctors will be curtailed. So, it is not surprising that on Wednesday the nation's biggest health insurers acknowledged funding TV ads designed to kill or water down the health-care overhaul measure.

This admission came after a published report said the spots were paid for in secret to avoid a public-relations fiasco.

The trade group America's Health Insurance Plans said it put up funds at the behest of its members. AHIP represents the nation's largest insurers, including Aetna Inc. Cigna Corp, Humana Inc., UnitedHealth Group Inc. and Wellpoint Inc. AHIP acknowledged paying for the ads after a story appeared in the National Journal's online editions late Tuesday.

Citing health-care lobbyists, the National Journal said each insurer secretly put up at least $1 million and that the organization as a whole contributed $10 million to $20 million dating back to last summer.

The Journal reported that AHIP solicited the funds and funneled them to the U.S. Chamber of Commerce to underwrite the ads. Two business coalitions set up and subsidized by the chamber were responsible for the ad, the story said. AHIP started funding the ads last summer as the industry came under fire from lawmakers and the Obama administration over high profit growth and abuses.
AHIP did not fund the entire effort, the story indicates, as the chamber spent $70 million to $100 million on the ads.

A health insurer which sells policies in Georgia and other states has been subjected to a major fine and other sanctions by the state of New York, after New York officials accused it of leaving patients with huge hospital bills.

The American Medical and Life Insurance Co., advertising through an intermediary called Cinergy, markets health insurance as a lower cost option for the uninsured and underinsured. It was pitched as costing just $5 a day, or the cost of a hamburger or pack of cigarettes.
In one TV ad, the narrator said the insurance is available "regardless of any pre-existing conditions," while the print on the screen stated "most pre-existing conditions accepted" and the fine print stated there is a six-month waiting period.

As a result of the New York action, the company must stop running the national ads and pay a fine of $700,000 .

New York’s Acting Insurance Superintendent said Wednesday that the cases uncovered in New York's two-year investigation included a Rochester woman who had $419 a month charged to her credit card for the insurance, only to have the company cover just $1,164 of her $28,000 hospitalization. A 36-year-old New Yorker who had a stroke found his policy covered just $250, leaving him with a bill for $29,917. In both cases, the company paid off the balances after the state intervened.

The New York City-based company sells policies in 38 other states, including Georgia, and the District of Columbia. It sold about 12,000 policies in New York, about 5,000 of which have lapsed, and about 38,000 nationwide.

New York is also prohibiting the company from selling its partial coverage policies in New York, in part because state officials said the company failed to fully disclose the extent of coverage or use licensed agents as required.

A lawsuit has been filed by Georgia surgery centers against Blue Cross Blue Shield Healthcare Plan of Georgia Inc. and Blue Cross and Blue Shield of Georgia, seeking class action. The lawsuit, like many others around the country attacks the insurer’s practice of discouraging visits to out-of-network providers by reimbursing procedures at a tiny fraction of “usual and customary” charges.

The suit is similar to one filed earlier this year by a dialysis provider against Blue Cross. That suit was dismissed. The new suit alleges Blue Cross members paid higher premiums in exchange for the flexibility to receive coverage for care from providers who are not part of the plan’s preferred network.

Blue Cross Georgia is alleged to have engaged in the practice of targeted out-of-network providers, including ambulatory surgery centers, for a drastic reductions in reimbursement to a mere fraction of usual and customary charges. The suit alleges these practices violate federal and state laws protecting patients and providers, as well as Blue Cross Blue Shields contracts.
The suit alleges that Blue Cross has cut its reimbursement to out-of-network surgery centers by about 80 percent and reduced reimbursement rates to non-member surgery centers making it impossible for their insureds to receive the benefits they are paying for. Thus, the suit alleges the insurer is charging for a service it has effectively eliminated.

The Plaintiffs are seeking monetary damages for Blue Cross Georgia’s alleged failure to pay the contracted reimbursement rate and they are asking the court to force Blue Cross Georgia to honor its agreements.

Our Atlanta, Georgia lawyers see health insurance companies deny valid claims on a daily basis, depriving policyholders of necessary medical care to which they are entitled. Now, a California health insurer has been caught red handed. The insurer, Health Net, has agreed to pay as much as $14 million to settle a pair of lawsuits brought on behalf of 800 former policyholders whose coverage was dropped after they submitted substantial medical bills.

On February 11, the court granted preliminary to a settlement in which individuals whose health insurance policies were canceled since 2004 are eligible for payments of up to $218,000. The average payment is expected to be $7,836.

The settlement would resolve a class-action lawsuit filed by private attorneys and by Los Angeles City Atty. Rocky Delgadillo.

In addition to the payments to customers, it requires Health Net to pay a fine of $2 million to the city attorney and to contribute $500,000 to charities.

The settlement comes after a two-year crackdown by California regulators on the widespread and controversial practice known as rescission. Rescinding an insurance policy is a serious matter. It means that an insurer is accusing the policyholder of withholding or concealing vital information.

A policy rescission means that the consumers coverage is completely gone. Insurance companies can unilaterally cancel a health insurance policy, after issuance if the insurer later finds omission on the application. In many cases, the rescission is for a valid reason, such as failure to mention a history of severe cardiovascular problems. But many insurers collect premiums and when a large claim is filed, rescind the coverage over minor mistakes in the application.

In deals with California regulators, insurance providers Health Net, Anthem Blue Cross and Blue Shield all have agreed to make substantial changes in the way they sell individual coverage in an effort to reduce the number of rescissions. Health Net has agreed to pay more than $40 million to resolve the regulatory actions and litigation over rescission.

According to documents Health Net rescinded 1,600 policies and saved $35.5 million over several years. Health Net paid bonuses to an employee based in part on how many rescissions she carried out.

We applaud the California officials who protected consumers from these reprehensible practices, and can only hope that Georgia officials will show the same courage.

Continue reading "Unethical Health Insurance Practices" »

According to a report by the American Assocaition for Justice, the U.S. insurance industry has trillions of dollars in assets, enjoys average profits of over $30 billion a year, and pays its CEOs more than any other industry. But insurance companies still engage in dirty tricks and unethical behavior to boost their bottom line even further. The current economic turmoil affecting the insurance industry onWall Street has only made the outlook bleaker for consumers living on Main Street. Insurance companies are likely to demand huge rate hikes and refuse more claims than ever. Some of America’s most well-known insurance companies—the same ones that spend billions on advertising to earn your trust—have endeavored to deny claims, delay payments, confuse consumers with incomprehensible insurance-speak, and retroactively refuse anyone who may cost them money.

The report describes some of the most egregious ways the insurance industry attempts to make money at the expense of consumers. These are some of the tricks described in the report:

Denying Claims
Some of the nation’s biggest insurance companies— Allstate, AIG, and State Farm among others—have denied valid claims in an attempt to boost their bottom lines. These companies have rewarded employees who successfully denied claims, replaced employees who
would not, and when all else failed, engaged in outright fraud to avoid paying claims.

Delaying Until Death
Many insurance companies routinely delay claims, knowing full well that many policyholders will simply give up. Some have gone so far as to lock paperwork away in safes. Undoubtedly, the most shameful use of delay tactics has been by long-term care insurers, who often take advantage of their policyholders’ age and ill health. In the words of one regulator, “the bottom line is
that insurance companies make money when they don’t pay claims…They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.”

Confusing Consumers
Insurance contracts are some of the most dense and incomprehensible contracts a consumer is ever likely to see. More than half of all states have enacted “plain English” laws for consumer contracts, yet many Americans still do not fully understand the risks they are subject to. After Hurricane Katrina, insurance companies used obscure “anti-concurrent” clauses to get out of paying claims. Consumers who purchased hurricane insurance and thought they were covered
suddenly found the coverage eliminated by an obscure clause they could not hope to understand.

Discriminating by Credit Score
Increasingly, insurance companies are using credit reports to dictate the premiums consumers pay, or whether they can even get insurance in the first place. The practice penalizes the poor, senior citizens with little credit, and those who have suffered financial crisis through no fault of their own. Insurance companies have denied fiscally responsible people who paid their bills in cash, but refused renewals because of a lack of credit history. Others have seen auto rate hikes near 600 percent despite clean driving records after falling on economic troubles.

Abandoning the Sick
Health insurers looking to cut costs have taken to canceling retroactively, or rescinding, the policies of people whose conditions have become expensive to treat. Some insurance companies have even offered bonuses to employees who meet “cancellation goals.” Rescission targets patients in the midst of treatment when they are at their most vulnerable—even cancer patients in the midst of chemotherapy have been targeted.

Canceling for a Call
Many people are rightly reluctant to make small claims on their home insurance for fear their insurance company will raise their premiums. But few realize that insurance companies often refuse to renew a policy because the policyholder did as little as inquire about the possibility of making a claim.Many times an insurance company will count an inquiry over the phone as the same as a claim, and then they will do everything in their power to drop the policyholder.

Our attorneys routinely handle serious injuries arising out of car collision and crashes. We are always amazed to learn just how little the public knows about automobile insurance coverages and generally how they work. The purpose of this blog is simply to set forth some of the basic principles so that the public can be educated about how automobile insurance coverage works in the typical case.

When someone runs a stop sign and causes a car crash and collision, the innocent victim who did nothing wrong to cause the collision but, nonetheless, is injured has a claim against the at fault driver. Under Georgia law, as is true in most cases, the legal claim cannot be filed against the insurance carrier for the driver but only the driver alone. The driver’s automobile liability insurance policy, however, will provide the at fault driver with a defense against the claim.

In order to legally operate a vehicle in Georgia, all drivers must have a valid liability insurance policy with minimum coverage in the amount of $25,000.00 per person $50,000.00 per accident. What this means is that if there is a car crash or collision and someone is injured, the at fault driver’s insurance company will be responsible to pay no more than $25,000.00 to any person injured in the accident, and no more than $50,000.00 for all persons injured in an accident no matter how many persons are involved. Obviously, such minimum limits are woefully inadequate to address the serious injury or catastrophic claim. This is why we always recommend to our clients that they purchase uninsured or underinsured motorist coverage.

In the hypothetical case mentioned, if the at fault driver runs a stop sign and catastrophically injures the innocent victim, should the at fault driver only have the minimum limits required by law, that being $25,000.00 per person $50,000.00 per accident, it is evident that the $25,000.00 in coverage would probably be consumed by medical bills arising from the incident not to mention lost wages, pain and suffering and other economic and non-economic damages. To protect one’s self from the negligence of a third party who has minimum or no insurance coverage, the public should always purchase uninsured or underinsured motorist coverage for the benefit of themselves. If in the hypothetical situation the innocent victim had $100,000.00 in uninsured motorist coverage, even if the at fault driver only had $25,000.00 in coverage, the innocent victim could seek the difference from their carrier, that being $75,000.00 in underinsured coverage for a total recovery of $100,000.00 ($25,000.00 liability coverage and $75,000.00 underinsured coverage) verses a recovery of only $25,000.00 which would have been the maximum recovery had there been no uninsured/underinsured motorist coverage available.

In addition to liability insurance coverage which is mandated by law to operate a vehicle, as mentioned, the importance of uninsured motorist coverage cannot be stressed enough. For those who do not have good healthcare plans, there is also the availability of Medical Payments coverage which applies to medical bills arising out of an automobile collision regardless of fault. Once again, we advise those clients that we represent to always look at their medical payments coverage very carefully and to explore whether they need such coverage should they not otherwise have good healthcare coverage.

Continue reading "Car Crashes, Car Collisions and Automobile Insurance" »

To identify the worst insurance companies for consumers, researchers at the American Association for Justice (AAJ) conducted a comprehensive investigation of thousands of
court documents, SEC and FBI records, state insurance department investigations and complaints, news accounts from across the country, and the testimony and depositions
of former insurance agents and adjusters. The AAJ final list includes companies across a range of different insurance fields, including homeowners and auto insurers, health insurers, life insurers, and disability insurers.

Allstate stood out as the worst insurance company for consumers,. The AAJ reported that Allstate’s concerted efforts to put profits over policyholders has earned its place as the worst insurance company in America. According to CEO Thomas Wilson, Allstate’s mission is
clear: “our obligation is to earn a return for our shareholders.” Unfortunately, that dedication to shareholders has come at the expense of policyholders. The company that publicly touts its “good hands” approach privately instructs agents to employ a “boxing gloves” strategy against its own policyholders. A former Allstate adjuster Jo Ann Katzman, reported that “We were told to lie by
our supervisors—it’s tough to look at people and know you’re lying.”

The insurance industry has so much excess cash it may spark a downturn in the industry. According to analysts at Standards & Poor’s, U.S. insurers are sitting on too much capital, and will likely endure at least three years of negative performance as a result.

According to the report, the ten worst insurance companies are:
1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. WellPoint
7. Farmers
8. UnitedHealth
9. Torchmark
10. Liberty Mutual

The report pointed out that the U.S. insurance industry takes in over $1 trillion in
premiums annually. It has $3.8 trillion in assets, more than the GDPs of all but two countries in the world. Over the last 10 years, the property/casualty insurance industry has enjoyed average profits of over $30 billion a year. The life and health side of the insurance industry
has averaged another $30 billion.

The CEOs of the top 10 property/casualty firms earned an average $8.9 million in 2007. The CEOs of the top 10 life and health insurance companies earned even more—an average $9.1 million. And for the entire industry, the median insurance CEO’s cash compensation
still leads all industries at $1.6 million per year.

Allstate Insurance Company is known by plaintiff’s attorneys for engaging in bad faith tactics. Last week, the Missouri Court of Appeals upheld a jury verdict that hit Allstate with more than $16 million in damages for bad faith tactics.

On March 24, 2000, Wayne Davis Jr., while drunk, drove his truck across the center line of a roadway and hit a compact car head-on. The force of the collision pushed the car back more than 100 feet. The driver and the passenger survived but suffered life-threatening injuries, and incurred combined hospital bills totaling $320,000.

The injured parties offered to settle with Davis for his insurance policy limits of $50,000. But, his carrier, Allstate, did not respond until six months later. That was after a statutory 60-day limit for accepting had expired.
After Allstate failed to settle, a lawsuit was filed and a consent judgment was entered in the injured parties’ favor for more than $5 million. The injured parties then agreed to forego execution of the judgment against Davis for assignment of his claims against Allstae for failure to settle his case.

Allstate claimed it lost the letter proposing the offer and responded late because it did not receive the parties’ medical record. The jury did not believe these claims and on Nov. 8, 2006, found that Allstate had acted in bad faith and awarded compensatory damages of $5.8 million plus 9 percent interest since the date of the judgment, as well as $10.5 million in punitive damages.
Allstate appealed, and on Tuesday a three-judge panel of the Missouri Court of Appeals held that the evidence was sufficient to justify the verdict.

Incredibly, Allstate argued that it was unsure the crash had caused the injured parties’ injuries. This was in spite of testimony that they had to be cut out of the wreckage, were flown by helicopter to the hospital and received intensive care.

This past year our firm handled several motorcycle accidents involving wrongful deaths and serious injuries. What we see in these cases is the importance of a motorcycle rider having uninsured motorist coverage to protect their interests. Even where a motorcycle rider is doing everything right, is wearing a helmet and is operating the motorcycle safely, it is not uncommon for us to see wrongful death and serious injury cases in such contexts. For whatever reason, many people pull right out in front motorcycle riders simply because they do not “see” the approaching motorcycle. People are used to perceiving large vehicles moving towards them and when they glance in a particular direction and do not see what they are accustomed to seeing they pull out sometimes with deadly results. In those cases where the rider survives, obviously, it is crucial that there be sufficient liability coverage and/or uninsured motorist coverage available to address their medical needs and long term disabilities if the injuries are serious.

Most motorcycle accidents that we have seen are very serious matters involving either death or long term permanent injuries. There is so little protection for the motorcycle rider that in the event there is a bad collision, the rider, if he or she survives, may lose a limb, sustain head injuries and/or be permanently impaired in some manner. In many such cases, the at fault driver has the minimum limits available under Georgia law, being $25,000.00. Obviously, a $25,000.00 settlement is insufficient to meet the needs of the innocent rider, thus again emphasizing the importance of having uninsured motorist coverage.

In the hypothetical case where the at fault driver fails to yield right-of-way and hits a motorcycle rider, if the at fault driver only has $25,000.00 in coverage, the motorcycle rider can protect himself/herself, in such a situation by having excess uninsured motorist coverage. In Georgia, thanks to a new law, beginning in January of 2009, the amount of such coverage can be stacked on top of the available liability insurance coverage without any offset credit. Between now and then, the only amount of coverage which is available is the difference between the available liability coverage and the amount of uninsured motorist coverage above that amount. Thus, between now and January of next year, in the hypothetical case presented, if the rider had $100,000.00 in uninsured motorist coverage, he/she could collect $25,000.00 from the at fault driver and $75,000.00 from their own policy. Beginning January of next year, the rider can ask for stacking coverage as part of their own insurance policy which will allow the rider to collect $25,000.00 from the at fault driver and the full $100,000.00 under their own policy.

Insurance should be purchased for the catastrophic event, not for the minor event. The coverage that one purchases to protect themselves is uninsured/underinsured motorist coverage. Motorcycle riders who purchase such coverage as part of their own policy do not have to depend on the at fault driver having sufficient liability coverage to protect themselves in the event of a serious collision. We recommend that all motorcycle riders look at their policies and determine just how much uninsured/underinsured motorist coverage they can afford to purchase. We have seen far too many cases where the lack of uninsured/ underinsured motorist coverage rendered to us as attorneys unable to assist our clients simply because they at fault driver had minimum limits and had no personal assets sufficient to satisfy an excess judgment against them.

The Louisiana Supreme Court has ruled that a flood exclusion in an "all-risk" policy barred a claim by the owner of an apartment building damaged by flood waters during Hurricane Katrina.

The owner lived in the five-unit building when four feet of water entered the basement during the hurricane. He had a commercial "all-risk" policy and submitted a claim for the damage. An insurer's inspector claimed most of the damage was due to poor maintenance and flooding.

The insurer paid only $230 on the claim because the policy excluded coverage for damage caused by various forms of water, including "flood." But the policy did not specifically define the word "flood."

The owner sued claiming the policy's failure to distinguish between naturally-caused flooding and flooding resulting from the failure of man-made structures like those protecting New Orleans rendered the exclusion too ambiguous to enforce.

But the court rejected that argument.

If you think the prescription drug you took for headaches caused your heart attack, the Food and Drug Administration says you can't sue the maker for injury if it met agency standards. The Consumer Product Safety Commission (CPSC) says you can't sue a mattress maker if your mattress bursts into flame despite meeting CPSC standards. Companies making sport utility vehicles would get similar protection from suits brought by people injured or the families of those killed in rollovers under National Highway Traffic Safety Administration (NHTSA) proposals for stronger roofs.

Consumer advocates call this "silent tort reform." It is part of the tension between state and federal law that has existed since the nation's founding. If there is a conflict, state laws must yield under Article 6 of the Constitution. But where there is no federal law, federal courts must defer to laws of the state where a lawsuit is heard. Big business and insurance companies are now using this to avoid responsibility for negligent actions and omissions at the expense of innocent consumers.

Under the Bush administration, a developing body of judicial opinion could place new limits on the rights of those who buy or use products. It also could mean the savings of billions of dollars by companies insulated from lawsuits.

Federal agencies are increasingly promulgating rules favorable to big business and insurance companies at the expense of ordinary citizens. They then assert their rules override state tort and product-liability laws. In a novel approach, these agencies are claiming that the preemptive effect is based on statements in the introductions to their rules, not the rules themselves.

The practice varies by agency but is spreading. It delights corporate defense lawyers. The argument is that federal agencies are the absolute rule-makers.

Actor Dennis Quaid and his wife are preparing to fight such a contention — this one made by the FDA — in a suit accusing Deerfield, Ill.-based Baxter Healthcare Corp. of putting vastly different doses of a blood-thinner into confusingly similar packages. The Quaids went to court in November 2007, after their infant twins were given 1,000 times more heparin than babies should get. Their suit contends Baxter should have changed the packaging after three babies died in 2006 at an Indianapolis hospital.

Serious injury lawyers like ourselves often hear clients involved in serious accidents tell us that they had “full coverage” at the time of the accident and that they therefore have “excellent” insurance protection. The vast majority of the time, this is not the case at all. This is because the term “full coverage” means that one has the coverage one is minimally required by law to possess. Full coverage does not mean adequate coverage nor does it mean excellent coverage. It means minimally required coverage required by law.

Here in Georgia, in order to operate an automobile, the driver must have a minimum of $25,000.00 in liability coverage protection for any one person, $50,000.00 per accident. What this means is that if someone runs a stop sign and seriously injuries another, he has “full coverage” if he has $25,000.00 in liability insurance coverage for an innocent third-party victim, $50,000.00 for all victims in a single accident. Anyone familiar with hospital and medical costs today knows that any serious injury can hardly be compensated for $25,000.00. Indeed, any serious injury usually involves medical bills far in excess of $25,000.00.

It is heartbreaking for our lawyers to see cases where the at fault driver has “full coverage” and our clients are indeed seriously injured, sometimes with amputations, permanent disabilities and death. In those cases involving death of a family member, $25,000.00 could never adequately compensate the survivors, much less address issues such as medical expenses, funeral bills, lost wages and the like. And yet, we hear over and over again from people inexperienced in this area that they have “full coverage” thereby deluding themselves into believing that they have adequate insurance coverage.

To truly have adequate insurance coverage, one needs to have excellent uninsured motorist coverage. The at fault driver may have “full coverage” that is the minimum amounts required by law, but to have excellent coverage one must protect themselves with uninsured/underinsured insurance coverage. If the at fault driver runs the stop sign and injuries you but only has the minimum coverage required by law ($25,000.00 per person, $50,000.00 per accident), you can protect yourself through the purchase of uninsured or underinsured motorist coverage in any amount desired. One can purchase $100,000.00, $500,000.00 or $5 million. In the case where the at fault driver causes serious injury or death, the higher “underinsured” limits will provide relief whereas the minimally required “full coverage” will provide virtually no relief at all.

We continue to urge all Georgia citizens to carefully review their automobile insurance policies. What protection do you have if you are seriously injured? If you do not have uninsured/underinsured insurance protection, you are at the mercy of the at fault driver. If he/she has “full coverage,” you are seriously injured, and you do not have uninsured/underinsured coverage under your own policy, you may be in more trouble than you know.

Our serious injury attorneys frequently see cases in which insurance companies refuse to pay valid claims and then turn on their insureds accusing them of fraud.

Last Tuesday, the Western Missouri Court of Appeals upheld a jury verdict of nearly $8.5 million against State Farm Mutual Automobile Insurance Company for breach of contract claims and malicious prosecution against a claim holder. The case originated in 1997 when Jennie Hampton reported that her vehicle had been stolen and filed a claim with her insurer, State Farm. Several days later, the car was found abandoned and burned.

State Farm allegedly investigated the claim and denied it on the grounds that Hampton had listed her engine as being in excellent condition when State Farm contended that the car had suffered an engine failure. The Company further alleged that Hampton and an acquaintance towed the car after the engine failure and burned the vehicle. State Farm took their claims to the district attorney’s office and allegedly pressured prosecutors there to file insurance fraud criminal charges against Hampton and the acquaintance.

The criminal charges were tried and Hampton and the acquaintance were acquitted.

In a 3 - 0 ruling, the Appellate Court affirmed the judgement against State Farm holding that State Farm not only improperly denied the claim but also pressured the prosecutors to file criminal charges against Hampton.

As serious injury attorneys we frequently see cases in which insurance companies refuse to pay for treatment for their insureds, knowing that any appeal by the insured will take months, if not years, and that there is no legal remedy which can force the companies to offer timely treatment. In fact, in many cases the only legal remedy is that the company will be required to pay what they already owe, with no allowance for attorney fees and expenses. Unfortunately, in many cases the remedy comes too late.

An article was just published describing how a 17-year old died just hours after her health insurance company reversed its decision not to pay for a liver transplant that doctors said the girl needed. Nataline Sarkisyan died last Thursday night at University of California, Los Angeles Medical Center. Nataline had been battling leukemia and received a bone marrow transplant from her brother. She developed a complication, however, that caused her liver to fail.

Doctors at UCLA determined she needed a transplant. They sent a letter to CIGNA Healthcare on Dec. 11. requesting approval for the procedure. Cigna denied payment for the transplant. Last Thursday, about 150 teenagers and nurses protested outside a California CIGNA office. The company then reversed its decision and said it would approve the transplant. But, it was too late.

Nataline’s mother was quoted as saying that CIGNA was responsible for her daughter’s death. CIGNA issued a press release stating that: "Our hearts go out to Nataline and her family, as they endure this terrible ordeal."
This rings hollow, as CIGNA has just saved thousands of dollars to increase its profits.

Bad faith insurance claims have always been difficult because the insurance industry has routinely been able to hide behind restrictive laws designed to protect them from even egregious conduct. However, a case pending in Missouri may change this situation.

A Jackson county Missouri trial judge issued an order directing Allstate Insurance Company to produce records which the Plaintiff lawyers allege show how Allstate set up a claims payment system in the 1990s that shortchanges clients while earning huge profits. Despite the judges directive, Allstate refused, and drew a $25,000 per day fine from the judge. The fine, which began in mid-September is now approximately $2.4 million.
Last month, the Missouri Supreme Court ordered the documents produced, but Allstate, has stated it will not produce these records for public view no matter how much the court fines it.

Allstate contends the documents are trade secrets used to create company policies, methods and claims procedures.

The case stems from a car wreck seven years ago. Allstate’s insured struck the rear of a truck and severely injured the driver. He is suing Allstate for bad faith for refusing to pay the claim for years. The case is still pending.