State House Democrats promote bill to penalize insurance companies that deny legitimate claims

[Bozita]

Source: Grand Rapids Press

State House Democrats promote bill to penalize insurance companies that deny legitimate claims
by Nardy Baeza Bickel | The Grand Rapids Press
Monday July 13, 2009, 6:10 PM


After having four surgeries in 13 months, Kathy Roaleen spends a big chunk of her day dealing with her frequent medical bills. If only she could get her insurance companies to handle them promptly.

"I'm constantly dealing with them," the Rockford woman said of her battles with insurers, which have resulted in many denied claims.

On Monday, Roaleen spoke of her experiences as a handful of state House Democrats promoted a 12-bill package that would penalize home, auto and health insurance companies who delay and deny legitimate insurance claims.

The legislation would:

• Strengthen consumer protections, punishing companies who unnecessarily delay or deny rightful claims with fines up to $1 million.

• Hold accountable corporate leaders who encourage wrongful denial of claims, making the misconduct a felony punishable by prison and hefty fines.

• Create a whistle-blower protection plan to shield employees who report an insurance company is engaging in wrongful denial.

• Require companies to repair a consumer's credit that has been harmed by wrongful denial.

Read more: http://www.mlive.com/news/grand-rapids/index.ssf/2009/07/state_house_democrats_promote.html#more

[babylonsister]

1. Rec'd. This should be the law throughout the country.nt

[DUlover2909]

20. I agree! K&R

:kick:

[Towlie]

2. Fines? I wonder how much of those fines will be forwarded to the victims.

I like the idea of sending corporate leaders to prison. That's a pretty radical change from the way things are done now, isn't it?

[RC]

5. That is what need to be done, prison.

Start with the fraud charges and work your way up to RICO.

[proud2BlibKansan]

15. These insurance execs need to share a cell with Madoff

[No Elephants]

34. Or the victim's survivors.

[aikanae]

35. Denying someone of medical care is a violent crime

If you've never experienced denial of medically necessary care, it feels the same as staring down the barrel of a gun. It is a violent crime and should be punished the same - to heck with fines. Some of these companies consider fines to be nothing more than "costs of doing business".

[OhioChick]

3. Rec. n/t

[pleah]

4. This should have been done years ago.

K&R

[santamargarita]

6. Am I smelling bait n' switch?

:bluebox:

[aquart]

12. Are you?

[MannyGoldstein]

7. Excellent. Perhaps the war has begun.

Maybe Congressional Democrats are seeing the light on health insursnce.

[unblock]

8. odds of passage, pretty much zero

but i'm damned impressed that it's even being proposed!

i think the real game is that the house democrats are proposing this simply so they have something big and nasty to drop in exchange for the opposition (both republican and blue dog democrats) caving on single payer.

just watch the insurance lobby and their shills have a cow over this one!

[aquart]

13. STATE house, not HOUSE house.

[unblock]

17. d'oh!

[The Stranger]

9. Why not grant anyone injured or damaged a cause of action against the insurer?

No one has to pay for a huge bureauracy -- we already have the courts in place.

[AlbertCat]

19. I know! Insurance insurance!

[valerief]

24. LOL! I love it!

:rofl:

[Faygo Kid]

10. This is why we must have a public plan. Grateful that Cliff Taylor is off the MI Supreme Court.

If Taylor was still on the court, the vote to deny the legislature's will would have been clear.

Let's hope this passes. It has a chance of sticking, without that fascist on the Michigan Supreme Court to provide the fourth vote that the reich-wing needs to again overturn the legislature.

And they say liberals are judicial activists. Bull.

[aquart]

11. Michigan? Ah.

THAT state house.

[boppers]

14. MI continues to impress.

This should be a nice kick to any nationwide insurance business that issues policies there.

[Mr. Sparkle]

16. $1 million, meh, try $1 billion ...

a million dollar fine is like a drop in the ocean for them. Also, through in some jail time for the ceo, cfo and the board, then we might see some real change.

[DUlover2909]

21. A million dollars is NOT a drop in the bucket in their eyes.

When you multiply that times a thousand in a population of millions, it matters. They do this shit ALOT.

[Mr. Sparkle]

43. I think you may have misunderstood my post, and that we are actually in agreement.

:think:

[unapatriciated]

18. This is a good start...

would be nice if you could sue them for punitive damages when they willfully delay or deny claims that results in disability or early death.
It would be great if blue cross and cigna were held accountable for delaying treatment for my child that almost cost him his life and left him disabled 15 years ago.
Since that isn't going to happen I will settle for them being held accountable for the wrongful denials they are committing now.
So many think you can sue them for damages but you can't. The Insurance Industry knew from the beginning that they would need to deny legal claims in order to make a profit, so they helped to write the laws to protect their interest.

[HughMoran]

22. This is very important

These evil fuckers need to be punished for the crap they do to people.

[KT2000]

23. Hope this passes and

spreads across the country. Why we are held hostage to these extortionists is unbelievable.

[quidam56]

25. In TN & VA, it's called "high quality" health care...

As a former health care giver, I am shocked and saddened to see what has become of health care in America. $ 1. 4 million is being spent per day in DC by the health care lobbyists so your elected representative is getting taken care of and has quality health care we pay for and can't afford ourselves for our families, I know what is deemed, defended and supported in Tennessee and Virginia as quality health care and clearly profit care comes ahead of patient care. http://www.wisecountyissues.com/?p=62 MRSA ( methicillin resistant staphylococcus aureas ) is infesting our communities because filthy, uncaring hospitals and emergency rooms are breeding them and spreading them into our schools, homes, restaurants. How many more Americans' will be diseased or die while 74 % of Americans' are begging for health care reform ? More people died in America last year from MRSA complications than AIDS. When MRSA and a flu bug start mixing, it won't be pretty and we are being infected by the very health care system we depend on and trust to keep us safe and healthy.

[Monica1335]

37. No joke...

We pay all this money for a peace of mind in case something happens and all the insurance company does is make a horrible matter worse. Not only have you paid thousands of dollars through out the years but then end up paying for what the insurance company is responsible to fix.

Ridiculous that this hasn't been done sooner.

Monica ---> Softball Clinic

[lk9550]

26. Greedy Bastards

Fantastic, the greedy fucks in the insurance industry are at it again.

[Piewhacket]

27. LONG OVERDUE. About flippin time.

[Just-plain-Kathy]

28. It's times like this which makes me proud to be a democrat. ..n/t

[wantoutnow]

29. Well thats not fair to those honorable companies

How will they every be able to profit then? Ive heard so much positive talk about how great profit is here. Denying care? That would never happen with for profit companies or even non-profits run by greedy people. :(

[Piewhacket]

31. They can still make a profit. Glad for them to make a profit....

They just don't get to profit from wrongfully denying and delaying
medical claims. Awwww...

I know, I know, they feel so abused to be forced to disgorge
their undeserved and obscene profits from trading in
human suffering, but hey... things are tough all around.

Health Care in the US has been an insurance game (scam) for 40+ years.
So massive and entrenched they became "too big to fail", even as
they melted down and looted the world economies.

I'm so sorry for them. Not.
Actually I would happily attend some hangings.

[wantoutnow]

32. I agree

but what do you think the difference is between an obscene profit and just profit? Im not glad for them to make any profit. How exactly do you think profits are made?

[Piewhacket]

39. OMG, a question! A real question. Oh, goodie...

If only I had an answer as good as your question.
Alas, I'm not an economist, merely a moralist.

Some people think profit is evil. Sometimes it is exactly that.
Some think it a great good. Sometimes it is also that.
What makes it good? What makes it evil?
Certainly



Profit is the difference between the income of a business and all
its costs. It is an INCENTIVE for investment RISK. If the
incentives for investment and building are insufficient then the
hospital doesn't get built, and people who could be cured
instead suffer.

If the risk/investment incentives are too high then investment
flows into that activity, too many hospitals get built while
depriving other investment activities necessary for civilization
to flourish, children to be fed and educated, and such.

However, it should be made clear that profit is but one incentive, there are
many other incentives/disincentives to consider. Those are in
the realm of government POLICY.

A complex economy requires some management, it cannot (for long) be
"unregulated" (aka "lawless", or "corrupt" as it has been) , nor can it be a
"free market" that seeks profit only - because profit is not an END,
it is the MEANS to an END.

The MEANS to what END? There is the true question.

Thank you for this excellent question. I regret my brief answer does
not do it justice, but I offer it for your consideration.

[aikanae]

36. You have to find an honorable one first

Healthcare insurance operate more like investment firms. They do what will bring them profits and that's denying care. If there was an honorable one they lost investors long ago and were assimilated. None of them are honorable.

[tinrobot]

30. Let's make this a Federal law.

[cabluedem]

33. Smoke and mirrors. Send the bastards to prison if you want change. nt

[primavera]

44. Oh, if only we could!

I agree, the prospect of hard time is about the only thing that would make an impact upon their despicable business practices. Allowing punitive damages in tort suits only causes them to pass the burden on to policyholders through higher premiums. Yet, in the unlikely event that Congress was ever willing to criminalize their misconduct, insurance execs would probably just throw a few low level claims adjudicators to the wolves as sacrificial lambs and pretend they had no knowledge of the actions of "a few bad apples." No, the only realistic possibility is to offer a public option and get people wondering why they're spending $500/month in premiums in exchange for crappy coverage when there's a better alternative. Only then will the insurance companies loosen their stranglehold over the country.

[No Elephants]

38. I've got it. Let's make the ins. co execs go through whatever the denied patient had to go through.

Anyone see Wendell Potter, the former Cigna executive, on Bill Moyers Journal this past weekend? Claims he never really understood the ramifications of what Cigna was doing to sick people until after he left the health insurance industry. I'm glad he finally became a whistle blower, but wow.

"Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations."


http://www.pbs.org/moyers/journal/07102009/profile.html

Do I believe him? You betcha.

In other news, I'm going to make millions myself, from the tolls on this beauty I just picked up at a bargain price, because I had to pay it all in cash.

[OwnedByFerrets]

40. Fuck that, just make it illegal with a penalty of jail time.

[fascisthunter]

42. I agree... setting a price tag on a crime won't stop those with lots of cash

especially corporations. This happens more times than most want to admit.

[Wednesdays]

41. K&R

:kick:

[bemildred]

45. Indeed, bring on the tort law, that will slap these weasels into line.

And make a bunch of lawyers rich too.