Insurance Claims And Issues

COBRA Ending for Your Clients as the Great Recession Continues.

   More potentially useful information on COBRA comes from "Patient Money/Steps to Take Before Cobra Subsidy Ends" by Walecia Konrad (New York Times Online, Saturday, December 12,  2009).

   Sadly, inevitably, assistance in paying the very high COBRA Premiums is coming to an end for many people, which means that their Health Insurance Coverage Premiums will rise like a rocket if things remain as they are, let alone if things get worse.  See  Patrick McGeehan, "Unemployed Facing End of Subsidy for Insurance Bought Through Cobra" p. A39, col. 1 (New York Times Nat'l ed., Thursday, December 17, 2009).

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Health Insurance Bills: What is Possible May Not be Good.

   One of the repeating themes in newspaper reports about the Obama Administration is the theme that the new Administration is focused on achieving results.  Any result, so long as the Administration can call the result a "win".

   One of the recurring concepts in newspaper reports is that the Obama Administration will compromise on anything at all, except for achieving a result.

  Oh come on, oh come on, Emmanuel.

   This way of governing is failure. 

   The Health Bill making the rounds of the gantlet known as the United States Senate is a good example.  The Health Bill that the Senate is likely to vote up or down, no longer has any provision for a Public Health Insurance Option.  It no longer has a provision that would extend Medicare Benefits to people younger than 62 and the disabled.  However, it does retain all provisions that would require people to buy Health Insurance from private Health Insurance Companies, which would thereby receive a wealth of new Policyholders paying Premiums.

   What for?

   So that the Obama Administration can declare that they have a result and therefore a "win"?

   Senators, vote against the current Health Bill.  It has no good and much bad  in it.  Start over if you cannot come up with something Good -- something more than just a declared "win".

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Election to American Law Institute.

  

I just learned that I have been elected to the American Law Institute.  The ALI is made up of over 4,000 judges and lawyers of the highest qualifications.  One of the most prestigious organizations open to selected lawyers, the ALI is the leading independent organization in the United States dedicated to producing quality work to clarify and modernize the law and to make the law work better.

This is an honor.  I am both gratified and humbled by it.  Thank you, ALI.

Payments Preserved in Senate for Health Insurance Execs, Policyholder Attorneys.

   Payment rights have been preserved by the United States Senate for two unlikely groups of frequent adversaries:  Health Insurance Company Executives, and Policyholder Attorneys.

   In a vote on Sunday, December 6, 2009, the U.S. Senate defeated an amendment offered by Senator Blanche Lincoln, Democrat of Arkansas.  The amendment would have reduced or eliminated tax deductions for corporations paying high salaries to their executives, in basic and simple terms, thereby reducing the incentive of such corporations to pay such salaries:  but the amendment was limited to payments by Health Insurance Companies to Health Insurance Company executives.  The amendment was defeated.

   In another vote on Sunday, December 6, 2009, another amendment was defeated.  The second amendment was offered by Senator John Ensign, Republican of Nevada.  Mr. Ensign's amendment would have reduced or eliminated contingency fees for attorneys who represent persons suing doctors for medical malpractice.  That amendment was also defeated.

   The newspaper reports of Senate action over the weekend were focused instead on other activities, such as whether the Senate will find happiness in a compromise over a Public Health Insurance Option.  For example, in this report by Robert Pear and David M. Herszenhorn, "Push For Public Plan Deal Intensified" p. A12, col. 1 (New York Times Nat'l ed., Monday, December 7, 2009), the following two paragraphs are literally the bottom line:

   The Senate on Sunday rejected two proposed amendments to the health care bill.  One, offered by Senator Blanche Lincoln, Democrat of Arkansas, would have limited the tax deductions that health insurance companies could take for compensation paid to top executives.

   The other, by Senator John Ensign, Republican of Nevada, would have limited contingency fees that could be paid to plaintiffs' lawyers in medical malpractice lawsuits.

 Please Read The Disclaimer.

Computer Models Calculate Risks of Buying Your Life Insurance Policy.

   Not content with the limitations of securitization and bundling so amply revealed in late 2008 and early 2009, many investors are turning to Computer Models to calculate the risks of buying Life Insurance Policies -- from you and your clients.  The prospects held out by this approach include bigger returns on investments for Wall Street and maybe most investors, but not for you.

   Wall Street investors are reportedly gathering steam as they grow excited about the returns they could receive on investments in other peoples' Life Insurance Policy payouts.  Investors' risks in "life settlements" and "viatical settlements" include the Insured outliving her or his life expectancy.  "The sooner the seller [Insured] dies, the more money the investment makes."  Michelle Singletary, "Playing Investment Games With Life and Death" (Washington Post Online, Thursday, September 10, 2009).

   This particular "investor's risk" carries with it the specter of potential fraud and potential peril to the Insured seller.  If investors receive a sufficiently greater return on their investment if you or your client die sooner rather than later, i.e., if the purchaser of your Life Insurance Policy payout gets more money the sooner you die, there is obviously a range of incentives built in to that investment, ranging from an incentive to perpetrate mayhem to  at least acquiesce in all sorts of life-threatening policies, practices, and procedures.  Talk about "Moral Hazard"!  This type of 'investment' gives a whole new meaning to that phrase.

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Mr. Weis Wavers, Millions Whisper.

   Mr. Charlie Weis, the Head Football Coach at the University of Notre Dame, says that he would have a tough time coming up with an argument against his firing if the University decides to let him go.  See Pete Thamel, "Analysis/Weis Says His Firing Would be Understandable" (New York Times Online, Monday, November 23, 2009).  His words.  Imagine?

   Mr. Weis, it will be remembered, received a huge contract extension several years ago.  He has already been paid unknown Millions of Dollars since then.  If the University buys him out of the remaining years on his contract, estimates have been reported ranging from $10,000,000.00 to $18,000,000.00.

   Apparently, if he resigns voluntarily, he would not receive any part of the remaining Millions.

   As a result of Saturday's loss to the University of Connecticut Huskies in double overtime (the third loss in a row), the Irish Football Team under Mr. Weis's tutelage has:

Lost to "a decisively less talented Big East team" on Senior Day, as they did in 2008.

Come up with a 16-20 won-lost record to date since 2007.

Started the players recruited by Mr. Weis over those same last three seasons.

Post a lower winning percentage during the tenure of Mr. Weis than was posted by the Football Teams coached at the University of Notre Dame by either of Mr. Weis's last two predecessors, both of whom were fired.

Refused to allow the Huskies to snatch defeat from the jaws of victory when the Huskies had two consecutive touchdown runs called back for holding in the final 2 minutes of regulation time.

See Pete Thamel, "Loss Leaves Weis Hanging by a Thread" p. 8, col. 2 (New York Times Nat'l ed., "SportsSunday" Section, Sunday, November 22, 2009), substantially rewritten online under the same headline.

   Money cannot buy happiness.  It apparently cannot by itself buy success, either.  Millions whisper.

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Health Insurers, United States Senate: Why "Federal" and "Regulation" Incompatible.

   Some folks say that Insurance Regulation of Health and other Insurance Companies would be better handled by the Federal Government than by State Governments.  States have regulated the business of Insurance for almost 150 years.  Arguments are made for and against this idea.

   A number of arguments against the idea of "Federal" Insurance "Regulation," which present themselves from bills pending in the U.S. Senate, are reported by David S. Hilzenrath, "Health Insurers Could be Allowed to Bypass Some Key Reforms/Senate Bills Would Include Loopholes for Proposed 'Exchange'" (Washington Post Online, Sunday, November 15, 2009).

 The author is Co-Chair of the American Bar Association Subcommittee on Health, Life and Disability Insurance.  The views expressed in this post, if any, are his own unless clearly attributed to other sources.

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Group Health Insurance Premiums Rise as Small Businesses Fall.

   Across the nation, owners of small businesses are reporting that their Health Insurance Companies are raising Premiums by double digits, from 10% to 25% and in some cases by 35%, 47%, and perhaps even more.  See Robert Weisman, "Small Businesses Bridle at Health Insurance Hikes/Many Told to Expect Double-Digit Jumps" (Boston Globe Online, Sunday, November 15, 2009).

   As Group Health Insurance Premiums rise, small businesses fail.  Given the current, continuing arguments over Healthcare in Washington, D.C., is this such a good time to raise those Premiums, anywhere?

 The author is Co-Chair of the American Bar Association Subcommittee on Health, Life and Disability Insurance.  The views expressed in this post, if any, are his own unless clearly attributed to other sources.

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(Some) Features of House Bill (Possibly) Can Be Described, Now.

   Once there were three (3) Healthcare Reform bills pending in the U.S. House of Representatives.  Now there is (kind of) one.  It is fair to say that the work of merging the three bills into one bill, is still a work in progress.  A vote will be taken in the House on the resulting one bill ... sometime in the future.  In the meantime, here are the results of two reporters' insights into "Reader Questions on House Healthcare Bill" by Kim Geiger and James Oliphant (Los Angeles Times Online, Sunday November 1, 2009).

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Push For Premiums, Pushback From Politicians -- Health Insurance Heats Up.

   Health Insurance Companies reportedly are ready to launch a bare-knuckles fight to secure the greater Premiums they thought they had already negotiated in deals with the White House.  They have clearly taken the gloves off.  They are not bound by the Marquess of Queensberry Rules, if ever they were bound by such niceties at all.  In its corner, the Obama Administration is reportedly ready to turn from the attending crowd and face the Companies.  Whether they will actually meet in the ring and fight it out, or compromise again, remains to be seen.

   Speculation abounds that the Administration now has something in its hands which it is willing to fight for:  The Baucus Bill passed by the U.S. Senate Finance Committee last week.  See Political Notebook, "Obama Pushes Back at Insurers" (Boston Globe Online, Sunday, October 18, 2009).

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