Virginia Personal Injury and Medical Malpractice Blog

“Stacking” Allowed Under Uninsured/Under-Insured Motorist Coverage Plan

Many attorneys would have said "there's not enough coverage", but recently one attorney "dug deep" to discover a way to vastly increase the insurance coverage available to his client. And the way he did it means great news for the plaintiff’s bar! The Supreme Court of Virginia ruled earlier this week that “stacking”, or combining, the Uninsured Motorist/Under-Insured Motorist coverage in a policy is allowed.

In the case at issue a young girl was badly injured in a car wreck but both the car she was riding in (a friends) and the car at fault were underinsured. Her father’s policy covered three other vehicles for a total of $850k for bodily injuries (split $300k, $300k, and $250k).

The insurance company argued that they had included provisions disallowing “stacking” meaning that the most they could offer in coverage was $300k for one vehicle.

The Court held that the insurance company had not appropriately excluded stacking and that the plaintiff was entitled to the full value of the policy.

With the SCVa’s ruling it opens up a window of litigation for plaintiff’s until the insurance companies are able to modify their policies to properly disallow “stacking.” This case could prove to be quite important as attorneys will now be scrutinizing “stacking” clauses much closer to make sure they are up to snuff. Of course, if you consult with an experienced personal injury attorney before you even buy your plan, you probably wouldn't need to rely on a "litigation window" to be successful in your claim.

Ohio $1.25 Million Truck Accident Case Verdict

Toledo truck accident attorney Chuck Boyk and his legal team are to be congratulated for a terrific $1.25 million dollar verdict. You should read Chuck's post on this case because it shows, truly, the fight that many injured victims must go through to get justice.

Boyk is one of the premier truck accident attorneys in Ohio. If you've been injured in a car accident in Ohio, give Chuck Boyk a call.

MetLife Gets Reamed By New York Judge

Here's a case involving MetLife's group disability plan for Eastman Kodak. The plaintiff suffered from chronic fatigue syndrome (CFS) and was initially given full benefits.

MetLife decided to review the case and, well, they didn't do a very good job of it. The doctors they had evaluate the plaintiff didn't really use any evidence and when they did, they did so selectively.

There is no one test that can be used for CFS because it is an amalgam of several symptoms rather than a disease. So all the tests that the plaintiff's primary care physician said pointed to CFS, MetLife's docs said they didn't, claiming that there was not objective proof of the condition. And when they were asked repeatedly what the plaintiff could do to provide objective proof (remember there is no test for CFS) the question was ignored.

Brilliant. The insurance companies want a level of proof that's not possible. A definitive result from a non-existent CFS test.

The opinion, linked above, is quite a good read. The judge really goes after MetLife on some of its self-contradictions and gets after a MetLife doc's report saying it "can be characterized as shoddy and incomplete."

The whole point is that insurance companies have to be responsive and specific when they deny a claim. They have to answer the question of why the claim was denied and also explain what they would need to accept it. If they don't, something's up.

My disability company wants to give me a "free lawyer" to pursue social security benefits

My disability company wants to refer me to a social security lawyer to pursue SSDI benefits. They way it will be free. Is that a good idea?

No. In my view it is most often a very bad idea and offers you no benefit whatsoever.

To see why disability attorney Ben Glass says "no" to "free" social security lawyers, go here.

 

Suze Orman Sued for Fraud -- Read the Fine Print

Looks like Suze Orman is finding herself in a bit of hot water out in California. She's being sued for "civil fraud, conspiracy and breach of fiduciary duty" for an insurance deal she set up in 1999. She was the insured's financial advisor AND insurance salesperson, talk about conflict of interest. Check out the article, linked above, and you'll see what I mean.

It's not all negative though. This provides an important lesson to those purchasing insurance plans. The fancy brochure used to sell this policy said one thing and the fine print said another - typical stuff. The sales people don't even know what they're selling. Always make sure to read your policy thoroughly, especially the fine print, and if need be, get an attorney to help you do so.

More Praise for Robbery Without a Gun, Why Your Employer's Long-Term Disability Policy May be a Sham

North Carolina personal injury attorney Brent Adams has this to say about Robbery Without a Gun, my popular book which exposes the disability insurance companies' tricks:

At first blush, you may feel the title is outrageous.  However, upon reading the book, you will realize that Glass has probably understated the mass deception that results from employers and insurance companies “stealing” hundreds of millions of dollars each year in disability insurance benefits which should have gone into the pockets of disabled employees and their families.

You can read more about what Brent Adams said about Robbery Without a Gun here.

The Insurance Company Will Spy on You--You can bet your money on it

Nancy Cavey has a great discussion about disability insurance companies spying on you and videotaping your activities. There are some real clues to know when this will happen and Nancy discusses this here.

Should You Buy an Individual Disability Insurance Policy or Just go With the One the Employer Offers

I get this question all the time. Is my employer's disability insurance plan "good enough" or should I buy one of those individual policies?

The answer is that if you want any real coverage, and can afford it, get an individual policy. Most group policies are virtually worthless.

There's a couple of financial writers who commented on this recently. You can see my response to their article as well.

Disability Insurance Lawsuits on the Rise

If the activity in our office is any reflection of what's going on nationally, the disability insurance companies seem to be ratcheting up the screws recently. We've seen everything from sudden terminations of long-running claims to companies denying claims without any appropriate medical review (or anything close). Video surveillance seems to be on the increase as well.

I explain the rip off of group disability insurance policies issued through employers and governed by ERISA in my book, Robbery Without a Gun, Why Your Employer's Long-Term Disability Insurance Policy May be a Sham.. A major individual disability insurance company (i.e. they don't sell these crappy, worthless group policies) just placed a major order for my book (probably to give to its sales agents.)

Federal Jury Finds Unum Guilty of Fraud in Forcing Claimants to File for Social Security

Insurance companies routinely require disability claimants to apply for social security benefits, even though they know that the vast majority won't qualify.

Now, a federal jury has found Unum guilty of fraud in some cases where Unum has required the claimant to go through this time and energy wasting process.

The story in today's New York Times is here.

Nancy Cavey: What if the disability adjuster wants to pay you a visit?

Tampa long term disability attorney  Nancy Cavey has an excelent post over at her website about what to do when the disability insurance attorney wants to come pay you a visit. As Nancy points out, this is almost never good news.

Beware, this "friendly visit" probably means that they already have you on video. These companies are tricky.

Nancy Cavey is the best long term disability attorney in Florida. Read her post here.

ALLSUP and Prudential Insurance Company, What's the Deal?

Here's an example of how one might approach the issue of the disability insurance company referring the client to ALLSUP to pursue Social Security Benefits and then denying the disability insurance claim.

Court rejects MetLife Fibroymyalgia Denial and Rips Jeff Lieberman, MD Opinion

Anyone who's ever had a disability claim based on fibromyalgia should read this opinion from a court taking MetLife to task. The court shreds the paper review done by Jeffrey Lieberman, MD (rheumatologist.)

What does "abuse of discretion" mean for a disability claimant?

When employers allow insurance companies to put a "we have discretion to determine" benefits clause in a group long term disability policy, they are doing their employees a grave disservice. Only crappy disability plans have this language, which tilts the playing field mightily in favor of the insurance company.

You can read more about what "abuse of discretion" means for disability claimants here.

Myths You Hear about ERISA long term disability claims

If you are thinking about filing for disability under your employer's long term disability insurance policy, you are bound to get some "advice."

Beware.

Some of that advice can sink your claim.

Read about ERISA disability insurance myths here.

Get your own copy of Robbery Without a Gun here.

New Disability Website Launched

We launched a new disability website to promote our new book, Robbery Without a Gun, Why Your Employer's Long-Term Disability Insurance Plan may be a Sham.

Huge Loss for Prudential Ins. Co In ERISA disability case

The Fourth Circuit Court of Appeals dealt a huge blow to Prudential Insurance Company of America yesterday in an ERISA long-term disability case.

The case is Patricia Woods vs. Prudential Insurance Company of America.

The big issue in these cases is whether a federal judge and look at a claim denial "all over again" or whether he has to grant deference to the insurance company denying the claim.

In order to grant deference, the disability plan must have certain magic language in it "granting discretion."

The Court of Appeals ruled that standard language that Prudential uses in its plans does not grant discretion and that claims must be reviewed de novo.

This could effect thousands of Prudential group long term disability insurance policies and is a major victory for claimants.

Attorney Ben Glass is the author or Robbery Without a Gun, Why Your Employer's Long-Term Disability Policy May be a Sham.

Another Sc**w Job By a Disability Insurance Compamy

Some of the major disability insurance carriers will stop at nothing to keep sticking it to claimants.

Its tax time and the insurance companies are sending 1099's to those with whom it entered settlements last year.

At least one company is telling the IRS, via the 1099's that the settlements are taxable benefits, even if the benefit itself was not taxable! If you are getting disability benefits and you paid the premium for the policy, then any benefit you get is non-taxable. That's straight up federal tax law.

A major company is taking the position that "yes, you are right but since this is a settlement we are going to report it to the IRS as taxable."

Pure, outright fraud on the part of this company. The disabled insured is left paying more attorney and CPA bills to straighten out the mess...all because this major insurance company is either stupid as all get out or mean as the devil.

Take your pick. I've seen them both!

Virginia Supreme Court Rules Against Parents in "Wrongful Birth" Case

The Virginia Supreme Court has reversed a $4,000,000 verdict awarded by a Fairfax Circuit Court jury several years ago in a case involving "wrongful birth."

Julie and Joseph Granata had alleged that Jan Paul Fruiterman, M.D. and Eleni Solos-Kountouris, M.D. had failed to advise them about the availability of chorionic villus sampling (CVS) which would likely have disclosed that the Granata's twins were afflicted with Down syndrome. The Granata's alleged that had the testing been offered and performed, they would have known about the Down syndrome and terminated both pregnancies.

The Supreme Court ruled however, that there was no evidence in this case that had CVS testing been done that it would have been positive (and required no further testing by amniocentesis, which Mrs. Granata had testified she did not want).

The Supreme Court also ruled that Mr. Granata was not a "patient" of the doctors. A jury had previously awarded Mr. Granata $500,000 in addition to the $4,000,000 verdict.

Nursing Home Patient Walks from Home and Dies

Maryland medical malpractice attorney Sharon Christie has a sad story at her website about a nursing home patient who walked away from the place that was supposed to protect her and died.

This is not supposed to happen. When an individual (or their family) places a loved one in the care of a nursing home, you should be able to rest easy at night, knowing the individual is safe and secure.

Sharon Christie is one of Maryland's premier medical malpractice attorneys, in my opinion. She is the author of several books. If you are contemplating filing a medical malpractice claim, particularly against a nursing home, contact Sharon Christie and get her book.

But, Ben, the doctor's done this before!

Some folks believe that their malpractice case will be easier because they've found that their doctor has been in trouble before.

Unfortunately, in most cases, evidence of alleged prior "bad acts" won't help in YOUR malpractice case.

This case from the Supreme Court of Virginia explains things:

Personal Injury and Medical Malpractice: What's the Difference?

Some folks are confused about the difference between a personal injury attorney and a medical malpractice attorney. Some are confused by lawyer ads which make it seem like every personal injury attorney can handle a medical malpractice case. I discuss the difference here.

Roanoke Times Editorial Critical of Virginia's Silly "Cap"

The Roanoke Times has a terrific editorial that clearly demonstrates all of the reasons why, in 2008, Virginia's"cap" on medical malpractice damages remains downright harmful to the most seriously injured in Virginia. There is no malpracice crisis in Virginia and never has been.

Here's the article on the Virginia Medical Malpractice Cap

Board of Medicine Acts Against Two Doctors

For the first time in 20 years, two doctors who gained immunity from suit in catastrophic birth-injury cases have been administratively punished by the medical board of the state of Virginia.

I recent hearings, two obstetricians, Dr. Evelyn Anna Ruelaz of Fairfax County and Dr. Regina Burton of Woodbridge, received formal reprimands for the handling of births which resulted in devastating, lifelong personal injuries to infants while they were being delivered.
The reprimands go on the permanent record of a doctor and appear on his or her public profile at www.vahealthprovider.com/search.asp. No monetary penalties come from the reprimands and they have no effect upon a doctor’s ability to practice.

The sanctions reflect a tougher scrutiny of cases of injury during birth. The threshold for punishment was reduced by changes in 2003, which was after both incidents occurred.
A total of 209 sanctions were issued in the year 2006 by the board among 34,813 holders of Virginia medical licenses. However, until these cases, no sanctions had ever been made in birth-act generated cases.

Lee Ann Hershberger related to a medical board panel how her son was born, unable to ever care for himself after she was left unattended for long periods of time by Ruelaz.
According to records, for hours Hershberger labored alone at Inova Fair Oaks Hospital as the heart rate of her baby slowed and oxygen was shut off to him in utero due to multiple medical complications.

Her son is now age 4 and requires 24-hour care because of cerebral palsy, no coordinated use of his limbs, and inability to speak.