Insurance Firms

Re "Quake Victims Denounce Insurers," Oct. 8: Insurance companies are neither benevolent societies nor our "good neighbors." They are businesses whose purpose is to sell products and make money doing so. Their products are not simple, unfortunately. They often come with endless and complicated conditions--exclusions, claims procedures, deadlines and more exclusions. If one's insurance claim is rejected because he failed to meet a basic, 12-month deadline, then he learns a sad and costly lesson.

NEW YORK - As Bank of America Corp. pulls itself free from a swamp of mortgage liabilities, new troubles keep threatening to suck it back under. BofA agreed to settle a big insurer's claims over faulty mortgage bonds for $1.7 billion Monday. But it found itself threatened with new legal action for failing to abide by a landmark settlement aimed at saving homeowners from foreclosure. The Charlotte, N.C., bank said it would settle a lawsuit dating from the financial crisis with mortgage insurance specialist MBIA Inc. The insurer had been pressing BofA for more than $5 billion in damages.

The state of California is likely to receive tens of millions of dollars more from insurance companies to clean up the Stringfellow Acid Pits toxic waste dump as a result of a ruling Thursday by the California Supreme Court. In a unanimous decision, the high court said consecutive insurance policies by various companies required each to pay up to their policy limits for damage caused by the Riverside County waste site. The companies wanted to restrict liability to just a share of the damage that occurred during the time each insurer's policy was in effect.

The state of California is likely to receive tens of millions of dollars more from insurance companies to clean up the Stringfellow Acid Pits toxic waste dump as a result of a ruling Thursday by the California Supreme Court. In a unanimous decision, the high court said consecutive insurance policies by various companies required each to pay up to their policy limits for damage caused by the Riverside County waste site. The companies wanted to restrict liability to just a share of the damage that occurred during the time each insurer's policy was in effect.

Re "How an overhaul might affect you," July 27 Sadly, this "clarification" of healthcare plans in the works describes perfectly an obstacle course that simply doesn't have to be. What ought to be a straight shot from Point A to Point B -- everyone kicks in according to how much they benefit from living and working in this great country, and all have coverage no matter what illness or injury befalls them -- is being turned into the same kind of...

The state filed suit against the firms that sold Baldwin-United annuities in Georgia between 1981 and 1983. The suit, filed in Fulton County Superior Court under the state's Racketeer Influenced and Corrupt Organizations statute, seeks the forfeiture of about $2.25 million in commissions earned by the firms on sales to Georgia residents. Before it filed for bankruptcy protection in 1983, Baldwin-United was one of the nation's leading marketers of single-premium deferred annuities.

A dentist was charged in federal court Wednesday with a fraudulent billing scheme in which insurance companies paid out tens of thousands of dollars for services never performed. To avoid detection, federal prosecutors said, Julie Valentine used a mail drop to receive letters from the insurance companies to her patients seeking verification of services. She also was accused of "upcoding"--billing for procedures that were more expensive than those actually performed.

A Beverly Hills doctor accused of submitting false insurance claims on behalf of patients given nose jobs, tummy tucks and other cosmetic surgeries pleaded guilty in federal court Monday to mail fraud. Alvin Reiter, 55, was one of five cosmetic surgeons charged this month for billing insurance companies for procedures not covered by patients' health plans. "We hope these cases serve as a wake-up call to cosmetic surgeons" said Assistant U.S. Atty. Jack Weiss.

Two insurance companies have agreed to pay Westminster $4 million to replace a water tank that ruptured last fall, injuring six people and causing millions of dollars of property damage. "This is a major step of forward," City Manager Don Vestal said. "The demolition of the tank a couple of weeks ago was a significant milestone. This settlement is another." The water tank on Hefley Square burst Sept. 21, unleashing 5 million gallons of water and leaving more than 30 families homeless.

Is a punk concert really a punk concert without a roiling mosh pit and daredevil body surfing and stage diving? Punk bands and fans of the resurgent, aggressive style may have to find out in the not-too-distant future. A growing stream of lawsuits concerning mosh-related injuries is leading insurance companies to crack the whip--and raise their rates--on vulnerable promoters and performers. Last year, at least two fans were paralyzed due to mosh-related injuries at U.S.

When I was a lad, I suffered from asthma. And on more than one occasion, the doctor in my small town made a trip to our house - usually in the evening - to treat me. No, really. Healthcare in the U.S. has come a long way since then - and not necessarily in a good way. Take Wednesday's story in The Times: "[S]ome healthcare companies are starting to shift clinical services and decision-making on medical care overseas, primarily to India and the Philippines. " Yikes!

After years of shipping data-processing, accounting and other back-office work abroad, some healthcare companies are starting to shift clinical services and decision-making on medical care overseas, primarily to India and the Philippines. Some of the jobs being sent abroad include so-called pre-service nursing, in which nurses at insurance firms, for example, help assess patient needs and determine treatment methods. Outsourcing such tasks goes beyond earlier steps by healthcare firms to farm out reading of X-rays and other diagnostic tests to health professionals overseas.

A major health insurance company has settled an enforcement action with state regulators over providing special therapy for autism patients. California Insurance Commissioner Dave Jones on Tuesday said that Blue Shield of California Life & Health Insurance Co. agreed to immediately cover the cost of applied behavior analysis therapy, which Jones described as a well-recognized and effective treatment. The settlement with the Insurance Department stems from a dispute that began in July when Jones filed an enforcement action against Blue Shield.

The federal investigator took the witness stand and described the crime scene: a sprawling field clogged with boulders, native grasses and knee-high sagebrush. The defendant, a California farmer, had said the site was a 200-acre wheat field. But the investigator found no tilled soil, no tractors, no plows. In fact, she testified, she found no wheat. The field was just a field ? and a prime example, federal prosecutors allege, of a wave of agricultural insurance scams sprouting across the nation.

Nearly four years ago, state authorities forced out top-level officials at the government-run workers' compensation insurance firm, revamped the operation and launched a criminal investigation into reports of conflicts of interest, self-dealing and misuse of as much as $1billion. Today, that probe involving the State Compensation Insurance Fund continues in silence as prosecutors face possible statutes of limitations that would bar some criminal charges and civil lawsuits. The last publicly known activity occurred 18 months ago, when a search warrant was issued on a former board member in Redding, about 150 miles north of Sacramento.

Farmers Group Inc., a Los Angeles-based insurance management firm, and its Swiss corporate parent Thursday agreed to pay $455 million to 13 million current and former policyholders to settle a 2003 lawsuit that accused them of charging excessive fees to customers. The settlement, if approved by a Los Angeles County Superior Court judge, would resolve all claims dating back to 1999. Payments to people who purchased Farmers home, automobile, personal liability and commercial property coverage are expected to average $35, but individual settlements could vary considerably, Farmers Group said.

The government of Taiwan will allow five U.S. insurance companies to set up branch offices in 1991, stiffening foreign competition in an already ferocious battle for market share, analysts said today. The Finance Ministry has approved applications by Time Insurance Co., American Security Insurance Co., New York Life Insurance & Annuity Co., John Hancock Variable Life Insurance Co. and Manufacturers Life Insurance Co. of America, officials said. The approvals bring to 20 the number of U.S.

The dispute arose over coverage for claims against the company for asbestos-related health problems. GAF had sued the insurers in California state court in 1979, claiming they were required to provide coverage in all present and future asbestos cases filed against the company. The company did not disclose the amount of the settlement, reached with Insurance Co. of North America, a unit of Cigna Corp.

Ending the Democrats' decades-long quest to create a healthcare safety net to match Social Security, the House of Representatives on Sunday night approved sweeping legislation to guarantee Americans access to medical care for the first time, delivering President Obama the biggest victory of his young presidency. The bill, which passed 219 to 212 without a single Republican vote, would make a nearly $1-trillion commitment in taxpayer money over the next decade to help an estimated 32 million uninsured Americans get health coverage.

Insurance giant Anthem Blue Cross refused to pay for a California produce merchant to get a liver transplant in Indiana because the company wanted to save money, a lawyer for the patient told jurors Monday. But a lawyer for the state's largest for-profit insurer argued that the patient, Ephram Nehme, was not sick enough to qualify for an exception to his policy's requirement that transplants be performed in Blue Cross-contracted hospitals in California. The high-profile trial is expected to shed light on how Anthem Blue Cross, which covers about 8 million Californians, decides what medical care to cover -- and what to deny.