that\’s an interesting charge; carriers commit more fraud than gets committed against the carriers.
Please share the source of your state with us Jim. I\’m just one claims guy, but in 16+ years I\’ve not cheated a single insured or claimant. Since most claims are decided at the claim adjuster level, you obviously do not think much of adjuster/representatives. I do look forward to your data/stats/proof. Thanks.
This case is the proof. This and the hundreds of cases just like it. Like the Hurricane Katrina / Rita claims; like the recent class action verdict against AmFam for screwing people on substandard car parts; like the class action against Farmers for using Collossus to undervalue uninsured motorist claims; like the use of collossus by all the major insurance companies to undervalue bodily injury auto claims. Like Allstates policy of denying all but the most undeniable claims. Like the way every insurance company rarely pays fair market value for a totaled auto. I don\’t doubt that you feel you pay a fair value on the claim because what is fair is what the insurance company execs tell you is fair. When one get to define reality, one gets to define fairness. That\’s what the jury system is all about. The insurance execs can buy the politicians who appoint the judges or they can buy the judges themselves- Illinois- but they can\’t buy the jurors. They have mounted a massive misinformation campaign to get people like those who\’ve commented here, jurors, to believe the problem is fraud committed by the injured. But, surely you\’ll dismiss all this as nonsense. That\’s what adjusters have been trained to do. Notice the quality of the adjusters has gone down lately??
The original WC decision was can be found on the Iowa Worker\’s compensation commission website under \”decisions\”. Look under 2003 decisions for Zimmer v. Norwest Financial. The decision is 17 pages long and gives a pretty good explanation as to why the WC claim was found compensable. Plaintiff had had a long pre-existing history of back pain, so it is understandable that the claim was challenged. Two dates of injury were alleged, one was time-barred by the statute of limitations, but the plaintiffs were allowed to proceed.
The defense appears to have made a fundamental error by failing to offer any medical evidence to dispute either causation or nature and extent. There is certainly no mention of any contrary evidence in the decision. Plaintiff was awarded permanent total disability benefits.
The theory under which they were able to pursue the bad faith claim is still unclear, however.
This case no more proves insurers are out to screw insureds than the OJ jury proved OJ to be innocent; give me a break.
You may not like the evaluation tools the insurers use, two you mention are Colossus and I assume CCC, but you still did not tell me why they are in error and you are right.
Same goes for \’inferior parts\’. Most aftermarket parts are warranted longer than oem; that suit is nothing more than GM, Ford, et al trying to keep their market share in parts sales. Not all parts should be left to aftermarket, but to pretend they are all evil misses the point. Many companies allow you to pay add\’l premium if you want only new original manufactured parts.
We\’ve all seen misjustice; just pointing to a case where a jury agrees with you doesn\’t make you right. It may make you feel better, but not right. And no, I find the quality of adjuster I work around to be much higher than it was 15 years ago. Maybe you\’re with the wrong company, Jim. Or are you even in the industry? You don\’t seem to like it much? You could be a disgruntled chiropractor or auto repairman?
Like I said. When you define the universe, you define what\’s fair. The fact that collossus is used without the insurance companies telling ANYONE what it uses to evaluate a claim is paradigmatic of the inequity. You\’re right- you can look at one case and say that doesn\’t prove a point. You can conversely look at thousands of cases and determine the point has been proven. (And civil vs. criminal cases are apples and oranges.) Allstate, StateFarm, AmFam and the Zurich owned companies are some of the greatest offenders.
HA! Who says that there is all this fraud? The insurance companies? Of course. BUT….. what they don\’t tell you is that it\’s less then 1%. That\’s right and a fact. That there is less then 1% fraud.
Funny how no one will tell you how many injured workers have been horribly abused by the WC system. Many have committed suiside becasue of the stress and pain. You don\’t hear that in the news. You don\’t hear about injured workers that have lost everything because of WC. Many have been seriously damaged because WC denies, won\’t do what is court ordered, falsify reports….. the list goes on.
If the day ever comes that you are subjected to a WC claim (which I hope never happens) you will see the real truth of the system.
You my friend here rumors, you don\’t hear the truth. Seek out some of these injured workers and listen to there stories. They are NEVER good. I myself wish I was never involved with WC. It\’s the IC that are fraudulant!!!
The WC system has more rights then an injured worker. An injured worker has no recourse when they have been done wrong by them. Where as, the insurance company can abuse the injured worker to there hearts content.
WC is there to make money. They don\’t care about anything else and they don\’t care how they make or keep there money. No matter who they hurt.
If injured workers and I\’m not talking about those with a sprain or strain. These are hard working individuals that have serious injuries. Had the right to sue then the system it would seriously changed for the better. Instead, politians, doctors, lawyers…. all the way down the line have there hands out for a pay out from WC. Mind you not ALL these people are paid off by WC but the majority are.
Jim…… gotta love ya. You see, you\’ve been there or know someone who has. It\’s obvious that bubba hasn\’t a clue. Many hear rumors of fraud. NEVER do you hear of the real cases.
When you have to go to court with all the medical proof you have needing surgery, or any medical treatment and denied treatment something is wrong. When all your doctors agree that this should be done and an adjuster who hasn\’t a clue denies it there is something wrong. When you go through, in 1 year, 6 adjusters…. something is wrong. When the insurance company constantly passes the buck to someone else to ignore your problem, something is wrong.
It\’s obvious that most people that are bad mouthing the IW have never been throught the WC hell. I\’ve never known anyone that planned on being on WC. I\’ve never met anyone either that wanted to get hurt on the job on purpose. Trust me, living disabled and suffering in terrible pain is not what I call \”quality living\”. I and many others would trade there position from being on WC to working there job.
I\’ve talked to doctors, I\’ve talked with attornys, I\’ve talk everyone you can think of and they know a false case when they see one. They don\’t get the treatment they are looking for. It\’s the ones that need the treatment that get denied because the INSURANCE companies don\’t want to pay out! It\’s that simple. Insurance companies or WC should become a bank instead. NOT play with peoples lives.
If I got the treatment I needed I would have been back to work years ago. Instead, WC decides to drag it out NOT the IW. Trust me. The insurance company could save themselves probably millions if they just let the IW get better.
jewel, their is a lot you don\’t know about this system. It\’s not all the adjusters. I would imagine it\’s most of them though. It\’s not only adjusters doing this.
Believe it or not…. WC hires out other companies to hurt the IW as well. Voc Rehab for instance. They are hired to get the IW back to work and off WC. They make false reports, the interfere with medical treatment when they are to stay away from all medical. It\’s doctors that are hired by WC to make a 15 minute diagnoses that there is nothing wrong with you when you already have 5 doctors documentation telling you otherwise.
Dear, there are no jumping to conclusions. It\’s the insurance way. Something has to be done to make the insurance companies responsible for there actions. Strange how the insurance companies are so well protected but the IW worker isn\’t. Why is that??? Don\’t tell me fraud either. That\’s not the case. It\’s all about money. The injured worker is not in it for the money. That\’s what you have to understand. They are in it to get better!
If ONLY word could get out to the public how bad WC treats IW\’s only then will things change. Problem is??? The industry, the politians, the networks everyone is afraid of the insurance companies because they are all connected. Will a network want to loose a sponsor? I don\’t think so. Willa politian want to loose his/her support money? Heck no.
Chad, sounds like you work for an insurance company. Nope, gotta disagree with you about the so called \”low life people\” that are committing fraud.
That kind of explains the type of person you are. It\’s obvious you\’ve never been there and lets hope you never are. Only then you would change your name calling to something else.
I don\’t consider myself as fraudulant let a lone a low life. Understand… those who make false claims are found out right off the bat. You have to fight to hard to get the medical treatment that is needed and have a lot of proof for it.
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that\’s an interesting charge; carriers commit more fraud than gets committed against the carriers.
Please share the source of your state with us Jim. I\’m just one claims guy, but in 16+ years I\’ve not cheated a single insured or claimant. Since most claims are decided at the claim adjuster level, you obviously do not think much of adjuster/representatives. I do look forward to your data/stats/proof. Thanks.
This case is the proof. This and the hundreds of cases just like it. Like the Hurricane Katrina / Rita claims; like the recent class action verdict against AmFam for screwing people on substandard car parts; like the class action against Farmers for using Collossus to undervalue uninsured motorist claims; like the use of collossus by all the major insurance companies to undervalue bodily injury auto claims. Like Allstates policy of denying all but the most undeniable claims. Like the way every insurance company rarely pays fair market value for a totaled auto. I don\’t doubt that you feel you pay a fair value on the claim because what is fair is what the insurance company execs tell you is fair. When one get to define reality, one gets to define fairness. That\’s what the jury system is all about. The insurance execs can buy the politicians who appoint the judges or they can buy the judges themselves- Illinois- but they can\’t buy the jurors. They have mounted a massive misinformation campaign to get people like those who\’ve commented here, jurors, to believe the problem is fraud committed by the injured. But, surely you\’ll dismiss all this as nonsense. That\’s what adjusters have been trained to do. Notice the quality of the adjusters has gone down lately??
The original WC decision was can be found on the Iowa Worker\’s compensation commission website under \”decisions\”. Look under 2003 decisions for Zimmer v. Norwest Financial. The decision is 17 pages long and gives a pretty good explanation as to why the WC claim was found compensable. Plaintiff had had a long pre-existing history of back pain, so it is understandable that the claim was challenged. Two dates of injury were alleged, one was time-barred by the statute of limitations, but the plaintiffs were allowed to proceed.
The defense appears to have made a fundamental error by failing to offer any medical evidence to dispute either causation or nature and extent. There is certainly no mention of any contrary evidence in the decision. Plaintiff was awarded permanent total disability benefits.
The theory under which they were able to pursue the bad faith claim is still unclear, however.
This case no more proves insurers are out to screw insureds than the OJ jury proved OJ to be innocent; give me a break.
You may not like the evaluation tools the insurers use, two you mention are Colossus and I assume CCC, but you still did not tell me why they are in error and you are right.
Same goes for \’inferior parts\’. Most aftermarket parts are warranted longer than oem; that suit is nothing more than GM, Ford, et al trying to keep their market share in parts sales. Not all parts should be left to aftermarket, but to pretend they are all evil misses the point. Many companies allow you to pay add\’l premium if you want only new original manufactured parts.
We\’ve all seen misjustice; just pointing to a case where a jury agrees with you doesn\’t make you right. It may make you feel better, but not right. And no, I find the quality of adjuster I work around to be much higher than it was 15 years ago. Maybe you\’re with the wrong company, Jim. Or are you even in the industry? You don\’t seem to like it much? You could be a disgruntled chiropractor or auto repairman?
Like I said. When you define the universe, you define what\’s fair. The fact that collossus is used without the insurance companies telling ANYONE what it uses to evaluate a claim is paradigmatic of the inequity. You\’re right- you can look at one case and say that doesn\’t prove a point. You can conversely look at thousands of cases and determine the point has been proven. (And civil vs. criminal cases are apples and oranges.) Allstate, StateFarm, AmFam and the Zurich owned companies are some of the greatest offenders.
HA! Who says that there is all this fraud? The insurance companies? Of course. BUT….. what they don\’t tell you is that it\’s less then 1%. That\’s right and a fact. That there is less then 1% fraud.
Funny how no one will tell you how many injured workers have been horribly abused by the WC system. Many have committed suiside becasue of the stress and pain. You don\’t hear that in the news. You don\’t hear about injured workers that have lost everything because of WC. Many have been seriously damaged because WC denies, won\’t do what is court ordered, falsify reports….. the list goes on.
If the day ever comes that you are subjected to a WC claim (which I hope never happens) you will see the real truth of the system.
You my friend here rumors, you don\’t hear the truth. Seek out some of these injured workers and listen to there stories. They are NEVER good. I myself wish I was never involved with WC. It\’s the IC that are fraudulant!!!
The WC system has more rights then an injured worker. An injured worker has no recourse when they have been done wrong by them. Where as, the insurance company can abuse the injured worker to there hearts content.
WC is there to make money. They don\’t care about anything else and they don\’t care how they make or keep there money. No matter who they hurt.
If injured workers and I\’m not talking about those with a sprain or strain. These are hard working individuals that have serious injuries. Had the right to sue then the system it would seriously changed for the better. Instead, politians, doctors, lawyers…. all the way down the line have there hands out for a pay out from WC. Mind you not ALL these people are paid off by WC but the majority are.
WC is no picnic to be on. It is a living hell!
Out of all the posters here, how many of you have been on workers comp?
How many of you have had a serious injury?
Jim…… gotta love ya. You see, you\’ve been there or know someone who has. It\’s obvious that bubba hasn\’t a clue. Many hear rumors of fraud. NEVER do you hear of the real cases.
When you have to go to court with all the medical proof you have needing surgery, or any medical treatment and denied treatment something is wrong. When all your doctors agree that this should be done and an adjuster who hasn\’t a clue denies it there is something wrong. When you go through, in 1 year, 6 adjusters…. something is wrong. When the insurance company constantly passes the buck to someone else to ignore your problem, something is wrong.
It\’s obvious that most people that are bad mouthing the IW have never been throught the WC hell. I\’ve never known anyone that planned on being on WC. I\’ve never met anyone either that wanted to get hurt on the job on purpose. Trust me, living disabled and suffering in terrible pain is not what I call \”quality living\”. I and many others would trade there position from being on WC to working there job.
I\’ve talked to doctors, I\’ve talked with attornys, I\’ve talk everyone you can think of and they know a false case when they see one. They don\’t get the treatment they are looking for. It\’s the ones that need the treatment that get denied because the INSURANCE companies don\’t want to pay out! It\’s that simple. Insurance companies or WC should become a bank instead. NOT play with peoples lives.
If I got the treatment I needed I would have been back to work years ago. Instead, WC decides to drag it out NOT the IW. Trust me. The insurance company could save themselves probably millions if they just let the IW get better.
jewel, their is a lot you don\’t know about this system. It\’s not all the adjusters. I would imagine it\’s most of them though. It\’s not only adjusters doing this.
Believe it or not…. WC hires out other companies to hurt the IW as well. Voc Rehab for instance. They are hired to get the IW back to work and off WC. They make false reports, the interfere with medical treatment when they are to stay away from all medical. It\’s doctors that are hired by WC to make a 15 minute diagnoses that there is nothing wrong with you when you already have 5 doctors documentation telling you otherwise.
Dear, there are no jumping to conclusions. It\’s the insurance way. Something has to be done to make the insurance companies responsible for there actions. Strange how the insurance companies are so well protected but the IW worker isn\’t. Why is that??? Don\’t tell me fraud either. That\’s not the case. It\’s all about money. The injured worker is not in it for the money. That\’s what you have to understand. They are in it to get better!
If ONLY word could get out to the public how bad WC treats IW\’s only then will things change. Problem is??? The industry, the politians, the networks everyone is afraid of the insurance companies because they are all connected. Will a network want to loose a sponsor? I don\’t think so. Willa politian want to loose his/her support money? Heck no.
Chad, sounds like you work for an insurance company. Nope, gotta disagree with you about the so called \”low life people\” that are committing fraud.
That kind of explains the type of person you are. It\’s obvious you\’ve never been there and lets hope you never are. Only then you would change your name calling to something else.
I don\’t consider myself as fraudulant let a lone a low life. Understand… those who make false claims are found out right off the bat. You have to fight to hard to get the medical treatment that is needed and have a lot of proof for it.