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Eric Turkewitz, The Turkewitz Law Firm, New York, NY |
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Monday, March 26, 2007Conseco Insurance Scandal Follows Movie Plot As I read the front page story in today's New York Times on insurance companies that deny, deny, deny -- waiting for the policy holder to either give up or die -- I was reminded of a movie. The NYT focuses primarily on insurance giant Conseco continually denying claims for benefits based on long-term-care policies.From the article: In lawsuits, complaints and interviews, policyholders contend that Conseco, Bankers Life or Penn Treaty denied claims because policyholders failed to submit unimportant paperwork; because daily nursing notes did not detail minute procedures; because policyholders filled out the wrong forms after receiving them from the insurance companies; and because facilities were deemed inappropriate even though they were licensed by state regulators...Where have we seen this scene before? In Francis Ford Coppola's rendition of The Rainmaker (book by John Grisham), Matt Damon and Danny De Vito go to trial against an insurance company whose first, second and third courses of action are to deny a claim, hoping the people will give up. This is, apparently, very good for insurance company profits. Perhaps Conseco took tips from the book or movie on how to run its business. This is the movie version: Witness (reading): Great Benefit, July 7, 1996. Re: 7849909886. Dear Mrs. Black. On seven prior occasions this company has denied your claim in writing. We now deny it for the eighth and final time. You must be stupid stupid stupid. Sincerely, Evert Luftkin, Vice President, Claims Department.And this is the real-life version from the article: Conseco and Bankers Life [a subsidiary] "made it so hard to make a claim that people either died or gave up," said Betty J. Hobel, a former Bankers Life agent in Cedar Rapids, Iowa.The executives at Conseco must be very big film or pop literature fans to have followed the Grisham script so closely. It almost makes one wonder if they can be sued not only for benefits, breech of contract and bad faith, but on intellectual property grounds. Conseco now joins the ranks of State Farm (State Farm to Pay Punitive Damages. Again.), Allstate (Is Allstate really Allsnake?), and Blue Cross of California (Insurer Fined for Dropping the Sick and the Pregnant) who have been exposed this year for improperly denying coverage or claims. And it's only March. (Eric Turkewitz is a personal injury attorney in New York) Labels: Insurance Industry
Comments:
My parents purchased LTC insurance from Penn Treaty in 1997 with premium waiver benefit for the surviving spouse. (if one spouse dies, the surviving spouse does not pay any more premiums for the rest of his/her life.)
My mother passed away on May 5, 2007 and Penn Treaty is trying to deny my father the surviving spouse benefit, on the grounds the insurance policies are not exactly identical. The insurance agent talked them into purchasing policies that pay a maximum of $90 per day benefits on my mother, and $80 per day for my father. Other than that, the policies are identical, with identical plan numbers, and both policies state the surviving spouse premium waiver benefit is included. The insurance policy states that they must be the same policies, but it does not say that they must be identical. The agent never explained at the time that this would disqualify them for the surviving spouse benefit. It was clear in all of our minds at the time of purchase that we were getting that benefit. We are going thru an appeal with Penn Treaty right now, but are not sanguine about the potential outcome in our favor. We have consulted a lawyer, and he recommends that we try to find others who may have had this same run-around with Penn Treaty. Do you have any ideas how we might do this, or can you post a blog for us? Alma Megeath 2140 Rolling Hills Drive Morgan Hill, CA 95037
This sounds ominously familiar, only with Stonebridge LTC, now owned by Conseco. My parents bought policies in '93, and when he passed away we moved her to another state and placed her in a care facility (not a nursing home). The CSR at Conseco told me on the phone they did not pay for any facility except a nursing home.
After an injury and a hospital stay, she was moved to a nursing home and I read the policy, finding they indeed paid a portion of any care not considered a nursing home. She is due to move into a more appropriate facility, and her application for benefits has been in their hands since April 9. They will not return my calls, despite promising to "call me when they received the rest of the required paperwork" AND that they would "walk the application through". According to the policy, they require approval of benefits before moving into a facility, except in unavoidable circumstances. I consider their methods dishonest and obstructive, and I would like nothing better than to join a group dedicated to changing the paradigm at this corporation. Teresa Strube teresastrube@sprintmail.com
Is Conseco Life Insurance Co. really real or are they conning elderly people so they can scam them into anything. Even extra payments because they say they haven't received your payment. So the elderly would automatically pay if they say they haven't gotten there payment yet. Because that's what is happening to me. And I am not going to give up or am as stupid as they think. I will get a lawyer and I have all proof since I started with them on making my payments on time each month. Sick of Conseco trying to screw with my brain about they didn't get my payment. Ya right! My bank statements say YES THEY DID! ON TIME! So there scandel is not going to work on me. HA! HA!
I applied for a job with Bankers Conseco of New York in Buffalo and was told they are "not the same company that you are mentioning. I've googled the names and don't see any difference. Anyone know how to verify their claim?
My mother purchased a LTC insurnace policy over 20 years ago and when she reach 65 she took out another LTC policy to supploement the first so there would be no waiting period. She was so happy because she would not be a burden to her kids in her old age. She is now 85 and in a long term care. WE PUT THE CLAIM in May and this End of August and they re still delaying.Conseco is a master of delay. They make their living preying on the old and sick.This is the norma not just a one person problem. Insurance buyer beware!!
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