LegalMatch: Personal Injury

Rescinded: Bad Blue Cross Health Insurance Policies?

The LA Times reported last week on a major violation by the huge private health insurer, Blue Cross. (Or, as they’re now called in California, “Anthem Blue Cross”).

The California Blue Cross division is under fire for pre-planning rescissions. As I mentioned a few posts ago, rescissions are the heavy artillery behind insurance cancellation. They allow private insurers to find discrepancies in your original application (an abnormal PAP smear, for example) and swing on that “error” to retroactively deny you coverage. Their claim is that the omitted information would have altered their original decision to approve you for a plan, and in some cases it’s valid. But Anthem Blue Cross has apparently been taking this process a little too far—by planning their rescissions in advance.

Rocky Degadillo, an attorney for the city of Los Angeles, even went so far as to say that “countless Californians who believe they have insurance actually have policies that aren't worth the paper they're printed on” [1]. Not exactly a reassuring sentiment for policy-holders who have already dished out thousands in monthly payments.

Those with individual insurance, such as many self-employed or unemployed citizens, are being hit the hardest.

While the HIPAA (Health Insurance Portability and Accountability Act) makes it easier for people with pre-existing health conditions to get insurance through work, health protection for individuals remains subject to cancellations via rescission, outright denials for pre-existing conditions, and exorbitant premiums and monthly charges.

 

What can I do if my health insurance plan has been rescinded?

If your policy was rescinded and you believe that it was done so unfairly, you may still be able to get coverage. If you are in California, you should be also aware that past rescissions by Blue Cross are currently being reconsidered, which means that you could get retroactive reimbursement for surgeries, procedures, and other work done if you were uninsured because of a canceled policy.

Get in contact with a personal injury attorney and explain your situation.

A few minutes of discussion can give you a professional look at your options and allow you to make an educated approach to getting your health insurance back and your debt repaid.

by Kate Beall

"Slip and Fall" Fakers and Fraud Artists.

Faced with an episode of “America’s Funniest Home Videos,” someone unfamiliar with the States would probably conclude that we are a nation obsessed with infants, humorless voiceover, and serious personal injury.  But intentional personal injury—that’s a strange one.

Yet we see this kind of damage (or people faking it) all the time. We’re extremely familiar with the car-accident “victim” and his convenient case of whiplash, and we laugh about the shady stranger faking a dog bite wound.  But these aren’t just popular images from a syndicated sitcom. Occasionally, the insurance fraud artist becomes a feature in the very real, very modern news.

 

This “slip and fall” faker made the news last year after security cameras caught her pouring olive oil on a store’s tile floor. Returning later to “slip” on the pre-planned slick, the Florida woman made her cunning plan a little too obvious, and the store owner’s his $30,000 surveillance system caught the entire fraud on film. Unluckily for that woman, the film caught the internet by storm too.

Despite the glut of popular images about fake victims and insurance fraud criminals, dangerous property and building laws were put in place for a good reason: to protect. For property owners who don’t conform to the safety rules, the consequences can be serious. In this recent Texas case, over $75,000 is at stake because of a puddle of wax on a WalMart floor. Even a New York inmate is taking a stab at the pie with her case against the prison system, claiming that a “slip and fall” injury resulted from her shower-cleaning duties.

 

With so many cases to thumb through, how can we tell which ones are legit?

The legal system generally uses three criteria to determine whether a property owner is at fault:

1. The property owner caused the spill, worn or torn spot, or other slippery or dangerous surface or item;
2. The property owner knew of the dangerous condition but did nothing about it; or
3. The property owner should have known of the dangerous surface because a "reasonable" person taking care of the property would have discovered and removed or repaired it.

So, owners—keep your property in good repair, keep your customers safe, AND—

…consider installing a surveillance system.

by Kate Beall

iPhone Chemicals Violate California Law.

Apple took a hit today after testing by the Center for Environmental Health (CEH) showed excessive levels of phthalates in iPhone and iPod headphone cords.

Wired’s blog network quotes CEH director Michael Green as saying that “Apple customers should know that when they get their hands on an iPhone they may be getting a dose of toxic chemicals as well.” However, the CEH also claims that their beef is not with the levels of PVC in the products, but with Apple’s failure to label those thousands of iProducts with a warning.

 

You may be familiar with U.S. standards for food product labeling—but labeling products for potential hazards is a serious matter as well. This error of omission is actually considered to be a kind of product defect, more specifically referred to as a “warning defect.” Warning defects refer to products that do have sufficient warnings or instructions for use and which injure consumers. It is this law that explains the seemingly obvious warnings on irons (“Do not iron clothes while wearing”) and other products.

But does the iPod fall under the defective products label?

CEH intends to decide just that with their most recent legal push against Apple, which follows the Greenpeace condemnation of those same phthalates. 

If you are an iPod or iPhone user who is concerned about the detrimental effects of these chemical levels on your health, keep an eye on this case. While it’s unlikely that phthalates will negatively impact your health (as they will pose more of a risk to the environment itself when they are inevitably replaced or disposed of), you may have a chance to be involved in a defective products class action lawsuit.

by Kate Beall

Are you about to lose your health insurance?

Losing your health insurance is a terrifying experience.

After my most recent trip to the hospital, I started treating my mailbox like it was packed with venomous snakes. I’d pretend that I forgot to check it, or lie to myself about doing it tomorrow. And even when I did work up the guts to approach it, the key would tremble in my hand like a divining rod—shuddering in response to the bill I knew rested just beyond that small, rusty door. 

...And that was with insurance covering most of the costs.

But with over 47 million Americans lacking health insurance, how can we avoid being charged thousands of dollars for medical procedures, check-ups, and emergencies?

 

Know your rights as a health insurance holder. Review your policy and don’t choose your doctor arbitrarily, because whether you’re on a PPO or HMO plan, you must conform to the regulations set down by your insurance company. Familiarizing yourself with your health insurance policy will spare you a lot of time lost chasing approval for procedures, visits, and tests, and your wallet will feel a little healthier when you aren’t dishing out cash for out-of-network issues.

But what if you don’t have any insurance at all? Or what if your insurance policy gets canceled?

 

Cancellation of health insurance policies can be a serious issue—especially if you’re suffering from a chronic condition that needs regular or expensive treatment. And almost all cancellations occur when an insurance company decides that you have either omitted or misrepresented something in your initial insurance application. Forgetting to note something as minimal as childhood asthma could mean that when you get rectal cancer at 50, your provider might refuse to pay for it—simply because of a completely unrelated inaccuracy in your paperwork.

However, your insurance cannot be canceled arbitrarily, and some states prevent providers from canceling insurance if the insured individual has HIV, mental dementia, or a mental illness. Your provider is also unable to cancel your policy if your omission or misrepresentation is discovered after 2 years have passed since the date of your application.

If you feel that your insurance has been unfairly canceled, please contact a health insurance lawyer. You could save yourself thousands of dollars in medical bills that would otherwise be spent on uninsured procedures and medications.

By Kate Beall

If His Bite is Worse Than His Bark.

I’ve always been a little nervous around dogs. Big dogs, little dogs, sausage dogs, fat-faced dogs—if they snarl, jump up on me, or even bound toward me a little too quickly, I tense up like a rabbit in a snake cage. I grew up a few doors down from an aggressive white beast of a dog, and the adrenaline rush I got from dashing past that yard flares anew when I run into off-leash canines in the city.  But how irrational is this kind of phobia?

Most dogs are good natured, playful animals. They may smell a little or drool on the carpet, but they’re a far cry from the half-wolves and “dangerous” breeds that drive the presses. But as with any group, there are the bad apples—the dogs that bite and maul their way into sensationalist headlines.

One such case from Madison county recounts a dog bite case that led to a $50k settlement.  Victims like the woman in this case often file for a variety of reasons, as options for dog bite victims include suing the animal’s owner for medical treatment, loss of wages, torn clothes, damaged property, or emotional distress.

If you or your child have been the victim of a dog or animal attack, you should be aware of the statute of limitations for animal bites. You may have as little as six months to file your case before it becomes invalid, so it is in your best interest to contact a personal injury lawyer as soon as possible.

If you are the owner of a dog, it might be wise to check your local laws before letting Benji run loose in the yard. If you own a Rottweiler or Pit Bull, you should make an extra effort to familiarize yourself with local breed restrictions and dog laws. Be aware of your rights and responsibilities as a dog owner, and know what your options are if your dog bites someone. Even if there is no history of violent behavior with your animal, you can still be sued if your animal bites or attacks an innocent person (mail carriers included).

Remember—even though you may believe that your dog is harmless, strangers who are unfamiliar with your pet can find a strange dog intimidating or threatening. Please observe local leash laws and consider spaying or neutering your dog.  A "fixed" animal is statistically less like to engage in aggressive behavior.

Check out the ASPCA for information on low-cost spay and neuter options in your area.

 

by Kate Beall

You Found What in Your Soup?

We have all heard stories about family members, friends or colleagues finding something strange in their food.  You may even be one of the unlucky ones who fall into this category. Some of the stories I’ve heard: bugs, alive or dead; screws; glass; hair; and even a finger (okay, so we’ve all heard that one).

Can you really sue the manufacturer or restaurant in which the foreign object was found? This is everyone’s first question and the American Way.  Who do I sue first?  Unfortunately, in most circumstances your claim is worthless. Say you are opening a can of corn for your family for dinner. You pour out the can and in it lies a deceased cockroach. Pretty disgusting. You gag over the sink and throw out the can and swear that you will never eat canned corn again. You want to sue but for how much. You have been “emotionally damaged” by this bug in your corn but did you actually suffer monetary damages? In the above case, I would say no. You did not ingest the cockroach nor did you get sick from ingesting the cockroach. But what about emotional distress? I wish you luck with that cause of action. In most cases it is not worth the small claims filing fee. 

Your best bet is to call up the manufacturer and tell them what happened. They may send you vouchers for free food and maybe even a few coupons. This will compensate you for your losses (having to throw out the can of food). This is really all you are entitled to. Most want to sue for hundreds of thousands of dollars but in the end will probably not even receive coupons. 

I know what you are thinking. What about the finger in the chili?  I would say that is an extreme case and, since it was a hoax, almost never happens. My guess is the reason an attorney even looked at the case is that it was a human body part. Body parts contain fluids, blood etc. that may make you sick. And since it was such an extreme case one could argue emotional distress. A finger compared to a cockroach is a much different story. Had the woman in question contacted the same attorney complaining about a bug in her chili he/she would have never taken the case. It is really hard to say if she would have received a sizeable settlement or judgment. Remember, prior to her being arrested the claimant dropped her case. Maybe because it was a hoax or maybe because her attorney advised her that she had no case. 

Here’s the deal. I am in no way discouraging you from filing a lawsuit. But please be aware that unless you ate the foreign object and have medical expenses from doing so that you most likely will receive nothing for your claim. If you have been injured from ingesting a foreign object consult with an attorney to find out your legal rights. If there is any evidence be sure to preserve it and take plenty of pictures. Happy eating.

By Lisa Zanassi

The Teflon Con

Quite possibly one of the coolest kitchen inventions since the dishwasher.  A famous mobster bears the name.  What am I talking about?  TEFLON. It probably can be found on most, if not all, of our pots and pans and is what creates the stick-resistant surfaces we have come to know and love.

Well its time to stop cooking dinner and start over.  This time choose the pan that your mom gave you.  The one that is so hard to clean because everything sticks to it.  And you thought you kept it just for sentimental reasons. 

The Environmental Protection Agency (EPA) has identified perfluorooctanoic acid (PFOA), the chemical compound used to make Teflon, as a “likely carcinogen.”  Until now PFOA has been classified as a “suggested” carcinogen requiring fewer precautions.  Makers of Teflon are quick to point out that while PFOA is used to make their product, that it is not actually present in Teflon.  PFOA seems to be used to make many of our products including computer chips, phone cables and firefighting foam.  Despite DuPont’s strong defense of their product, a subpoena was served requesting documents about PFOA.

Yes.  I’m saying that many are worried that Teflon might cause cancer.  But don’t throw away anything just yet.  The EPA won’t draw conclusions that using products made with PFOA will cause cancer.  Instead it does point to studies in which animals were found to have four different types of tumors after having been exposed to PFOA.  Officials will now be required to conduct cancer-risk assessments for PFOA. 

What does DuPont have to say about all of this?  Their comments include the following:  “In the 40-plus year history of cookware coated with Teflon non-stick, there have been no reported cases of consumers contracting adverse health effects as a result of in-home normal cooking use.  There is no scientific basis to support claims that cookware coated with Teflon causes cancer.”  DuPont also says that PFOA is not in the Teflon coated pans because it is destroyed during the manufacturing process.  Despite these comments the EPA seems worried, as I guess we all should.  FYI: there are non stick coatings that do not contain PFOA.   

So what are we as consumers to do?  It seems that everything today causes some sort of health problems, especially cancer.  I would suggest waiting until the EPA makes a determination regarding PFOA and (in the meantime) use questionable products at your own risk.  They will conduct their cancer-risk assessment and then will inform consumers of their findings. 

If Teflon is found to cause cancer in humans and you believe you have been a victim of PFOA exposure you will want to speak to an attorney immediately to preserve your rights.

By Lisa Zanassi

Is It Really Worth the Risk?

I recently read about Viagra causing vision loss.  Can the impotence drugs you are taking cause you to go blind?  The FDA seems concerned and is not taking this possible side effect lightly and neither should you.

The FDA is currently in discussions with drug manufacturers of Viagra, Levitra, and Cialis to determine what those drug labels should say.  The maker of Cialis voluntarily added information warning of blindness to its label.  Currently all labels warn of temporary vision changes, among other side effects.

A condition called NAION (non-arteritic anterior ischemic optic neuropathy) is supposedly what is causing this vision loss.  There are currently 43 FDA reported cases of people suffering from NAION while taking impotence drugs.  Federal health officials as well as manufacturers are quick to point out that NAION can be linked to the same illnesses that cause impotence in the first place. 

Although NAION is one of the most common causes of sudden vision loss in older individuals, Dr. Howard Pomeranz of the University of Minnesota suggests there may be a connection between NAION and these impotence drugs.  In his ophthalmology journal it was reported that seven patients suffered from NAION within 36 hours of a Viagra dose.  More research will be needed to establish a definite causal relationship between the vision loss and the use of these drugs.  One thing is for certain: if you experience vision problems while taking any of these drugs consult your physician immediately.

Viagra is not alone in receiving problems from the FDA.  Other drugs/supplements that have been recalled, voluntarily taken off the market or required to include new warning information on their labels include COX-2 inhibitors such as Vioxx, Bextra and Celebrex, the supplement Ephedra and the weight loss drug Fen-Phen.  You can read more about these drugs at LegalCenter.  All but Celebrex has been pulled off the market because the risks of these drugs outweighed the benefits.  Merck & Co. is facing thousands of lawsuits related to the use of Vioxx and their liability may reach upwards of $18 billion.

Is it possible that drugs that are suppose to help us live normal lives may ultimately injure us beyond repair?  Remember that the warnings associated with your prescription are there to protect the drug companies from liability and inform users of the risks they are subjecting themselves to.  Most side effects are so rare that only a handful of users (out of millions) experience them.  Drug companies must list all potential side effects, no matter how rare, to avoid lawsuits based on their failure to warn users.

By

Lisa Zanassi

Welcome to the LegalMatch Personal Injury Law Blog!

Are you seeking legal advice or representation on a personal injury law-related issue? Perhaps you're an attorney who specializes in personal injury law? The LegalMatch Personal Injury Law Blog is the online source for relevant and informative articles and information.LegalMatch offers an authoritative and trustworthy voice on the issues of the day as they concern the legal industry and you as a consumer. Please note, the articles and information in this blog are for informative purposes only. Always consult the professional advice of a lawyer for your particular legal issue. Enjoy!

Ford Vehicle Fires.

Imagine being woken up by the sounds and smells of your house on fire.  This is an all too common story for many.  The cause of these fires… their beloved Ford vehicle parked in the garage.  It seems that there is a defective cruise-control switch found on many of these vehicles that is causing this devastation.

In March 2005 the National Highway Traffic Safety Administration (NHTSA) opened a second investigation focused on the cruise-control switch that may effect upwards of 3.7 million Ford vehicles.  The first investigation conducted by the NHTSA resulted in the recall of almost 800,000 vehicles in January 2005.  Ford has recalled more than 1 million vehicles through two separate recalls, the first in May 1999.  This may seem like a lot of vehicle recalls but in actuality industry estimates state that approximately 16 million vehicles have the same or similar switches installed in them. 

And what is Ford’s response to this?  A Ford spokesman stated, “We have not determined at this time that there is a defect with the switch, but for reasons we still do not understand the switch is failing…and we are trying to understand why.”  To those whose vehicles were recalled Ford sent this message, the “switch may overheat, smoke or burn which could result in an underhood fire.  This condition may occur either when the vehicle is parked or when it is being operated, even if the speed control is not in use.” 

Many of these fires result in only structural damages to the vehicle and surrounding property (homes, other vehicles etc.) but others who get caught in these fires lose much more.  There have been reported injuries such as severe burns and even fatalities.  To find out more about burn injuries and the remedies available visit LegalCenter.  While Ford tries to understand why their vehicles are causing injuries and damages many people are seeking compensation in courts of law across America.  At least 40 Ford owners have actually filed lawsuits against Ford while many more are engaged in settlement talks. 

In Florida, two class-action lawsuits were filed against Ford.  These are significant because they are the first class-action suits filed regarding the defect.  Now a judge must decide whether to allow the suits to go forward with the class action distinction.  If the judge allows these suits to remain class-action in nature then anyone who owns a Ford with one of the alleged defective switches can join the suit.  No matter the decision of the judge one thing remains certain.  If the switches are determined to be defective then Ford will be liable for the injuries and damages caused by their vehicles.  Read more about Automobile Product Liability.

By Lisa Zanassi

Disneyland or Bust.

Happiest Place on Earth?  Not for the family of a small boy who died suddenly on a popular ride at Disney World’s Epcot Center.  Their ride, known as Mission: Space is a space flight simulator which spins guests fast enough to create a feeling of weightlessness.  It is interesting to note that this ride comes equipped with motion sickness bags for those who can’t handle the g-force created.  Millions of people visit amusement parks every year, including 328 million people last year alone.  The question remains - are these rides safe for you or your children to ride?

Regarding the most recent death at a Disney Resort, Disney spokeswoman Jacquee Polak said, “We believe the ride is safe in its current configuration.”  But what is safe for most people most of the time was not safe for those injured or killed on one of these rides.  The amusement ride industry has said that riding thrill rides is safer than bowling, bobbing your head, having a pillow fight, sitting in a chair, or sneezing.  Although the official cause of death of this boy will not be known for several weeks, his death has sparked many questions and concerns about safety at amusement parks.

So how many people actually die in an amusement park ride related accidents?  According to the Consumer Product and Safety Commission, the rate of death resulting from amusement park rides is approximately one in 250 million riders.  To read comprehensive accident reports and related news visit RideAccident.  According to SaferParks, a consumer’s guide to safety at amusement parks and carnivals, “accurate nationwide data on U.S. amusement ride injuries doesn’t exist because the industry lobbyists and federal lawmakers have agreed not to collect it.”  Because there is no independent data regarding the actual number of injuries caused by rides every year one must be quite cautious when preparing, or shall I say daring, to board. 

What responsibilities do operators of these rides have?  Rides are regulated through federal, state, and local laws but presently there is a loophole in the law that prevents federal officials from participating in amusement park accident investigations. Depending on the size and mobility of the park or carnival, different laws apply.  The amusement ride industry has also developed a set of engineering standards through the American Society for Testing and Materials (ASTM).  For information regarding Amusement Park Liability visit LegalCenter.  While these safety standards and regulations are, to say the least, important they do not create accountability or ensure compliance.   

Despite all of these concerns I know at least one individual who will be, cautiously but excitedly, sitting in the bobsleds this summer…Me.  Ride carefully.

By Lisa Zanassi

Problem with SUV Rollovers.

It seems with all of the bad press that SUV’s get for their gas guzzling in this era of historically high oil prices, people forget that an even better reason for not owning an SUV is their high propensity for rolling over and injuring the passengers inside.

A lot of people might wonder why SUVs are more dangerous than a car, but the fact is that more roll-over accidents occur in SUVs than in any other type of vehicle on the road. Just look over any news websites and you’ll see the specific dangers with SUVs and rollover accidents. 

The practical advice for those not owning an SUV and want to avoid this type of accident is simply not to purchase one. However, sometimes it seems like automakers have been less than willing to disclose the exact dangers that are inherent in their SUV’s design. So, unfortunately, one must sometimes go to outside public resources to get the real information on these vehicles and to have some of their basic questions answered. But what happens when you unknowingly bought an SUV or were misled by the promises of some auto salesperson or commercial and have suffered injuries in a roll-over collision?

Well, just as the sales of SUVs increased, the number of roll-accidents also increased, prompting increased pressure from the public and the emergence of a whole area of law specializing in these types of personal injury accidents. Researching this topic further, it seems that unless there is a major re-call or a dangerous mechanical defect within a car line that results in a class action suit against a major car manufacturer, most of these cases emerge from specific accidents in which the victims seek damages for injuries, property damage, or wrongful death. Sometimes in the case of extreme negligence by the automaker, the injured party may be awarded punitive damages and attorney fees.

While the damages in these cases usually depend on the circumstances of the accident and the severity of the injuries, a lot of these lawsuits lead to very substantial settlements or jury awards. So what does a person do when they are confronted with the prospect of entering into this type of a lawsuit? First, it seems with all of the expertise out there with this specific type of accident, it would seem wise to contact an attorney that has worked on this type of case before, or who is at least experienced with handling suits against large corporations for product defects.

By Evan Anderson