Insurance Industry Gets Caught Lying Again

January 29, 2010 by boydkenter

When you suffer an injury because of someone’s fault, you have a right to be made whole for your losses.  This is called a tort claim.  The insurance industry has continued to perpetrate a fraud against that basic right, and here is further evidence that they will do whatever it takes in their attempt to continue that assault upon your basic rights.

A major new analysis released January 28, 2010 by consumer coalition Americans for Insurance Reform (AIR) finds that a recent claim by the insurance consulting firm Towers Perrin (now called Towers Watson) that the U.S. tort system costs $254.7 billion is highly exaggerated and misleading, based on unverifiable and flawed work, and is completely inappropriate for evaluating the U.S. tort system.  Even with all of its flaws and padded numbers, the Towers Perrin report, 2009 Update on U.S. Tort Cost Trends, still finds that tort system costs are growing slower than medical inflation, that medical malpractice trends are completely stable, that the U.S. tort cost environment is “relatively benign,” and that costs are less today, compared to GDP, than they were in 1983.

AIR’s critique, Towers Perrin: “Grade F” For Fantastically Inflated “Tort Cost” Report, is co-written by actuary J. Robert Hunter, Director of Insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas, and former Federal Insurance Administrator under Presidents Carter and Ford; and by Joanne Doroshow, Executive Director of the Center for Justice & Democracy.

Co-author J. Robert Hunter said, “It is really past time for Towers to stop publishing such flawed data year after year.  The fact that they persist despite criticism after criticism shows a deep disdain for fair and accurate presentation of facts.”

Joanne Doroshow said, “Even with all of its faults, which are extensive, the Towers Perrin report gives no credence whatsoever to any notion that tort costs are out of line, particularly medical malpractice costs.  Policymakers and opinion leaders should be extremely wary of how this document is used, because it is routinely presented in a misleading manner by corporate lobbyists who seek to weaken the tort system.  Fear-mongering is typical, for example, as taxpayers are often misled to believe they are paying these inflated costs in the form of a ‘tort tax’ or ‘litigation tax.’  Yet the Towers Perrin report provides absolutely no support for such a contention, nor for the insurance industry’s ‘tort reform’ agenda.”

Among AIR’s findings are:

•    Towers Perrin figures do not represent the costs of the legal system whatsoever.  For example, the report does not examine jury verdicts, settlements, lawyers’ fees, court costs, or any actual costs of what might generally be considered the “tort” system.
•    Towers Perrin examines only insurance losses whether or not a lawsuit was filed, plus insurers “guess” (historically, widely overstated) of what future losses could be, plus all of the industry’s bloated overhead (salaries, bonuses, lobbying costs, jet planes etc.).
•    Towers Perrin greatly pads its numbers by:

o    incorrectly counting as a “tort cost” the transfer of money from wrongdoers to victims, such as $500 to fix a dented car door;
o    including insurance costs whether or not a lawsuit was filed, including such incidents as common fender benders;
o    including billions of dollars of insurer future estimates of claims – not actual costs;
o    including billions of dollars of certain first party coverages, like auto insurance medical payments;
o    including the immense costs of operating the wasteful and inefficient insurance industry, an industry that is not fully competitive due to its exemption from anti-trust laws; fully 26.1 percent of Towers Perrin total “tort cost” figures are these administrative expenses, such as multi-million dollar salaries and bonuses of insurance industry executives, perks like private jets and country club memberships, lobbying and advertising expenses, rent and utilities for insurance company headquarters and commission paid to agents.

•    Towers Perrin adjusts figures without any basis and fails to provide explanations or sources;
•    Identifies as medical malpractice “costs”, which are largely unverifiable, all insurer expenses, which amount to fully 36.1 percent of its total cost figures; as for actual claims and reserves, Towers Perrin numbers are more than three times those of A.M. Best, considered the insurance industry standard;
•    Towers Perrin entirely ignores the amount of money the civil justice system saves the economy in terms of injuries and deaths that are prevented due to safer products and practices, wages not lost, health care expenses not incurred, and so on.
•    Towers Perrin’s calculations are not discounted one cent for the benefit that is gained from repairing damage.

Doroshow said, “These figures have no connection whatsoever to the costs of lawsuits, litigation or the courts, for which there is no evidence of any increase at all. For Towers Perrin to call their study ‘U.S. Tort Cost Trends’ is intellectually dishonest.  These figures are so misleading that they are completely irrelevant to any discussion of the civil justice system.”

The full study and executive summary can be found at: http://www.insurance-reform.org/.  AIR is a coalition of nearly 100 public interest groups from around the country.  It is a project of the consumer group, Center for Justice & Democracy.

Top 10 Fraud Cases for 2009

January 29, 2010 by boydkenter

Top 10 Fraud Cases of 2009

(Source:  Workers’ Injury Law & Advocacy Group, Leonard T. Jernigan, Fraud Task Force Chairperson)

1.         Orange County, California
4-30-09
ocregister.com

A Laguna Hills couple has been charged with a state record $38 million in workers’ compensation fraud through various roofing companies they own in southern California. Michael Petronella and his wife Devon Kile were arrested on 106 felony counts including insurance fraud, grand theft and filing false tax returns. Bail for each has been set at $3 million as they await trial. Investigators seized over $500,000 worth in jewelry from their home as well as two Ferraris, a Bentley and a Range Rover. Ranking officials hope to prosecute the couple to the fullest extent because of their involvement in driving up insurance premiums for legitimate businesses.

2.         Los Angeles, CA
4-18-09
mercurynews.com

The president and vice presidents of a Torrance security firm, International Protective Services, Inc., have pleaded not guilty to charges of conspiracy, grand theft and making false statements. Ousama Karawia, Larry Finley and Allan Bailey allegedly avoided paying state workers’ compensation premiums by creating a shell company that claimed to have only twenty workers. Their real company has over 1,500 employees and failed to pay $9.5 million in premiums.

3.         Southern California
11-17-09
The Desert Sun

The owners of a Japanese restaurant were arraigned on charges of tax evasion and workers’ compensation fraud.  Simon Sungheok Hong and his wife, Katie Kyanghee Shinn owned two restaurants in Southern California and are accused of shorting their insurance carrier and the state as much as $5.8 million, with penalties and interest.  They are accused of underreporting their payroll to the State Compensation Insurance Fund and the Employment Development Department, as well as underreporting sales tax revenue to the state Board of Equalization.

4.         Santa Ana, CA
5-18-09
whittierdailynews.com

Four people have been charged in a multi-million dollar workers’ compensation fraud case and could face up to 91 years each in prison if convicted. Kim Soares and her husband Joseph Soares own the Democo Corp. of Orange, a demolition company in La Habra Heights and southern California. The Soares, along with General Manager James Campbell and his son Robert Campbell, face a lengthy list of charges including conspiracy, perjury, grand theft, forgery, identity theft, misrepresenting facts to state Compensation Insurance Fund, recording false and forged documents, making false statements to deter workers from claiming benefits and income tax fraud. The couple failed to pay over $5.7 million in insurance premiums along with failing to secure workers’ compensation insurance for their employees. They also committed another $12 million in tax fraud.

5.         Sherman Oaks, CA
4-15-09
labusinessjournal.com

Two executives with a janitorial service company have been arrested and charged with fraud and conspiracy after failing to pay $4.4 million in workers’ compensation premiums and $1.9 million in unemployment and state disability taxes. Andrew Kim and Chan Hee Yang are executives of the Bell Building Maintenance Co. which misrepresented the number of employees it had from 2000 to 2005, Kim reported to the State Fund that he and his wife were the company’s only employee when there were actually hundreds of janitors working publically and privately for the company throughout southern California.

6.         Washington
11-5-09
EHS Today

The owner of Master’s Touch Drywall of Marysville pleased guilty to felony theft of sales tax and workers’ compensation fraud, and agreed to pay more than $2.1 million in restitution.  Snohomish County Superior Court Judge Ellen Fair gave Mark D. Standley, 53, until May 5 to make nearly $1.5 million in restitution to the Department of Revenue and nearly $650,000 to the Department of Labor & Industries.  Standley’s prison sentence could be as much as 9 ½ years, will depend on how much restitution he makes before his sentencing date.

7.         New York, NY
10-29-09
Comp News Network

Sun “Sunny” H. Park, who operated as an accountant from her home on Park Avenue, pleaded guilty to mail fraud and submitting false tax return in connection with operations of several asbestos abatement companies in a case of workers’ compensation fraud involving more than $1.7 million.  She faces up to 20 years in prison on mail fraud and 3 years for aiding in the preparation and presentation of a false and fraudulent tax return.  In addition, as part of her plea, she agreed to pay NYSIF $1,186,585, pay to the Zurich Group the restitution amount of $345,904, and also pay $238,187 to Princeton Insurance Company.

8.         Queens, New York
7-28-09
New York Times

A New York man has been sentenced to serve four years in prison after failing to pay $1.6 million in workers’ compensation premiums. Chong-mun Chae, of South Korea, owned an asbestos removal company but falsely claimed that he had only one employee and that it was a secretary. He avoided being caught earlier by changing the name of his company several times. He pleaded guilty to mail and tax fraud and will be deported after serving his time in prison.

9.         California
6-1-09
ifawebnews.com

Three men have been arrested for misclassifying the type of work their employees were performing and for falsely reporting the hourly wage of over seventy workers. The three men own NBC General Contractors Inc. which from May 2003 to May 2007 was awarded over 27 public works projects in at least five counties throughout the state. For falsely reporting the company dodged over $1.45 million in insurance premiums and the company did not pay overtime or sick leave either, allowing them to save $3.6 million in unpaid wages to employees. California Insurance Commissioner Steve Poizner has said that when companies attempt to cut corners to save money they will end up repaying their debts in jail time.

10.       Worcester
9-24-09
Telegram.com

The owner of a local temporary employement agency is indicted on charges of cheating the state, hundreds of employees and an insurance company out of more than $1 million.  Tam Vuong, 34, was charged with 66 counts of violating the state’s wage and hour laws and committing insurance and tax fraud.  His company was also charged with 6 counts of willful failure to provide a pay stub.  From 2004 to 2008, Mr. Vuong’s company, Labor Solutions Inc., collected more than $20 million by providing temporary workers to client companies, while paying out $11 million in wages and failing to disclose those wages paid in cash to its worker’s compensation carrier, as well as to the state Department of Revenue.

Protected or Neglected Workplace Safety Video

January 19, 2010 by boydkenter

Must see video .  “Every day in California, at least one person dies on the job…These are some of those workers’ faces… They were educators and engineers… construction workers and contractors. They wore white and blue collars…And every year, tens of thousands more are injured…”  Replace California with Missouri, Kansas or any other state, and you begin to sense the immensity of the risk facing America’s workers.

http://thepumphandle.wordpress.com/2010/01/18/find-28-minutes-to-watch-protected-or-neglected-workplace-safety/

Why should anyone be excluded from social safety nets?

January 19, 2010 by boydkenter

In this day and age, anyone who works for a living should have the same safety nets which protect their health and protect their income when injured or disabled from their labors. Sadly that isn’t the case, and businesses are allowed to profit on the blood and broken bodies of many. Maybe that will end with this lawsuit in New Mexico.

http://www.riskandinsurance.com/story.jsp?storyId=275897056

Not a Crime to kill workers in violation of safety laws–but don’t shoot a deer

January 19, 2010 by boydkenter

Shoot a deer without a license, carry its carcass across state lines. That’s a felony for which you go to jail for 5 years. Kill a worker in violation of safety laws? Not a crime. Incredible!

http://16deathsperday.com/

Employers held accountable for firing workers

January 19, 2010 by boydkenter

Unsafe Work–Not Lawyers–Adds to Cost of Work Comp Insurance

January 19, 2010 by boydkenter

Workers Compensation “Reforms” can go too far

January 19, 2010 by boydkenter

Job Safety

January 19, 2010 by boydkenter

2000s Lost Decade for Job Growth in US

January 19, 2010 by boydkenter