Year: 2017
Reports show that the Centers for Medicare and Medicaid Services does not have adequate protections procedures in place to prevent incidents of abuse and neglect in federally-funded skilled nursing facilities. A preliminary report from the Department of Health and Human Services shows numerous problems with the quality of health care, as well as investigations and reporting procedures on abuse and neglect in federally-funded nursing home facilities across the country. Federally-Funded Nursing Homes In an effort to prevent elder abuse, the Department of Health and Human Services is conducting [...]
Medicare Changes Could Spark Acts of Bad Faith
Upcoming changes to Medicare will require the use of evidence-based guidelines that are designed to ensure that patients receive appropriate tests and treatments for their conditions and avoid unnecessary care, but the changes could lead to a higher number of denied claims by insurance companies and might spark acts of bad faith. Medicare Changes and Benefits Beginning July 1, 2018, physicians will be asked to voluntarily use clinically supported software to document certain criteria for outpatient medical imaging orders. The period from 2018 to 2020 is intended to [...]
When Christmas Spirit Hurts [infographic]
Installing roof decorations, stringing up Christmas lights, dragging and lifting Christmas trees, and hanging tree ornaments commonly result in falls off ladders, fractures and broken bones, sprains and lacerations, eye injuries, and head trauma. Between 2011 and 2015, there were more than 13,000 Christmas-related injuries that resulted in visits to hospital emergency rooms across the country. (Article continues below infographic) Christmas-Related Injuries The Christmas season is a joyful time of year that brings cheer and good tidings to millions of people around the world. Unfortunately, it also puts [...]
Auto Safety Issues Often Overlooked
Drivers often overlook important safety issues such as vehicle defects, recalls, and proper maintenance that contribute to dangerous auto accidents. A vehicle’s age and style, and the type and scope of a safety-related recall have a significant impact on whether or not a recall is addressed or repairs are ever completed. When motor vehicle owners fail to make repairs, perform maintenance or address safety-related recalls, they place themselves, their families and other motorists at risk for serious injury and death. Overlooked Safety Issues Ignoring important safety issues and [...]
Your Rights in Disability Insurance Denials Depend on Several Factors [infographic]
Disability insurance claims are denied for a variety of reasons, including bad faith acts by insurers, but state and federal laws provide certain rights to protect consumers. When a disability insurance claim is denied by an insurer, the policy holder’s rights can depend on several factors including the type of disability plan, policy limitations and restrictions, waiting periods, and state filing statute of limitations. (Article continues below infographic) ______ Types of Disability Plans Individual disability policies include short-term and long-term disability plans. Individual short-term and long-term disability insurance [...]
Reaping the Benefits of a Bad Faith Insurance Claims Denial
When an insurance claim is denied due to bad faith, the insured may be awarded substantial benefits to cover damages and punish the insurer for wrongdoing. Under Nevada law, insurance companies have a duty to their policyholders to act in good faith and provide fair services on all claims. When an insurer breaches that duty, the law considers that the insurer is acting in bad faith. If an insurance company denies a claimant’s benefits without reasonable explanation, the Nevada Supreme Court allows the claimant to file a bad [...]
Troubling Safety Trends Result in More Large Truck Fatalities
The Truck Safety Coalition reports an increase in fatalities involving large truck crashes for 2016 due to troubling safety trends that have gone unresolved since 2009. Trucking Safety Concerns In 2016, the National Highway Traffic Safety Administration (NHTSA) released data on accidents and injuries involving large trucks. The data showed 4,317 fatalities, a 5.5 percent increase in deaths involving crashes with large trucks over 2015, and a 28 percent increase since 2009. The Truck Safety Coalition reports that an increase in fatalities is not a surprise since concerns [...]
Major Car Dealers Are Selling Unsafe Cars
Some major car dealers are selling used cars that have been recalled because of unsafe, unrepaired defects to consumers without their knowledge. Dealers have entered into settlements with federal regulators who allow them to market these unsafe vehicles as safe. Federal Trade Commission Settlement In 2016, the Federal Trade Commission (FTC) alleged that General Motors and CarMax dealers violated the Federal Trade Commission’s policies on unfair and deceptive business practices by selling open recall vehicles. Although dealers advertised Certified Pre-Owned vehicles that had undergone rigorous safety inspections and [...]
Does Your Disability Insurance Company Have You Under Surveillance?
Surveillance is a common tool used by disability insurance companies during the claims process. Insurance companies often hire private investigators to follow the activities of claimants who file for disability insurance benefits. Surveillance and Claim Investigations Disability insurance companies often use surveillance tactics during the claims process to determine benefit eligibility. Insurers claim that surveillance is used only as a fraud prevention tool to ensure that a claimant’s disabilities are legitimate. However, in some cases, surveillance is also used to deny claims. Private investigators are often employed by [...]
Why Disability Claims Assessors “Like” Social Media
Insurance claims assessors often review social media sites to determine eligibility for disability benefits. Media posts that raise concerns or show conflicts can result in disability claim denials. The Dangers of Social Media Millions of people regularly use social media sites such as Facebook, LinkedIn, Instagram and Twitter to share personal information and photos with the public. For people who apply for disability benefits or are already receiving them, social media can have negative effects on disability claims. Insurance claims assessors commonly review claimants’ social media sites to [...]