After a New York attorney general’s office launched an investigation based upon hundreds of complaints against UnitedHealth Group, a settlement reached on Tuesday ordered the health insurance company to pay $50 million dollars for overcharging millions of Americans for health care.

New York Attorney General Andrew Cuomo says Ingenix, a research firm owned by UnitedHealth Group, has been manipulating claim numbers so insurance companies pay less. “Americans have been under-reimbursed to the tune of at least hundreds of millions of dollars,” he says. Other major insurers also use Ingenix, including Aetna, CIGNA and WellPoint/Empire BlueCross BlueShield.

“This is a huge scam that affected hundreds of millions of Americans (who were) ripped off by their health insurance companies,” says Cuomo. “This was unethical, and it robbed vulnerable patients of insurance reimbursements they deserved.”

In a statement, UnitedHealth Group told TODAY: “We respectfully disagree with the New York Attorney General’s findings that we manipulated data or that our ownership of Ingenix was a conflict of interest. We agreed to his settlement because it was an effective way to address any perceived conflict of interest.”

Cuomo says he’s now investigating other health insurance companies. In addition, some patients plan to bring a class action lawsuit against UnitedHealth Group.

A class action is a case brought against a company whose actions have damaged a group of people in a similar way. A single person who has been injured may bring a class action on behalf of everyone who has been harmed. However, after the action has been started, other injured people can join the class action lawsuit (become class members).

Do you feel you have a claim as part of a class action? An experienced Lead Counsel class action attorney can advise you on whether filing a class action or an individual lawsuit is best for your case, as well as advise you on what steps you need to take.

Due to the financial meltdown felt by millions of Americans across this country, the number of people acting as their own lawyers is on the rise. In the past, less complicated cases such as uncontested divorces or small claims were often filed by parties serving as their own attorney. But in this tough economy, even those tied up in child custody cases, complex lawsuits and complicated bankruptcies are representing themselves as well. “It’s not just that poor people can’t afford lawyers. This is really a middle-class phenomenon,” said Sue Talia, a judge from Danville, California.

The result of this legal trend is causing court systems to clog with filings from people unfamiliar with the legal process. Sadly, some of these pro se litigants, as they are being called, are making mistakes with expensive and permanent consequences. “Courts are absolutely inundated with people who do not understand the procedures,” said Talia. “It is a disaster for high-volume courts, because an inordinate amount of their clerks’ time is spent trying to make sure that the procedures are correctly followed.”

Luckily, there is self-help Web sites (such as LawInfo) and desks at court offices that offer standard legal forms for such things as simple divorces. The American Bar Association is encouraging all states to set up such self-help desks and adopt standardized forms to help cut legal costs. Also, volunteer lawyers are available in some states to give legal advice to those who cannot afford legal counsel. Further, a majority of states promote a growing legal trend known as “unbundling,” in which an attorney handles just part of a contract, lawsuit or other litigation for a small fee, rather than taking on an entire case.

Despite these tough economic times, however, there are situations where hiring a lawyer is not only imperative for your case, but critical to your fundamental freedom, such as fighting a criminal charge. Matters like this leave no room for penny-pinching. For more information, contact a qualified attorney in your area today for an initial (and usually free) consultation to discuss the specifics of your case.

If you’ve been injured, arrested, or sued, you’re probably wondering how much it would cost to hire a lawyer. Or you might not even TRY to hire a lawyer because you just assume that it’s too expensive, or that you could probably get by on your own.  This is, unfortunately, all too common.  In fact, a lot of people who DO hire lawyers have learned their lesson by getting burned the first time. 

The good news is  this – many attorneys offer free consultations.  So, there is no reason, other than a bit of your time, to meet with a lawyer and let them tell you how they could help you.  Also, most personal injury attorneys work on what’s called a ‘contingency fee basis.”  This means you don’t have to have a lot of money to hire a lawyer.  The lawyer will not charge you legal fees upfront, but will take his or her fees out of whatever settlement or award you receive.  Usually, the attorney takes a percentage of the recovery.  And.. if you loose the case, then the attorney doesn’t get a fee either.  Although, keep in mind the costs incurred for the lawsuit are ordinarily the client’s responsibility, either way it turns out. 

Or, another way to think about it is this… what would it cost you NOT to hire a lawyer?  What consequences could you suffer by not having proper legal advice or representation?  While in minor cases, you might be able to successfully resolve the matter yourself, for cases in which anything valuable is at stake (your freedom, your health, your money, your pain and suffering), the consequences of not hiring a lawyer could be devastating. 

Take the example of a debt collections case.  Many people don’t hire a lawyer because they figure they’re already in debt, how much worse could a lawsuit really make it?  Trust me, it can be worse.  Having a judgment for a debt owned and unpaid is another negative on your credit report.  Also, that creditor may have been willing to negotiate if you got a lawyer involved, because a lawyer knows better how to deal with creditors and what risks they take in pursuing a collection against you. 

Another example – getting arrested.  Too often, those charged with crimes try to go it alone, thinking they’ll figure it out as they go along.  Wrong!  Getting a lawyer involved as early in the process is crucial to protecting your rights. Law enforcement, including the prosecuting attorney, are highly skilled at getting criminal defendants to talk.  Most times, you unwittingly say something that ruins your chances of getting a plea deal.  If you have an attorney speak for you, that won’t happen.  Also, an attorney may even be able to get the case dropped or the charges reduced early on… making everything else easier for you. 

Finally, if you’ve been in an accident, most times it is not in your best interest to talk to that nice insurance adjuster.  Their job is to make you think the settlement they offer you is a “good deal”… but the insurance adjuster, no matter how nice they seem, is looking out for the insurance company’s best interest – not yours.  Only an attorney would know what a “good deal” is under the law given your situation. 
 So, please, if you’ve suffered an injury, are facing criminal charges, are involved in a lawsuit, or have any other legal matter pending, don’t possibly jeopardize your rights.   Contact an attorney and ask about an initial consultation.  Only make the decision NOT to hire a lawyer after you know what a lawyer can do for you. 

Good luck!

If you’ve recently lost your job, you’re probably very concerned about the loss of any employer-sponsored health care coverage.  Your coverage may end not only through a job loss, but also if your hours are reduced.   Relax, the good news is that you do have rights when it comes to health care coverae. 

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you, your spouse and dependent children, might be able to purchase extended health coverage for up to 18 months. Individuals who qualify for Social Security disability benefits may be eligible to extend coverage for an additional 11 months. However, your employer is not required to pay your premiums – rather, you may pay the entire amount. 

Are there any other options available?  You or your family may be eligible for private health insurance or perhaps even public health insurance, like Medicaid or the new State Children’s Health Insurance Programs.  Also, under the Health Insurance Portability and Accountability Act (HIPAA), if your spouse has a health plan, you may also be eligible to enroll in his or her plan.

Browse LawInfo’s Free Legal Resource Center for more information about your rights and health insurance, particularly after a job loss.  If you believe your employer has wrongfully denied your health care coverage, or failed to follow the COBRA rules, contact an attorney in your are for more information about your legal rights.

Are you facing a legal issue?  Have you been sued, or are you wondering about foreclosure?  Did you just have a medical procedure that didn’t turn out as you expected?  Is bankruptcy looming?  What about your family life – are you and your spouse considering divorce?  Do you need to update your will?  Has someone you love been arrested for a DUI? 

These are examples of only some of the most common legal issues.  The fact is we actually deal with the law more than most people think.  More importantly, when we face a legal issue, many of us might not know where to turn for answers.  The legal system can certainly be overwhelming – especially because the consequences are often so grave. 

Since 1994, LawInfo has been providing the public with quality legal resources they can count on.  The idea for the company even came out of the founder’s own legal needs!  How do you find the right attorney?  How do you know the attorneys you contact are in good standing with the state bar association?  What if you want to learn about a legal issue before you talk to a lawyer?  Well, these are the reasons LawInfo was established!  LawInfo has a whole library of information about the most common legal issues including answers to frequently asked questions, articles, legal guides, legal forms, and other information – ALL FREE TO THE PUBLIC!  The really great thing is this – you can also easily find an attorney who will understand your legal needs.  It’s all designed to help the public – help someone find answers they need and find an attorney who can help them. 

Learn more about LawInfo’s Free Legal Resource Center and Find the Right Attorney in your area today!

What is Health Care Fraud? Health care fraud occurs when health care professionals make false or misleading statements in order to benefit financially. Health care schemes are diverse and often complex.

Examples include overbilling, billing for services not even provided, double billing for the same procedure, billing for a more expensive procedure than actually performed, or billing separately for items that are less expensive when bundled together (for example a group lab tests). It is also fraudulent to receive a “kickback” for referring a patient to another doctor. Doctors have even been caught selling prescriptions to patients for cash.

Part of the reason health care fraud is so prevalent is because health care is so expensive and is such a massive system. It is not unusual for a carrier to cut a check for over $100,000 to someone it does not even know! Because it is so prevalent, billions of dollars are being drained from the Medicaid and Medicare Industries on fraudulent claims. Scam artists often close up shop and flee before investigators can even attempt to recover the fraudulently obtained funds.

However, the Justice Department has made health care fraud a top priority. Many investigations are the result of complaints from patients and the public at large. Because fraud is conducted for the most part “in secret” these tip-offs from health care consumers are extremely valuable to the FBI and other law enforcement officials. Criminal penalties for health care fraud can be very severe. If you are involved in a health care practice you believe may be considered fraudulent, contact an attorney for more information.

Mississippi Attorney General Jim Hood said Wednesday that his office has settled its dispute with State Farm Insurance Cos. over how the insurer handled Hurricane Katrina damage claims in Mississippi.

State Farm has complied with a January 2007 agreement with the state by reopening some claims and agreeing to pay more than $74 million more to Gulf Coast policyholders whose homes were damaged or destroyed by Katrina’s storm surge, Hood said in a news release.

Hood said the insurer also has agreed to notify nearly 150 more State Farm policyholders who haven’t sued or settled their claims that they can still have their cases reevaluated.

Hood had sued State Farm, alleging the company failed to honor the January 2007 agreement, which called for Hood to end a criminal investigation into how Katrina claims were handled and for the insurer to pay millions more to policyholders.

State Farm spokesman Fraser Engerman said settling the attorney general’s lawsuit is another milestone in the company’s efforts to resolve “all pending matters related to Katrina.”

Hood’s January 2007 deal with State Farm was part of a broader settlement with private attorneys for policyholders that called for the company to reopen and possibly pay thousands of claims.

When a federal judge refused to sign off on that pact, State Farm later entered into a separate agreement with George Dale, who was then Mississippi’s insurance commissioner. Hood has said the agreement with Dale didn’t satisfy his deal with State Farm because it didn’t require arbitration.

Hood claims the original terms of his agreement would have required State Farm to pay out much more in claims — up to $400 million. He said his deal called for a panel of arbiters to oversee the claims reevaluation process.

“Nevertheless, the additional $74 million paid by State Farm pursuant to the Mississippi Department of Insurance reevaluation program apparently meets the minimum payments required under our original state court settlement agreement,” Hood said.

The $74 million reflects the amount paid from claims reopened under State Farm’s agreement with the state insurance department, not the total the insurer has paid out in Hurricane Katrina claims in the state.

Engerman said State Farm finds it “perplexing that he (Hood) would take full credit for a program he opposed and was the foundation for the lawsuit he filed against us and has now just settled. However, we are pleased the attorney general understands State Farm has met its obligations under the agreement his office made” in January 2007.

State Farm filed its own lawsuit against Hood, claiming he violated his bargain to end the criminal probe. But the sides reached a confidential settlement in that lawsuit in February.

There are a number of key decisions and an Insurance Code statute which govern this specialized area of law and can be of great assistance to the policyholder. This covers key decision #1 of Mr. Mark’s lecture:

1. Prohibition of Post-Claims Underwriting in Disability CasesSection 10834 states in its entirety):

Postclaims underwriting
No insurer issuing or providing any policy of disability insurance covering hospital, medical, or surgical expenses shall engage in the practice of postclaims underwriting. For purposes of this section, “postclaims underwriting” means the rescinding, canceling, or limiting of a policy or certificate due to the insurer’s failure to complete medical underwriting and resolve all reasonable questions arising from written information submitted on or with an application before issuing the policy or certificate.

It is important to note there is a nearly identical provision in California’s Health and Safety Code which prohibits postclaims underwriting of health care plans. Health and Safety Code Section 1389.3 states: Postclaims underwriting-No health care service plan shall engage in the practice of postclaims underwriting. For purposes of this section, “postclaims underwriting” means the rescinding, canceling, or limiting of a plan contract due to the insurer’s failure to complete medical underwriting and resolve all reasonable questions arising from written information submitted on or with an application before issuing the plan contract. This section shall not limit a plan’s remedies upon a showing of willful misrepresentation.

Mr. Marks has achieved superior results in serious personal injury cases and is a particularly effective insurance bad faith attorney. The Firm has assists residents throughout Southern California including Los Angeles, West Los Angeles, Encino, Woodland Hills, Sherman Oaks, Tarzana, Santa Monica, Reseda. For more information, call 888-638-2693 today!

A federal judge has ruled that State Farm policyholders in Mississippi whose claims were denied after Hurricane Katrina cannot form a class action as a speedy way to resolve lawsuits against the insurer.

Policyholder Judy Guice had asked U.S. District Judge L.T. Senter Jr. to permit her to join other policyholders whose homes were reduced to slabs by the August 2005 storm in a class action against Bloomington, Ill.-based State Farm Insurance Cos.

But the judge, who heard testimony on the proposal during a Feb. 28 hearing in Gulfport, Miss., ruled Thursday that a class action for ‘’slab cases” is ”inconsistent with the requirements of due process.”

”While each of the many ’slab cases’ has in common the fact that the insured property was totally destroyed during Hurricane Katrina, the many other factual differences between the cases preclude the relief that Guice is seeking,” Senter wrote in his three-page ruling.

In a class action, a court authorizes a single person or a small group of people to represent the interests of a larger group.

Guice’s attorneys have argued that the facts in each ‘’slab case” against State Farm are essentially the same and should be heard together. But State Farm says the cases must be tried separately because the facts of each claim are different.

”We’re pleased with Judge Senter’s affirmation that each claim is unique and no two property owners experience the same type of loss,” State Farm spokesman Phil Supple said. ”It’s only right that each claim be tried on its own merits, separately.”

A disappointed Guice said certifying a class action may be the only way to provide legal relief to homeowners who are ”too weak to forge ahead alone.”

”In the end, I’m sure that justice will prevail,” she said.

In his ruling, Senter said three recent trials for lawsuits against State Farm have taught him that ”there are as many differences between the ’slab cases’ as there are similarities” in how Katrina damaged homes.

”For this reason,” he wrote, ”I do not believe there is any procedural advantage in creating a class of State Farm ’slab cases’ that would not be offset by the factors that will ultimately require the individual treatment of these claims.”

A trial for Guice’s individual lawsuit against State Farm is scheduled to start in Gulfport in May, but Guice said she expects it to be postponed.

During last month’s hearing, several policyholders pleaded with Senter to find a speedy way to resolve hundreds of lawsuits that have been filed against State Farm and other insurers after Katrina.

The insurers say their policies cover damage from wind but not rising water, including storm surge.

Senter has expressed strong support for using court-ordered mediation to clear a backlog of federal lawsuits over Katrina damage. He said last month that a court-ordered mediation program, which has settled at least 47 of 88 cases heard so far, has exceeded his early expectations.

The judge, however, has solicited ideas on other ways to resolve cases in a ”just, speedy and inexpensive” manner.

Senter held a separate hearing Feb. 28 on the terms of a proposed settlement that calls for State Farm to pay at least $50 million to roughly 35,000 policyholders who didn’t sue the company but could have their claims reopened.

After the hearing, a team of lawyers led by Richard ”Dickie” Scruggs withdrew their request for Senter to sign off on the agreement, citing a legal ‘’stalemate” and the judge’s apparent reluctance to approve the settlement. Senter hasn’t ruled on that earlier request to approve the deal.

Meanwhile, Mississippi Insurance Commissioner George Dale announced Monday that his office has reached a separate agreement with State Farm that calls for the company to re-evaluate and possibly pay thousands of claims.

In January, Senter presided over the first jury trial for a Katrina insurance suit. He sided with policyholders Norman and Genevieve Broussard in that case, saying State Farm acted in a ”grossly negligent way” by denying their claim.

Senter ruled that State Farm has the burden of proving how much damage resulted from flood water.

Lexington injury attorney, Jeffrey A. Darling takes aggressive action to protect his client’s rights, deal with the insurance companies and go after the fair and just compensation that his clients deserve.

Experience, Integrity and Results:
Lexington personal injury attorney, Jeffrey Darling has been a trial lawyer for 22 years and has successfully litigated hundreds of jury trials. The following is a mere roster of the exceptional settlements Attorney Darling has secured for his clients:

• $1,050,000.00 settlement — Car accident, 1992
• $300,010.00 Verdict (including $100,000.00 loss of consortium verdict)
  – Slip and Fall accident, 1997.
• $450,000.00 settlement — Medical Malpractice case, 2003
• $1,120,000.00 Federal jury verdict, 2004

Lexington Kentucky Lawyer Highlights:
Reported Cases:

Deters v. Judicial Retirement and Removal Commission , Ky., 873 S.W.2d 200, cert den 115 S. Ct. 194, 130 L. Ed.2d 126 (1995)

Hall v. Transit Authority of Lexington – Fayette Urban County Government , Ky. App. 883 S.W.2d 884 (1994

Hourigan v. Commonwealth , Ky. App. 883 S.W.2d 497 (1994)

Take Action to Protect Your Rights:
If you or a loved one has been injured in Lexington Kentucky or within the surrounding cities and counties of Kentucky and you need the help of an experienced injury attorney. contact Lexington injury attorney Jeffrey A. Darling today at (888) 279- 9236.