Class Claims Insurers Cancel Just As Hurricane Season Begins
National News
According to Courthouse News, a class action claims Texas insurance companies collect premiums for storm coverage from November through May - when there's no risk of hurricanes - then cancel policies by the thousand just before hurricane season begins. Unitrin, an insurance holding company, allegedly canceled 40 percent of one of its subsidiaries' policies before this year's hurricane season began.
Plaintiffs claim the scheme allows Unitrin and its creatures to fix prices and charge for insurance without providing it. Unitrin has been doing this since 2006, according to the complaint in Jefferson County Court.
When the 2007 hurricane season was predicted to be a big one, the defendants canceled many "hurricane" policies, the class claims. After Hurricane Ike in 2008, Unitrin and its Capitol County subsidiary collected hurricane premiums from policyholders as long as possible, then canceled more than 40 percent of residential policies before the 2009 hurricane season started, according to the complaint.
Such cancellations require the defendants to return unearned premiums, but Unitrin is ducking that by calling its cancellations "non-renewals," the class claims.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.