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Feature
2/1/2000
HR
The passage of Proposition 103 represented a dramatic turning point in the insurance reform debate. Driven by the California initiative, insurance industry reform occupied the focus of policymakers throughout the United States. Proposition 103's passage inspired similar efforts in nearly every state legislature in the nation.1 In response,...
Feature
2/1/2000
HR
The modern auto insurance system dates back one hundred years to the introduction of the motor vehicle itself.1 Policymakers considered that operating a motor vehicle on public property was a privilege. It was proper to require that motorists purchase auto insurance coverage to protect innocent third parties against injury and property damage....
Feature
2/1/2000
HR
This is a brief explanation of no fault, who came up with the idea and its history. In the early 1930s, a group of academics examining the nation's nascent auto insurance system suggested an alternative approach, modeled after the workers' compensation system developed earlier in the century.1 Their aim was to achieve rapid and full compensation...
Feature
2/1/2000
Consumer Watchdog
Testimony of Douglas Heller, Consumer Advocate Foundation for Taxpayer and Consumer Rights Presented to the California Department of Insurance Thursday, November 9, 2000 The Foundation for Taxpayer and Consumer Rights (FTCR) has worked to protect California consumers for 15 years. FTCR's staff has led the efforts to defend and implement...
Feature
1/23/2000
Consumer Watchdog
Texas Senate Bill 386 became law on September 1, 1997 to provide patient protection by assuring that managed care companies are responsible for their health care treatment decisions. The landmark legislation holds HMOs and insurers accountable when they delay and deny medically necessary treatment. The language in SB386 allows all patients to...
Feature
1/21/2000
Consumer Watchdog
Numerous official studies show liability reform would be both health-enhancing and cost-effective. In a study of 1 million public employees in California, people who can sue their managed care plans already, the Kaiser Family Foundation found the cost of lawsuits and settlements was minimal-no more than 13 cents per member per month.1 The...
Feature
1/19/2000
Consumer Watchdog
An unintended loophole in the federal ERISA law prevents patients with private-sector, employer-paid healthcare from recovering damages against HMOs that harm them. The 1987 Pilot life v. Dedeaux decision has tied the hands of federal judges when the awarding of damages is warranted. Fifth Circuit Court of Appeal Judge Carolyn Dineen King,...
Feature
1/17/2000
Consumer Watchdog
External review systems are the HMO industry's reform of choice, because they permit bureaucratic maneuvers by HMOs that an ill patient has neither the time nor capacity to defend against. Most patients have a very short window of opportunity to get the care they need. Only the legal threat of damages against an HMO, should that patient not get...
Feature
1/15/2000
Consumer Watchdog
An internal video of Aetna lawyers training claims managers about procedures for denying claims shows the insurer considers liability exposure in determining whether or not to pay a policyholder's claim. According to the video, when faced with claims for identical medical problems, Aetna separates the claims where no damages are available - those...
Feature
1/11/2000
Consumer Watchdog
In California, "independent" external review has proven to be anything but independent, while failing managed care patients. The Friedman-Knowles Experimental Treatment Act was mandated in 1996 for patients in need of "experimental procedures" when "standard therapies would not be medically appropriate for the enrollee." So far only one agency...