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Is Insurance Company Greed The Reason For Higher Premiums?

Advocates for tort reform consistently claim that lawsuits are the reason that Americans face increasing insurance premiums. This claim has consistently been refuted by statistics that prove the number of lawsuits filed in the United States have been decreasing over the last 20 years, and that jury verdicts in favor of injured people have not been increasing over the last 20 years.

Now, there is additional proof that lawsuits have nothing to do with the increase in insurance premiums charged by the insurance companies. J. Robert Hunter in his study entitled "Property/Casualty Insurance in 2008: Overpriced Insurance and Underpaid Claims Result in Unjustified Profits, Padded Reserves and Excessive Capitalization" discovered that insurance companies are paying 20% less in benefits to its own insureds now as compared to 20 years ago. He also discovered that insurance companies have earned unprecedented profits in each of the last four years, which is remarkable in the aftermath of Hurricane Katrina and the Florida hurricanes. Mr. Hunter concludes that the property/casualty insurance industry has been highly effective in maximizing profits through rate increases, coverage reductions, inapprorpiate claims practieces and by shifting high risks into taxpayers.

Of note, Mr. Hunter was a former Texas insurer commissioner charged with ensuring that insurance rates are fair, and that insurance companies are financially stable and able to pay claims as promised.

Anecdotal support for Mr. Hunter's findings can be found in Allstate Insurance Company's long-standing refusal to comply with court orders demanding the production of the "McKinsey documents", which allegedly show how the company profited at policyholder's expense. In an effort to protect these documents from production, Allstate Insurance has incurred millions of dollars in fines. Recently, the Florida Insurance Commissioner went so far as to ban Allstate from writing new insurance business because of its refusal to produce documents or testimony to clarify its procedures for paying claims.

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Catastrophic Personal Injuries

5/12/2008
Michael Shevlin
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Patient Advocacy: A Growing Business

How many of us have gone to a emergency room, or even to a doctor's office, and waited for what seemed to be an eternity to be examined? How many of us have been in a hospital or a doctor's office but felt that the staff was not hearing our complaints? Unfortunately, these experiences can be all too common. In our legal practice, we often see the tragic consequences that can result from long delays and failure to listen to patient complaints. Sadly, we have handled numerous cases in which patients have died or have suffered life-changing injuries from conditions that were treatable with earlier intervention.

Recently, we have been reading a great deal about an emerging business industry - patient advocacy. A recent article in the Arizona Daily Star discussed the role and merits of patient advocacy. The patient advocate is to work on behalf of a patient to ensure that the patient receives the best possible medical care. These advocates can help monitor patient medication, review patient treatments plan, provide detailed patient medical histories, alert overworked nurses when vital signs go bad, coordinate care as nurses and doctors change shifts, and look out for patient comfort, hygiene and mobility. The use of patient advocates appears to be most prevalent during hospitalizations and nursing home visits.

For more informaton about patient advocacy, check out these websites below. We do not have any affiliation with these companies, but found that their websites provide helpful information for you in considering whether to hire or use a patient advocate.
Patient & Family Advocates, LLC
The Family Advocate
COPE Patient Advocates

Please note, however, that a patient advocate does not always have to be a hired advocate. Family members can always serve as an effective advocate if they are willing to become actively involved in the care of a loved one.

Labels: medical error medical malpractice patient advocate personal injury

Medical Malpractice

8/20/2008
Michael Shevlin
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Serious But Preventable Medical Injuries On The Rise

Previously, we have cited the landmark study by the Institute of Medicine published 2001 titled "To Err Is Human: Building A Safer Health System" as proof that preventable medical errors occur at alarming rates. That study estimated that preventable medical errors caused 98,000 deaths per year. It did not estimate the number of non-death injuries caused by preventable medical errors.

Today, seven years later, there is evidence that the rate of injury due to preventable medical errors continues to rise. The Salt Lake Tribune reports that since 2002 the number of preventable serious medical injuries in Utah hospitals has increased by over 50%. This figure is limited to "never events" which are defined are events that are never suppose to occur. Such events include surgeries done on the wrong body site, surgeries in which instruments are left inside the patient, blood transfusion using the wrong blood type, and medication errors.

Labels: doctor negligence hospital negligence, malpractice, medical error, medical malpractice, medical, medication error, negligence, Shevlin Smith, wrong site surgery,

5/25/2008
Michael Shevlin
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Another Frivilous Lawsuit Myth Debunked

In previous blogs, we have disputed claims by proponents of medical malpractice tort reform that insurance premiums are rising as a result of an increase in medical malpractice claims. A recent study out of the Suffolk University Law School offers further support for our position.

Examining malpractice insurance premiums in the State of Massahusetts from 1975 to 2005, the authors of this study found that medical malpractice premiums have actually declined from 1990 to 2005 for virtually all physicians practicing in Massachusetts. The authors noted that because Massachusetts has the fourth-highest median malpractice payouts of all states, if there was a premium crisis due to the number of lawsuit settlements, it should logically occur in Massachusetts

The authors proved yet again that malpractuce premiums are not higher than ever and that there is no premium crisis. Their study demonstrates the fallacy of such arguments, noting that the proponents of such arguments fail to account for inflation, discounts offered by insurance companies to increase their market share, and the historical rise and fall cycle in insurance underwriting.

Moreover, national figures published by the American Medical Association support the fact that malpractice insurance premiums do not have a significant impact on a physician's ability to practice medicice. These figures show that premiums make up 7 percent of total practice costs for all physicians.

Labels: insurance cost, insurance premiums, lawsuits, malpractice, medical error, medical malpractice, medical negligence, negligence, tort reform, Virginia

5/23/2008
Michael Shevlin
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Website Allows Patients To Compare Hospital Ratings

Until recently, it has been virtually impossible for patients to gather information that allows them to compare the quality of care that hospitals provide. Now there is Hospital Care. This website, which is hosted by the Centers for Medicare & Medicaid Services, provides scores for more than 30 measures of care and service. CMS officials hope that the website will encourage hospitals to improve their quality of care. There is another laudatory benefit to the website, however. It helps patients compare hospitals against other hospitals on issues such as how each hospital treats certain health conditions and which medical procedures each hospital performs. This information enables patients to make better hospital care decisions.

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3/6/2008
Michael Shevlin
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Shevlin Smith's Praise for "A Call To Action For Doctors"

Dr. SreyRam Kuy, a medical doctor, recently wrote an Op-Ed in the Los Anglees Times entitled "Stand up for Patients." We found this physician's perspective on the current status of our nation's health care system and the response of doctors to be both refreshing and enlightening.

Dr. Kuy noted that physicians are increasingly outspoken on issues such as tort reform and cuts in Medicare reimbursement rates, both of which affect physicians' income. However, there seems to be relative silence about reports of poor health care or medical negligence in the United States. He cites the report compiled by Institute of Medicine regarding statistics of medical negligence, which our firm has previously cited and discussed in prior blogs). He also pointed to the recent Commonwealth Fund's national score card showing that the U.S. ranks last among 19 industrialized nations on infant mortality, and 15th on "mortality from conditions amenable to healthcare" — that is, early deaths that might have been prevented with proper care. Dr. Kuy boldly reminds colleagues that a physician's first loyalty should be to his or her patients, rather than to bolstering personal income, stating that physicians hold a "sacred trust" to protect their patients' health.

Dr. Kuy cites a positive example of physicians with the proper motivation that recently occurred in California. Blue Cross of California requested physicians to disclose any medical conditions that might enable it to cancel patients' medical coverage. Dr. Kuy praises the California Medical Association and the physicians who protested this outrageous request, which was so obviously not in the best interests of the patients.

Although Dr. Kuy seems sympathetic to the low morale of physicians, he suggests that a fight for the patients rather than for greater income is the better way to boost morale. We certainly agree that the medical community would be better served, both in its public image and its own morale, if it were better policed from within.

As we have pointed out before, the drop in physician income has very little, if anything, to do with medical malpractice lawsuits, and has everything to do with how insurance companies choose to compensate physicians for patient care and how insurance companies choose to charge physicians for medical malpractice insurance. The enemy is not the legal system, which seeks to provide recourse for patients who have been injured by the negligence of physicians and other health care providers. The true enemy is insurance companies who consistently put their corporate profits ahead of everyone else -- physicians, other health care providers, patients, etc.

Unfortunately, physicians certainly feed the public and political outcry against cases of medical negligence. Innocent victims of negligence in other types of cases, such as automobile accidents, are not nearly as denigrated. At Shevlin Smith, it is our position that a victim is to be assisted and compensated, regardless of the origin of injury. Dr. Kuy took brave steps toward encourgaging his colleagues to abandon prejudice against medical reform when he insisted that the patients' best interest must come first.

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3/6/2008
Michael Shevlin
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How Can A Medical Malpractice Case Be Called Frivolous When Expert Medical Testimony Is Required Before A Lawsuit Can Even Be Filed?

If you have read our previous blogs, you have noticed that we take great issue with the tort reformers' claim that our legal system is plagued with frivilous medical malpractice lawsuits. We have previously cited on our website numerous studies that debunk this claim.

Now, there is additional support for our position. This time it comes from an article written by physcians in the December 2007 issue of the medical journal, Plastic & Reconstructive Sugery.

In an article captioned, "Expert Witness Reform," the authors correctly note that a lawyer cannot bring a frivolous claim to trial without a physician expert witness stating that the claim is not frivolous. Thus, as the authors conclude, it is the expert physician, not the attorneys, who define "meritless" and "frivolous" claims.

In Virginia, the protections against frivolous medical malpractice lawsuits are even greater. Under Virignia law, a lawyer cannot even file a medical malpractice lawsuit without a physician expert witness certifying that the case is not frivolous.

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2/15/2008
Michael Shevlin
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Three Virginia Nursing Homes Listed Among Nation's Worst

The Centers for Medicare and Medicaid Services (CMS) recently released its list of the worst nursing homes in the United States. Among the 131 nursing homes cited were three from Virginia -- Beacon Shores Nursing & Rehabilitation in Virginia Beach, Ruxton Health of Woodbridge, and Harbour Pointe M & R Center in Norfolk.

Nursing homes were placed on the list based upon findings made by inspection teams. Criteria employed by the inspection team included: (1) whether a nursing home had more deficiencies involving quality of care matters than an average nursing home; (2) whether a nursing home had more serious deficiencies involving quality of care matters than an average nursing home; and (3) whether a nursing home had a pattern of serious problems that has persisted over a long period of time.

The Centers for Medicare and Medicaid Services make the following suggestions regarding the selection of a nursing home:

Visit the nursing home and talk to staff, residents and other families

Ask to see the results from the last State or CMS survery

Look at the survey history of the nursing home on Nursing Home Compare to see what areas may be problematic

Ask the nursing home staff what they are doing to improve quality of care for residents in the nursing home

Call the State survey agency to find out more about the nursing home

Look to see if the nursing home has been placed on the the Special Focus Facility (SFF) Initiative by the Centers for Medicare & Medicaid Services in the past and see how long the nursing home remained on that list

Call you local State Ombudsman, Administration on Aging, and local groups to find out about the nursing home

Use the "Nursing Home Brochure" found at http://www.meidcare.gov/Publications/Pubs/pdf/nursinghome.pdf and "Guide to Choosing a Nursing Home" at http://www.medicare.gov/Publications/Pubs/pdf02174.pdf

Labels: medical malpractice Medicare nursing home nursing home attorney Virginia

11/21/2007
Michael Shevlin
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Is there too much medical malpractice litigation or is there too much medical malpractice?

In his book, "The Medical Malpractice Myth," Tom Baker seeks to answer the question whether there is too much medical malpractice litigation in the United States or whether there is too much medical malpractice. His answer may surprise you. Tom Baker examines every relevant study performed in the last thirty years on the issue of medical malpractice. Most of these studies were conducted by health care providers, including physicians, hospitals, and nurses. Based upon those studies and other data he has gathered on his own, Tom Baker concludes that there is an epidemic of medical malpractice in the United States. His figures are staggering. Doctors and hospitals injure about one out of every twenty-five hospital patients. Negligence is the cause of injury in about one of every four of those cases, meaing that one patient in every 100 is the victim of medical malpractice. Of note, more people are killed by medical malpractice than are killed by auto and workplace accidents combined. Other significant findings include: * Compared to the amount of medical malpractice, there is very little medical malpractice litigation. The evidence shows that very few victims of medical malpractice actually file lawsuits. Data show that there are approximately seven proven medical malpractice injuries for every one medical malpractice case that is filed. * The number of medical malpractice lawsuits is not growing. Similarly, the overall size of the lawsuit settlements and verdicts is not increasing, particualry once the rising medical care costs for treating medical malpractice victims is taken into account. * Medical malpractice lawsuits and jury verdicts are not to blame for the recent medical malpractice insurance crisis. In reality, the culprit for the insurance crisis is the boom-and-bust cycle in the insurance industry that has been an inherent part of the insurance business for over a century. * Medical malpractice lawsuits are not depriving Americans of access to health care. The evidence shows that the costs associated with medical malpractice litigation are less than 1% of the entire cost of the health care system. * Medical malpractice lawsuits actually do good. An example of this is the American Society of Anesthesiologist's closed case study of all past medical malpractice claim filed involving anesthesia. This study led to significant changes in how anesthesia was practiced in the United States. For example, better anesthesia equipment was developed and new practice guidelines were implemented. The end result was better health care for patients and lower insurance premiums for anesthesiologists. * Medical malpractice insurance premiums for health care providers is not as high as commonly reported. The average insurance premium paid per doctor is less than $12,000.

Labels: doctor negligence hospital negligence insurance cost jury verdicts lawsuits malpractice medical malpractice negligence nurse negligence

Insurance

8/12/2008
Michael Shevlin
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America's Ten Worst Insurance Companies

The American Association for Justice recently published a report entitled "The Ten Worst Insurance Companies in America." The companies identified were:

1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. Wellpoint
7. Farmers
8. UnitedHealth
9. Torchmark
10. Liberty Mutual

Labels: health insurance insurance insurance reform motor vehicle insurance

General

8/12/2008
Michael Shevlin
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It Is The Insurance Industry That Is In Dire Need Of Reform

The American Association for Justice recently published a report entitled "The Ten Worst Insurance Companies in America." The report identifies some pretty staggering figures relating to the profits made by the insurance industry over the last ten years. For example, the report states that "over the last 10 years, the property/casualty insurance industry has enjoyed average profits of over $30 billion a year." The report further states that "the life and health side of the insurance industry has averaged another $30 billion." It deserves special emphasis that these figures are the profits earned by the insurance industry.

The report also notes that the U.S. insurance industry takes in "over $1 trillion in premiums annually" and has "$3.8 trillion in assets." This later figure is more than the GDPs of all but two countries in the world.

Given these figures, it is hard to argue against the fact that the insurance industry is doing quite well. Yet, in comparison, how are policyholders doing? Many of us are aware that health care providers are complaining that the rising cost of their medical malpractice insurance premiums. Most of us know that our health insurance premiums continue to rise. Those who have had the misfortune of being victims of a natural disaster, such as Hurrican Katrina, know that our insurance companies often fight us by denying claims rather than help us recover.

Proponents for tort reform often advocate for changes in our civil justice system in an effort to stem the rise in insurance premiums. They argue that restricting the right of Americans to bring lawsuits, or arbitrarily limiting the amount of recovery by persons injured due to the negligence of others, will best effectuate such an end. Of course, there is little evidence to support such claims. Perhaps it is time that different questions are asked. For example, why do insurance companies continue to raise premiums when they are earning record profits? Why do insurance companies continue to emphasize profits over fair dealing with their policyholders?

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1/15/2008
Michael Shevlin
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New Harvard Study Deals Another Blow To Tort Reform Advocates

A new study from Harvard Medical School Researchers at Cambridge Health Alliance has found that the waiting time for patients seeking emergency care is getting longer each year. The study examined the time between patients' arrivals in the emergency department (ED) and when they were first seen by a doctor, and found that the average wait tme increased 36% from 1997 to 2004.

Some additional findings of significance in the study are:

(1) patients needing emergent care waited even longer - waiting on average 40% longer in 2004 than in 1997.

(2) patients suffering from hearts attacks waited even longer still -- on average 150% longer in 2004 than in 1997.

(3) the increased delays affected everyone, including those with and without health insurance, and people from all racial and ethnic groups.

The authors noted that "prolonged ED waits have serious implications for the quality of care." When treatment is delayed, particularly for severely ill patients such as those suffering from heart attacks, patient recovery and survivability is adversely affected.

Of note, the study did not find that medical malpractice claims were a factor in the reduction of quality of care at Emergency Departments, nor did it advocate the need for tort reform measures as a solution to the reduced quality of care. As such, the study is yet another blow to tort reform advocates who blame medical malpractice litigation for the poor quality of care received by Americans.

A link to the new study can be found at http://content.healthaffairs.org/cgi/content/full/hlthaff.27.2.w84/DC1

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12/7/2007
Michael Shevlin
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Frivilous Lawsuits Myth Debunked

Every year around this time, media outlets across America and the world get their laughs at "this year's" Stella Awards. The Stella Awards are a list of the year's seven "most outlandish lawsuits and verdicts in the U.S." For anyone who has cared to check, this year's seven cases are repeats of years past. Worse, as it turns out, the cases are fictional. Rick Casey, a journalisit from the Houston Chornicle, exposes the myth behind these cases in his article "Incredible Lawsuit Tales." In addition to exposing the myth behind the Stella Awards, Mr. Casey explains away many of the misconceptions behind the McDonald's coffee cup case that has led many Americans to believe (wrongly) that our civil justice system is flawed. Mr. Casey leaves us with an important reminder: "The next time an Internet tale makes you think things are even worse than you thought, check it out. Especially when the tale suggests that the American system is stacked against wealthy corporations."

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10/17/2007
Michael Shevlin
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Are Insurance Companies Shedding Their Role As Risk-Bearers In An Effort To Become Profitable Financial Institutions?

There have been numerous news headlines documenting the record profits being earned by insurance companies in recent years. These record profits come on the heels of many natural disasters such as Hurricane Katarina and California forest fires, in which many policy holders are being denied coverage or being offered less than full value for their replacement costs. Click here to review a detailed article recently published in the Biloxi Sun Herald discussing this issue.

Given the record profits being earned by insurance companies, do you believe that they are failing to meet their obligation to bear the risk for the losses of its insureds? Do you believe that these profits are coming at the expense of insureds whose claims are being unjustly denied or undervalued?

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10/17/2007
Michael Shevlin
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Study Finds Type Of Health Care Inusrance Affects The Quality Of Care Patients Receive

A recent New York study found a significant difference in the treatment received by patients based upon the type of health insurance coverage carried by the patient. The authors, who were from the Weil Cornell Medical Center in New York, examined treatment offered to patients suffering from an appendicitis. They found that patients who had health insurance through Medicare or Medicare were 14% and 22% more likely to suffer a ruptured appendix due to a delay in the performance of surgery as compared to patients who had private insurance. They also found that patients who had no health insurance were 18% more likely to suffer a ruptured appendix than patients who had private insurance. The differences persisted even after controlling for age, sex, socioeconomic status, type of hospital and other factors.

The authors' findings were published last month in The Journal of the American College of Surgeons and were also recently published in the New York Times. Click here to read the New York Times article.

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9/26/2007
Michael Shevlin
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FDA acknowledges loophole that allows non-FDA approved drugs to be prescribed by health care providers

CNN reports that doctors write approximately 65 million prescriptions for drugs not yet approved by the U.S. Food and Drug Administration, the federal agency that regulates prescription drugs. These drugs slip through a "black hole" in the drug approval system, whereby the FDA provides the drugs with an identification number to track the drug the regulatory process but that identification number is then used by pharmacies and health care providers to order the drugs for patient use. Because the drugs have an identification number, pharmacies and health care providers mistakenly believe the drugs have been approved by the FDA even though they have not.

According to the CNN article, the FDA has known about the existence of this "black hole" for over four decades, but has failed to address it. Perhaps even more shocking, the FDA refuses to identify for the public the drugs that have slipped into this "black hole" despite knowing the identity of such drugs. The result is that the public continues to be at risk.

Click here to read the CNN article in full.

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9/13/2007
Michael Shevlin
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Is The FDA Doing Its Best To Protect American Citizens From The Risks Of Drug Medications?

Avandia is a diabetes drug designed to lower a diabetic's blood sugar and kept it under control. As such, one of its aims is to protect against the risks of uncontrolled diabetes, including the risk of heart disease. The drug is made by GlaxoSmithKline.

Ironically, in May, reports began to surface that instead of protecting diabetics from heart disease, Avandia was actually having the opposite effect. A study published in the New England Journal of Medicine found that the use of Avandia increased a patient's risk of heart attacks. Another more recent study published in the Journal of American Medical Association found similar risks to patients, noting that the use of the drug doubled the risks of heart failure and raised the risks of heart attack by 42 percent.

A number of physicians have called for the withdrawal of Avandia from the market. A safety scientist at the Food and Drug Administration joined in that call arguing that Avandia's toxic effects on the heart had caused up to 205,000 heart attacks and strokes, some fatal, from 1999 to 2006. Regardless, the Food and Drug Administration overwhelming voted otherwise. Instead, the FDA has required GlaxoSmithKline to place strict warnings on Avantia labels.

Of particular interest, FDA officials have admitted that GlaxoSmithKline told the agency about heart risks nearly two years ago but that because of internal disagreements, it never warned patients.

This, of course, leads to the question is the FDA really doing everything within its power to help protect the American public?

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Shevlin Smith Blog

Is Insurance Company Greed The Reason For Higher Premiums?

Patient Advocacy: A Growing Business

Serious But Preventable Medical Injuries On The Rise

Another Frivilous Lawsuit Myth Debunked

Website Allows Patients To Compare Hospital Ratings

Shevlin Smith's Praise for "A Call To Action For Doctors"

How Can A Medical Malpractice Case Be Called Frivolous When Expert Medical Testimony Is Required Before A Lawsuit Can Even Be Filed?

Three Virginia Nursing Homes Listed Among Nation's Worst

Is there too much medical malpractice litigation or is there too much medical malpractice?

America's Ten Worst Insurance Companies

It Is The Insurance Industry That Is In Dire Need Of Reform

New Harvard Study Deals Another Blow To Tort Reform Advocates

Frivilous Lawsuits Myth Debunked

Are Insurance Companies Shedding Their Role As Risk-Bearers In An Effort To Become Profitable Financial Institutions?

Study Finds Type Of Health Care Inusrance Affects The Quality Of Care Patients Receive

FDA acknowledges loophole that allows non-FDA approved drugs to be prescribed by health care providers

Is The FDA Doing Its Best To Protect American Citizens From The Risks Of Drug Medications?

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