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Case ID: 3008 | Insurance | 12/27/2004
The parties have reached a $20 million settlement in an action filed against Midwestern insurance company Central States Health and Life Company of Omaha on behalf of cancer patients and their families who alleged that the company refused to pay for certain treatments allegedly covered under cancer insurance policies it sold, in violation of its contracts with the patients. Persons eligible to take part in the settlement should contact class counsel for more information.
Under the settlement agreement, Central States Health & Life Company of Omaha will pay $7.5 million to more than 1,200 cancer patients who were denied coverage under those policies. These class members are part of the monetary damages class. The agreement also calls for the establishment of a $10 million settlement fund to pay for future medical expenses of people who have cancer policies with the company. The class action potentially involves almost 15,000 people in 35 states who bought policies from the insurer, known as CSO. CSO began selling the cancer insurance policies in 1987. The class representative, Kay Bergonzi, claimed that the company refused to pay her claims for radiation and chemotherapy after she contracted cancer and began treatment. According to Ms. Bergonzi, the company underpaid or denied cancer claims based on an "overly restrictive interpretation" of chemotherapy, radiation therapy, and surgical benefit provisions of the CSO cancer policies. Among the practices alleged by the plaintiffs was CSO's refusal to pay for anything but the actual delivery of cancer-fighting medications. The action noted that “radiation treatment requires much more than simply standing the patient in front of a machine and flipping a switch." A number of complex steps--including treatment planning, dosage calculation, and lead blocking to protect noncancerous organs--are needed to provide safe and effective treatment. CSO allegedly implemented a policy change in 1998 to disallow coverage for everything but "treatment delivery," such as focusing the radiation beams during radiation therapy. CSO marketed its "Cancer and Dreaded Disease" policies through large employers in South Dakota and other states. The wording of the policy allegedly suggested that the coverage would pay nearly everything that major medical insurance will pay for. At Lawcash.com, it is our goal to keep you informed about important legal cases, class actions and settlements. Our lawyers offer free legal evaluations in tort cases, class actions, personal injury, and other lawsuits because we are dedicated to helping you resolve your legal complaints. Other Insurance Cases of Interest The use of substandard non-original equipment manufacturer parts in auto repairs as required by auto insurance companies is a topic of growing controversy. The class has been certified in a class action filed against Government Employees Insurance Company on behalf of Illinois auto insurance policyholders who allege that the company forces them to use lower-quality parts to fix their vehicles in violation of their policies. The theory of diminished value asserts that buyers choosing between two otherwise equal vehicles will select one that has not been previously damaged and repaired, even where the repairs to the other vehicle were first-rate. The parties have reached a tentative $2,346,535 settlement in an action filed against SAFECO Insurance Company of America and numerous affiliated companies on behalf all persons insured by an automobile insurance policy issued in Georgia by the defendants and who made a claim for damage to their vehicles under their collision, comprehensive, underinsured, or uninsured motorist coverage for a loss that occurred between June 19, 1997, and November 28, 2001. Though there is no claims deadline at this time, persons who are eligible to take part in the settlement who have not received a notification letter should act as soon as possible to alert the company of their eligibility. The parties have reached a settlement apparently valued at $5,850,000 in an action filed against the Insurance of America Agency, Inc., the National Business Association, Inc., the American National Insurance Company, Inc., and the American National Life Insurance Company of Texas on behalf of all persons (1) who obtained certificates of insurance from American National Life Insurance Company of Texas, Inc., or American National Insurance Company, that were the subject of a trust agreement in which those companies were the administrators for the National Business Association insurance program after October 12, 1996, or (2) who were over eighteen as of July 1, 2003, and were insured under certificates containing a co-pay and wellness benefit rider offered by American National Life Insurance Company of Texas when notices issued in their state of residence that the rider was to be deleted. Persons who have not received notification, but are eligible to take part in the action should contact class counsel as soon as possible. The class has been certified in an action filed against insurance company Farmers Group, Inc., on behalf of all Nevada automobile insurance policyholders of Farmers Insurance Exchange who submitted a first party claim for vehicle theft or property damage, whose vehicle was declared a total loss as valued by CCC Information Services, Inc., or its predecessor Certified Collateral Corporation, and who were paid the valuation amount by Farmers between August 5, 1992, and March 31, 2004. Persons eligible to take part in the action should contact the attorneys for the class for more information.
Numerous class actions have been filed against New Hampshire banks and credit insurance companies on behalf of persons who financed vehicles in New Hampshire, purchased credit life or credit disability insurance, and then paid off their loans early between 1999 and the present. The actions allege that the defendants failed to return the unused premiums in violation of New Hampshire insurance law. If the insurance system doesn't work as it should, dentists and doctors can be hurt as badly as their patients. The parties have reached a tentative $5 million settlement in a class action filed against insurer Aetna, Inc. and its subsidiaries on behalf of dentists who alleged that the Hartford-based insurer interfered with dental procedures to cut costs and forced dentists to comply with excessive paperwork in violation of antitrust laws and the federal Racketeering and Influenced Corrupt Organizations Act. Dentists who wish to take part in the settlement will have to fill out a claims form that is to be made available through the mail and on the settlement site that has been established by Aetna.
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