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News - 2009 Press Release

For Release: September 29, 2009

Insurance Commissioner Poizner Announces $600,000 Settlement with Life Insurance Company of North America for Alleged Claims Handling Violations

Insurance Commissioner Poizner announced today that the Department of Insurance has reached a $600,000 settlement agreement with Life Insurance Company of North America ("LINA") to resolve allegations of disability insurance claims handling violations from February 2005 through June 20, 2006. In addition to the fine, LINA agreed to make changes in its claims handling policies and procedures, and to review previously closed claims to determine if additional benefits are due.

"Individuals purchase long term disability insurance to protect themselves and their families in the event they become disabled and are unable to work," said Commissioner Poizner. "When insurance companies fail to follow the law in fairly and expeditiously adjusting these claims, it has a devastating impact on policyholders and their families. I am pleased that LINA has taken responsibility for its actions and has implemented changes in its policies, procedures and practices. The Department will continue to monitor the actions of all insurers selling and marketing disability insurance in the state of California."

The Department performed an onsite examination of LINA's claims handling practices. During this examination, the Department found instances where LINA had made claims determinations prior to requesting medical records and examples of LINA adjusters ignoring substantial new information after a claim had initially been denied. As part of the settlement, LINA has agreed to make significant improvements to its claims handling practices in order to avoid future violations.

Based on the results of the examination, CDI filed an Order to Show Cause/Statement of Charges/Accusation and Notice of Monetary Penalty alleging that LINA's claims handling practices were in violation of state law. In addition to the penalty, the settlement calls for LINA to cease and desist from engaging in any acts or practices in violation of California law. LINA's revised claims handling practices are designed to avoid the type of violations alleged and the Department will provide oversight to assure that this goal is being met.

LINA will review all California resident closed denied claims for the period January 2005 through December 2007 using the agreed upon quality standards outlined in the settlement.

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  • First of all, I want to express my extreme gratitude for probably saving my daughter's life.

    “First of all, I want to express my extreme gratitude for probably saving my daughter's life. By staying in treatment, the improvement is remarkable. She had been in eating disorder facilities many times, and treatment had been interrupted repeatedly by Anthem Blue Cross's denying benefits. Many of the health professionals were telling me that maybe my daughter was a hopeless case. You both gave me hope. She is still struggling with some residual issues around eating, but the change in her attitude, her ability to assess her own recovery, and her wish to live instead of to die, is evident in her life. Now she is back in school, after years of having her education disrupted by the eating disorder. She goes places with friends, and even goes out to restaurants for fun! This year marked the first holiday season for many years, when she had not been in a treatment facility. Other people gave up and you didn't. I can't thank you enough. You took the action that was necessary to keep my daughter in treatment long enough for it to work.”

    Anonymous

  • Truly outstanding in every way!

    “Both Glenn Kantor and his associate attorney Brent Brehm are truly experts in the field of disability law. They handled a complex individual disability policy issue for me. Their knowledge of the law, coupled with their experience, resources, and tactical skills, helped me obtain results that exceeded my expectations. Truly outstanding in every way!”

    Anonymous

  • I won the appeal.

    “Hi Glenn- This is a very belated thank you for your generous assistance and advice last summer, when I was appealing UBH's decision for my son. I won the appeal, at least for care at the partial hospitalization level (they wouldn't budge on residential, but the facility was accepting the partial care reimbursement for residential treatment). But the appeal was a great moral victory, and I think it's a great thing to have in the record, just in case he needs to go for treatment again. Thanks again for your generous help, I was very grateful for it. Wishing you a most happy Thanksgiving.”

    Terry S.

  • You are the light in the darkness for all of us.

    “Lisa- You are the light in the darkness for all of us in the eating disorder community. I believe that you were born to take on these challenges.”

    Pam S.

  • Thank you for being lawyers with a heart.

    “Thank you for being lawyers with a heart.”

    Miriam T.