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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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  • 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.

  • I am a life you have touched. May God bless you richly.

    “After suffering with constant pain for nearly seven months, losing the job I loved and then being denied my long term disability, I was extremely discouraged when I began looking for help. With a few phone calls from Mr. Kantor to my insurance company, my long term disability was reinstated . The financial burden was lifted and I have hope again. I am a life you have touched. May God bless you richly.”

    Susan H.

  • Thank you a zillion times for your patience and time and absolutely helpful information.

    “Thank you a zillion times for your patience and time and absolutely helpful information. You've helped me understand my position with my disability insurance and payments so much better. There is some real comfort in feeling anchored in knowledge…of what is and what might be in the future. Thanks to you!”

    B.

  • You have restored my faith in the goodness of people!

    “Thank you Glenn for accepting my case. I had all but given up on finding an attorney that was willing to take this case, and although you may not remember, I enclosed a note to you when I sent my [ins. co.] file asking you to please help me. You did that sir, and I can't thank you enough. My thanks to you Corinne for pursuing my case with vigor. I don't know much about how these legal things are handled, but I could tell by your communications with me, making sure I was always informed, that you were on top of it all. Also, you were ALWAYS available to me to answer questions, and your compassion for me and my situation is so much appreciated. I have had limited exposure to the legal system and attorneys, but I have never been able to just call and talk to them, as I could with you. I always had to speak with someone in the office that couldn't really answer my questions. My sincerest thanks and best wishes for you both You have restored my faith in the goodness of people!”

    Dick H.

  • there are no words that can express the feelings of gratitude and relief I have that you helped us

    “I wanted to thank you again for all of your help. My daughter would not be in treatment without your help. I can never thank you enough, there are no words that can express the feelings of gratitude and relief I have that you helped us, and I believe saved my little girl. Taking her back to Timberline Knolls was very difficult in many ways, I wish UBH could know the damage they have done to her by having her go in and out like this. When she went into Timberline Knolls the first time she was not happy to go exactly, no one wants to go into treatment, but she was open to going in and ready, for the first time, to really look at her issues and work hard to get better. When she had to leave Timberline she expressed that she wished she could have stayed because she felt like she was finally at a place where she was getting better and, though it was hard, she was really opening up and dealing with her issues for the first time, something she has had a hard time doing. I just wanted you to know that she was going down to a really bad place and without you I don't know what would have happened except that she would not be at Timberline Knolls right now getting better and I thought you should know this. With unending gratitude.”

    R.