Dan Hoagland’s Death Sentence at the hands of AIG’s Overly Zealous Defense

Injured War Zone Contractor Dan Hoagland shares his story of medical treatment denied  by KBR/AIG resulting in a death sentence by Cancer with Sean Calleb.

Scott Bloch, Defense Base Act Attorney tells the truth about the Defense Base Act Insurance Scandal and our Defense Base Act Class Action Lawsuit.

Join our Defense Base Act Class Action Lawsuit here

Defense Base Act War Hazards Act: Overly Zealous Representation in Defending Against a DBA Claim

employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

So Mr Rayburn how many War Hazards reimbursements has the DFEC denied

in part or whole over the following

Overly Zealous DBA Insurance Company Defense Tactics ?

The use of repeated Defense Medical Examinations with Doctors Over Paid to produce a report detrimental to the claimant, to run them through the drill

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The claims process being drug out for as long as nine years with no end in sight while the defense racks up ever more legal fees, the insco keeps charging administrative fees, not to mention the claimants attorneys fee’s, while the claimant goes without  medical and/or indemnity

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Unnecessary mileage, airfare, lodging, expenses paid out due to due coercing claimants to travel as far as five states away to attend Defense Medical Examinations, Mediations, Depositions, Hearings

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The use of private investigators, some even criminals themselves, to stalk and intimidate injured contractors and their families far beyond simply confirming a claimants status

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The use of  Third Party Administrators to handle claims processes that could easily be done without the added expense and fees.

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Unnecessary fines and interest due to non payment or late payment of  indemnity

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The financial ruination of injured contractors and their families caused by the overly zealous controverting of legitimate claims

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The Temporary Disabilities which are now Permanent due to their failure to provide medical care under the guise of investigating clearly legitimate claims.  Now the US taxpayer is responsible for disabilities far beyond what they ever had to be.

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The PTSD Suicides caused by the Insurance Companies, their claims examiners, and their attorneys

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The break up of families caused the constant pressure and abusive tactics used by the Employer/Carrier

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The forced acceptance of inadequate settlements or stipulated agreements due to starving the claimant out for years on end and/or threatening the claimant and family that if they do not accept the inadequate settlement they will make them miserable for the rest of their lives (see The Weaponization of the Defense Medical Examination)

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Unfairly denying the claimants attorneys fees in order to discourage good attorneys from handling these claims

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FECA BULLETIN NO. 12-01

XI. Miscellaneous

1. DFEC requires, before acceptance of any WHCA reimbursement claim, that the employer/carrier has made only reasonable and prudent efforts in presenting all meritorious defenses against a DBA claim without regard to whether the case is eligible for WHCA reimbursement. An employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

CECILY A. RAYBURN
Director, Division of Planning, Policy and Standards

AIG/Chartis stops writing excess workers’ comp

It had previously been predicted elsewhere that the DBA Insurance Companies would begin to crash as they lost the huge premiums they were taking in for Contractors working in the War Zones.

Take the money and run

Best Week Press Release

Big changes lie ahead for the excess workers’ compensation line, as the third-largest writer leaves the stand-alone market in the wake of rising medical costs and the possible impact of the Affordable Care Act, according to the latest issue of BestWeek U.S./Canada. Chartis said in February it stopped writing the business on a stand-alone basis.

“Workers’ compensation is in a very different place today than where it was 10 years ago,” said Russ Johnston, who runs U.S. and Canada casualty operations for Chartis.

AIG said one reason it was leaving the stand-alone business was the Affordable Care Act. AIG “concluded that there is increased vulnerability to the risk of further cost-shifting to the excess workers’ compensation class of business in particular,” the company said in a regulatory filing.

Under the ACA, some 33 million people will gain health insurance coverage at a net cost of $1.1 trillion. That increase in the insured population will result in an increased demand for doctors, resulting in a shortage of primary care doctors and some cost shifting, said Don Hurter, senior vice president of Chartis’ medical management services

What is Excess Workers’ Comp Insurance

Workers’ Comp Executive  Analyst says AIG Workers Comp Reserves are short (2010)

Shares in American International Group (NYSE: AIG) were taking a hit on Wall Street after a prominent analyst warned that three of its long-tail lines of coverage were significantly under reserved. The warning was issued by analysts at Bernstein Research who said the bulk of the reserve deficit is with its general liability and professional liability lines of coverage, but workers’ comp accounted for $1.8 billion of the total, according to published accounts of the research report.

Overall, the three lines amounted to an estimated $10 billion shortfall, while another $1 billion is spread across other lines. AIG spokesman Mark Herr says AIG is “not commenting” on the report and contacts at Bernstein Research were not available to elaborate on their findings.

Those findings could spell trouble for taxpayers who are on the hook for approximately $180 billion in financial aid to the troubled carrier. Taxpayers own 80% of the company and the value of their investment tumbled in trading on Monday in the wake of the report. Shares were off over 14% in late-afternoon trading to $28.52 a share.

While the report is troubling, the company had been showing signs of improvement. AIG and its Chartis general insurance unit recently closed the third quarter with $455 million in net income — the second quarter in a row in which it posted a profit. AIG had adjusted net income of $1.9 billion in the quarter compared to a $9.2 billion adjusted net loss last year. For its Chartis unit, which covers its workers’ comp operations, the company reported net operating income of $722 million. This is up from $105 million in the same period last year and was helped by $612 million in net investment income.

Premiums, however, were down for the unit. AIG says Chartis’ net written premiums amounted to $8.1 billion in the quarter – a 13% decline from the prior year period. AIG said the drop-off was due in part to a decision to hold the line on prices for its workers’ comp business, which accounts for 14% of its gross written premiums.

In California, AIG had nearly $576 million in written premiums in 2008 or 7.5% of the market. AIG companies filed for rate increases of 10% and 7% during the January 1 and July 1 filing periods last year. It hasn’t filed its 2010 rates. Companies in the AIG group filed for an 8% increase for its 2010 rates.

Lawsuit seeks accounting of Fort Ord Reuse Authority money

Most of $100 Million of Federal Munitions Clean Up Money goes to AIG for Insurance

Fort Ord: Group files suit to get accounting of FORA’s $100M

Open space advocates filed suit Monday to get an accounting of how the Fort Ord Reuse Authority spent nearly $100 million in federal money.

Keep Fort Ord Wild is asking a judge to compel FORA to release documents it first requested under the Public Records Act in December. Molly Erickson, attorney for the group, said FORA responded with incomplete records and said it does not have or has destroyed the rest.

At issue is a $99.3 million grant, the Environmental Services Cooperative Agreement, issued in 2007 for cleanup of munitions and explosives on Fort Ord.

The records supplied say the majority of the money, $82.1 million, purchased an “environmental insurance policy.” Erickson said FORA representatives said they did not have a copy of the policy and didn’t have a right to request one unless a claim were filed.

FORA spokeswoman Candy Ingram said the policy is a fixed-rate contract with Chartis, formerly American International Group, to administer the cleanup work with independent contractors. AON insurance, in turn, underwrote Chartis, guaranteeing the job would be completed at cost by 2015.

Contracts between the two companies are private, she said. With few exceptions, FORA does not have purview over the individual invoices submitted as part of the ongoing work, she added

US-owned Chartis Insurance cancels private death and disability insurance policies of 3000 Australian soldiers

The Telegraph January 30, 2012

A FOREIGN insurer has left taxpayers with a $2.1 million bill after cancelling the private death and disability insurance policies of 3000 soldiers, including many serving in Afghanistan

US-owned company  ( AIG) Chartis Insurance received a discretionary grant of $2.1 million from Defence last year so that the policies could be honoured until August this year, documents show. The grant was based on deployed force numbers and the number of Chartis policyholders in the ADF

The company said that as a result of a smaller than expected insurance pool and high cancellation and payout rates it would have to cancel two of the three types of policies it offers with 60 days notice.

“Approximately 3000 ADF members held Chartis insurance products, with a strong probability that many of the existing policyholders were and are currently deployed,” Defence said.

“Chartis stated in September 2010 it could not continue to incur significant losses and advised Defence that it intended to cancel policies, giving 60 days notice, irrespective of the time the policy has been owned or if the member is currently deployed in an area of operations or within Australia.”

Defence signed a funding deed last May to ensure policies affected by the decision would be secure.

“The grant ensured that extant policies will be honoured by Chartis until August 2012 providing sufficient time for policy holders to make alternative arrangements in light of the commercial decision taken by Chartis,” Defence said.

Chartis Australia chief executive Noel Condon denied the company had cancelled policies but admitted that because of the high number of claims during 2010 it had reduced the maximum payout figure from $750,000 to $250,000.

Injured Blackwater Xe war contractor approved for treatment by AIG

Bravo to Kevin Graman for exposing AIG’s  dangerous “risk management” practices.

We too hope it is not too late for Jennifer as it has been for so many who have come before her.

A Big Salute to you both !!

Kevin Graman The Spokesman Review  June 16, 2011

A Spokane-area woman who was injured by an enemy mortar explosion while working as a helicopter mechanic in Afghanistan has received approval from a government-contracted insurance company to receive the treatment her doctors say she needs.

Jennifer Barcklay, 40, of Chattaroy, was been diagnosed with traumatic brain injury after the September 2009 attack at a forward operating base in eastern Afghanistan, where she was employed by Blackwater, the private defense security contractor now known as Xe Services.

On Wednesday, she was told that Chartis WorldSource, the giant insurance company once known as American International Group, AIG, would cover the cognitive rehabilitation therapy recommended by eight medical providers in Spokane.

“This is bittersweet,” Barcklay said. “I’m hoping it’s not too late.”

It has been more than a year since Barcklay’s providers first began recommending comprehensive cognitive rehabilitation, which is more effective the sooner it is begun. It is not offered locally.

She continues to endure seizures, memory loss, headaches, tremors and problems with her balance that prevent her from returning to work.

“Frankly, I am appalled at how many obstacles have been placed in the way of her receiving the treatment she needs,” Spokane neuropsychologist Winifred Daisley wrote the insurer on Barcklay’s behalf.

A nurse contracted by Chartis to manage Barcklay’s case was unexpectedly terminated in October after notifying the insurer that her patient was approved for treatment at the Centre for Neuro Skills in Bakersfield, Calif.

Under the Defense Base Act of 1941, defense contractors must provide medical and disability insurance for their workers in war zones. The premiums are included in the companies’ contract with the Department of Defense.

There were nearly 56,000 such claims for injuries or deaths from the start of the Iraq war to 2009. That year, a congressional investigation found that insurance companies have been slow to approve claims for injuries despite receiving millions in premiums from the federal government.

Another World War II-era law, the War Hazards Compensation Act, reimburses the employer or insurer for injuries or death to a worker caused by an act of war. The insurer is reimbursed by the taxpayers for 100 percent of the claim, plus 15 percent for administrative costs.

Chartis’s approval of Barcklay’s treatment followed a letter from the U.S. Department of Labor, recommending that she be allowed to go to the Centre for Neuro Skills.

The letter also was critical of an independent review of Barcklay’s medical records by a Chartis-contracted neuropsychiatrist in Rhode Island who appeared to diagnose the patient’s condition as psychological rather than physiological without examining her.

Please see the original story at The Spokesman Review

Army vet battling private insurer for coverage she feels is due

“The American Psychiatric Association has a very specific and rigid stance against psychiatrists rendering diagnoses on patients they have not examined.”

Injured as contractor in Afghanistan but denied specialized therapy at home

Kevin Graman The Spokesman Review  June 13, 2011

A highly trained helicopter mechanic sits in her Chattaroy home and wonders what will come next: another debilitating brain seizure or the therapy she hopes will help her recover from injury as a result of a mortar explosion 20 months ago in Afghanistan.

Jennifer Barcklay says she is being denied the specialized inpatient medical treatment her doctors believe is her only hope for a normal life.

“These are war crimes, using taxpayer dollars to profit from injuries incurred by people fighting for our freedom,” Barcklay says.

Although she is a U.S. Army veteran, Barcklay, 40, was injured as a civilian working for Blackwater, the private security contractor now known as Xe Services. She and thousands of other civilian employees injured in the defense of their nation have had to navigate an often unresponsive private insurance system.

Xe’s insurance carrier has so far denied Barcklay expensive inpatient treatment known as cognitive rehabilitation therapy, which was recommend by eight Spokane area physicians and mental health care providers.

She suffers from traumatic brain injury, the signature wound of the Iraq and Afghanistan wars, for which thousands of U.S. soldiers are receiving care in military or Department of Veterans Affairs facilities. Like many of them, she continues to endure seizures, memory loss, headaches, tremors and problems with her balance that prevent her from returning to work.

Under the Defense Base Act of 1941, defense contractors must provide medical and disability insurance for their workers in war zones. The premiums are included in the companies’ contract with the Department of Defense.

There have been nearly 56,000 such claims for injuries or deaths from the start of the Iraq war to 2009. That year, a congressional investigation found that insurance companies had collected $1.5 billion in premiums, while they paid out about $900 million in compensation and expenses.

Another World War II-era law, the War Hazards Compensation Act, reimburses the employer or insurer for injuries or death to a worker caused by an act of war. The insurer is reimbursed by the taxpayers for 100 percent of the claim, plus 15 percent for administrative costs. From 2003 to 2010, the federal government paid more to insurers for expenses, $19.7 million, than it paid in compensation, $12.1 million, to claimants under the act.

More than three-quarters of the Defense Base Act claims were handled by American International Group, which was rescued in 2008 by the U.S. government in the largest corporate bailout in history.

An AIG subsidiary, Insurance Company of the State of Pennsylvania-Chartis WorldSource, took months to authorize a neurological evaluation for Barcklay. Now Chartis is refusing to pay for her inpatient treatment.

“Frankly, I am appalled at how many obstacles have been placed in the way of her receiving the treatment she needs,” Spokane neuropsychologist Winifred Daisley wrote in a December letter to Chartis case manager Debra Ragan.

Marie Ali, a Chartis spokeswoman, said she could not comment on individual claims but that the company “is committed to handling every claim professionally, ethically and fairly.”

“We provide the highest level of service to our insureds, which includes the prompt adjudication and payment of claims.”

A spokesman for Xe Services said, “The company has worked diligently with the insurance provider to help ensure Ms. Barcklay receives the level of care and treatment she needs.”

Please read the entire story here

See Also

More Than 70 Members of Congress Demand Cognitive Treatment for Troops With Traumatic Brain Injuries

by T Christian Miller from his series at ProPublica Brain Wars

AIG Sells off Life Insurance Unit, but is keeping the lucrative unit that is bleeding the DBA claimants dry

The company is expected to keep Chartis, its larger property and casualty insurance company; two additional Japanese life insurers, and a handful of smaller, U.S.-based companies. They are very unlikely to be sold, according to a Treasury official.

AIG Sale Profitable  at  Huff Post

CHARLOTTE, N.C. — American International Group Inc. said Monday that it will sell its American Life Insurance Co. division for $15.5 billion to MetLife Inc. The government-approved deal, AIG’s second big asset sale in two weeks, will give the insurer more cash to repay the billions of bailout dollars it still owes the government.

The purchase expands MetLife’s presence in Japan and high-growth markets in Europe, the Middle East and Latin America. American Life Insurance, known as Alico, operates in more than 50 countries. MetLife currently offers services in 17 countries.

It also moves AIG closer to repaying taxpayers. As of Dec. 31, the company owed the Treasury and the Federal Reserve Bank of New York nearly $130 billion. AIG’s bailout package was originally worth up to $182.5 billion.

Met Life appears to be no less ruthless than AIG read here

The Implications of AIG’s cost cutting

“Claims will come in, reserves will be needed to fund those claims, and it is possible, if not likely, that there won’t be enough capital to fund future claims.”

From Managed Care Matters

by Joe Paduda

Eight months ago I reported AIG was buying business – slashing prices for property and casualty insurance coverage in an effort to hold on to current customers and hopefully land a bit of new business. Now comes a report from Bloomberg that analysts have confirmed what some brokers and most of their competitors have known for months – Chartis (the name of AIG’s core insurance business unit that’s been separated from the rest of the ‘old’ AIG) has been accused of ‘aggressive’ pricing by analyst Todd Bault of Sanford C Bernstein, a charge that’s been leveled for months by Chartis’ competitors.

Simply put, it appears that about a year ago AIG execs decided to cut prices on liability, workers comp, and some other lines of insurance to retain business and generate cash flow to prevent the company from going under. It worked then, but at a cost that’s becoming apparent now.

There’s a lot to consider here – the possible impact of AIG’s alleged pricing actions on extending the soft market; effect of underpricing on reserve adequacy; and consequences for the likely spinoff/sale of Chartis. I’ve discussed most of these topics here on MCM, but to save you the trouble of clicking thru, here’s the summary.

First, I’d be remiss if I didn’t acknowledge that AIG execs are denying the charges, with AIG Chief Financial Officer Robert Schimek claiming their rivals’ charges “reflect a big degree of frustration by the marketplace that they’ve been unable to unseat the Chartis organization in the vast majority of business.” That’s not exactly true, as AIG reported insurance sales dropped 13% in the most recent quarter while the combined ratio increased to 105.2, results significantly worse than those of competitors Liberty, ACE, and Chubb.

Reserve adequacy
Last winter, I heard from sources ranging from headquarters staff at large competitors to several brokers around the country that AIG was quoting rates for P&C coverage that had only a ephemeral relationship to the actual cost of risk. The sense then was AIG was doing anything it could to add premium, and thereby build up the companies’ financials. AIG’s desperate effort to add premium dollars, staved off deeper financial trouble, but as I noted back in March, “the shortsightedness of this approach will become obvious. Even more obvious than it is today. Claims will come in, reserves will be needed to fund those claims, and it is possible, if not likely, that there won’t be enough capital to fund future claims.”

Soft market
AIG’s pricing actions, to the extent that they were ‘real’, were but one of several factors contributing to the depth and duration of the current soft market . But those actions can’t be discounted; as one of, if not the, largest writers of property and casualty insurance in 2009, any discounting by AIG would send tremors thru the entire industry. The company had long been known, and highly respected, for its underwriting expertise. When brokers and risk managers received quotes from AIG at very attractive rates, many likely turned to the other carriers bidding on their business and said something along the lines of “if AIG can charge me this, why can’t you?” Sure, some, or most, knew that AIG’s pricing may not have been realistic, but all’s fair in love, war, and insurance, and using one company’s bid to beat down another’s is common practice.

Chartis sale
According to Bloomberg, “AIG shareholders and the federal government face considerably more uncertainty than they may have anticipated,” Bault said. “AIG would likely have to take some kind of reserve charge” before selling its Chartis property-casualty business or holding a public offering for the division.” That sale will be a key piece in the ‘taxpayer repayment program’; we’ve kept AIG from going under, and if we are going to get our money back, a sizable chunk will have to come from the sale of Chartis. I noted last month that the disposition of AIG’s assets was proceeding rather well, and should have added a reminder about the pricing issue.

What does this mean for you?

If you work for Chartis, know that I wrote this with reluctance. As I said in November, AIG’s destruction was the result of poor management oversight and a wildly out-of-control finance unit. The women and men who work at Chartis and most of the other AIG companies do a very good job, work very hard, and take justifiable pride in their work. Here’s hoping their talent and abilities are enough to overcome poor decisions by their erstwhile superiors.

Joe Paduda’s blog and original article here

The Defense Base Act Compensation Blog

Welcome to the Defense Base Act

$$$$   We are the Best Kept Secret of the Wars   $$$$

DoL Jacksonville District Office and CNA

Blood on their Hands

 Is the Department of Labor covering up for companies who fail to provide DBA Insurance and those who fail to file claims, late or never?

and how should the taxpayer feel about them hiring “Reputation Management” Firms to cover up their cover ups?

CNA Lies to the DoL

Civilian Contractor Casualty Count

Our Fallen Contractors Memorial

At Least 121 Civilian Contractor Deaths in Third Quarter of 2012

At Least 59 Civilian Contractor Deaths in Second Quarter of 2012

At Least 49 Civilian Contractor Deaths filed on in First Quarter of 2012

At Least 418 Civilian Contractor Deaths in 2011

After Injury, The Battle Begins House Oversight Committee

“Something cruel, heartless and cynical took place in the back rooms of carriers with responsibility for civilian claims. If you like Edgar Alan Poe, you’ll love the claims files of AIG and CNA.”

War Hazards Act pays Insurance Companies

more for expenses

than to Claimants for compensation

Class Action Tax Misclassification filed against Xe, Formerly Blackwater

CNA May Finally Face Criminal Charges

Eysslinck Vs Ronco Consulting Injustice Prevails

CNA’s Double Agent in South Africa

CIVILIAN CONTRACTORS IN IRAQ AND AFGHANISTAN

OVERSEAS CIVILIAN CONTRACTORS

MSSPARKY

Contact us at dbacasualty@yahoo.com

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