"However, actions have consequences." Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), at 6. Consider what those consequences can include, in this further post of what the Florida Appellate Court observed in this interesting new decision under Florida Statute Section 627.736(4).
The Florida Appellate Court reasoned in this new case that an overdue payment under the Florida Personal Injury Protection Statute, Section 627.736, entitles the insured "by law to an award of interest on the overdue payment and potentially an award of attorney fees for non-payment if counsel is involved." Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), at 6-7.
"Furthermore," said the Court in this recent decision, "an insurer who does not act 'fairly and honestly toward its insured' in the settlement of properly submitted personal injury protection benefits claims may be subject to a statutory first-party bad faith action with all of its attendant consequences.... This is the manner in which the legislature has chosen to regulate insurers in matters of this type." Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), at 7.
The role of legislative regulatory schemes in fashioning implied or private causes of action in first-party insurance cases in particular, or as in this recent decision, refusing to do so, is explored by Dennis J. Wall, "Litigation and Prevention of Insurer Bad Faith" §§ 9.15-9.16 (Second Edition Shepard's/McGraw-Hill, 2009 Supplement West Publishing Company).
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Their shared flaw? "Garbage In, Garbage Out" ("GIGO").
70 percent of current income is the model widely used for calculating the amount of income you will need when you retire. Unfortunately, that model, like Catastrophe Models, is not based on experience but on opinion.
In a newly released study, Professors John Karl Scholz and Ananth Seshadri wrote about "What Replace Rates Should Households Use?" Their study was published by the University of Michigan Retirement Research Center. Here is a pdf copy posted online of their Research Paper. They found many reasons why 70 percent of currrent income is a flawed model for calculating retirement income, but the biggest is the simplest: Calculate your retirement needs based upon your experience, not opinions.
Even if the opinions are your own, but even more so if the opinions are someone else's.
Here is a web page with some of the research papers made available online of Professor John Karl Scholz, Economics Professor of the University of Wisconsin-Madison. Here is the web page listing publications of Economics Professor Ananth Seshdari, also at the University of Wisconsin-Madison.
Oh, and forget about using those online calculators unless you are actually trying to fail. "In other words, if you're using an online calculator to plan your retirement, you might be undersaving or oversaving by a wide margin." MarketWatch, "Typical Retirement Savings Rate Models Are Often Flawed, Professors Say," published online in St. Petersburg Times Online, Friday, November 6, 2009.
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In a newly released Florida Appellate Court decision, the Court confronted two issues involving Florida Statute Section 627.736(4)(2004), which was and is a subsection of Florida's Personal Injury Protection or "PIP" Statute. The first issue was whether the Florida Statute establishes "a firm deadline" for providing a Policyholder with an Explanation of Benefits ("EOB") under Florida's Motor Vehicle No Fault Law.
The Florida Appellate Court held that it does not. Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), attached Official Slipsheet Opinion at 7-8.
The second issue was whether the Florida Statute conveys a private or implied statutory cause of action in cases where it is allegedly breached.
The Florida Appellate Court again held that it does not. Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), at 8.
"However, actions have consequences." Download United Automobile Insurance Co. v. A 1st Choice Healthcare Sys's, Inc. (Fla. 3d DCA Opinion Filed November 4, 2009), at 6. Consider what those consequences can include, in a further post yet to come, involving this interesting new decision under Florida Statute Section 627.736(4).
TO BE CONTINUED ......
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Adjusting to changing times and changing Insurance Coverages.
In a new report by Lesley Alderman, "Patient Money/In Anxious Times, Medical Help for the Mind as Well as the Body" p. B5, col. 1 (New York Times Nat'l ed., "Business Day" Section, Saturday, November 7, 2009), these and other useful insights are offered:
Senator Bill Nelson (D-Fla.) reports that in his judgment, a source of payment for Chinese Drywall Damages Claims other than Insurance is: The Chinese Government. However, he also announced on Friday, November 6, 2009 that when he broached this idea to Chinese Government authorities, "They basically blew me off." Janet Zink, "Nelson Says China Should Pay For Damage Caused by its Contaminated Drywall" (St. Petersburg Times Online, Friday, November 6, 2009).
This updates a post here on September 21, 2009.
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In a recent post, I made available to you and your clients a link for sources of advice in the selection process of open enrollment for Employer-provided Group Health Insurance Plans. This is the time of year that open enrollment season begins for many such Plans. Medicare recipients, too, may have choices to make in their own open enrollment season. Here is a good source of guidance and advice concerning Medicare opportunities for choice at this time: Walecia Konrad, "Patient Money/Now is the Time to Weigh Medicare Options" (New York Times Online Friday, October 30, 2009; published also in print edition Saturday, October 31, 2009).
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Once there were three (3) Healthcare Reform bills pending in the U.S. House of Representatives. Now there is (kind of) one. It is fair to say that the work of merging the three bills into one bill, is still a work in progress. A vote will be taken in the House on the resulting one bill ... sometime in the future. In the meantime, here are the results of two reporters' insights into "Reader Questions on House Healthcare Bill" by Kim Geiger and James Oliphant (Los Angeles Times Online, Sunday November 1, 2009).
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A new decision in a Florida case addresses many issues: Compliance with Florida's Insurance Disclosure Statute is only one of those issues in Download Hanson v. Maxfield (Fla. 1st DCA Opinion Filed October 30, 2009).
The Florida Statute involved is Section 627.4137. In the Hanson case, the injured claimant apparently attempted to condition a settlement offer on full compliance with all the insurance information disclosure requirements of the Florida Statute, among other things. In response, the Policyholder's Insurance Company's attorney (apparently not the Defense Attorney provided by the Liability Insurer, but instead a lawyer retained directly by the Defendants' Insurance Company, State Farm), represented among other things that the response constituted "full compliance with Florida Statutes, Section 627.4137." Download Hanson v. Maxfield (Fla. 1st DCA Opinion Filed October 30, 2009), attached Official Slipsheet Opinion at 7.
The First District Court of Appeal reversed a Final Judgment in favor of the injured claimant-Plaintiff and remanded for further proceedings consistent with its opinion. In part here pertinent, the Florida Appellate Court reasoned, after examining the offer and the response to it, that in this case the record facts displayed "a settlement offer with specific terms and an unequivocal acceptance of the terms offered." Download Hanson v. Maxfield (Fla. 1st DCA Opinion Filed October 30, 2009), at 8-9.
Some of the features of Florida Statute Section 627.4137, the Insurance Information Disclosure Statute, are addressed by Dennis J. Wall, "Litigation and Prevention of insurer Bad Faith" §§ 4.08-4.11 (Second Edition Shepard's/McGraw-Hill; 2009 Supplement West Publishing Company).
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Sources of advice for you and your clients concerning the choices embedded in Employer-Based or Employer-Provided Group Health Insurance Plans are offered in this linked newspaper article, by Elizabeth Cooney, "Apples to Apples?/During Open Enrollment Time, it Can Really Pay Off to Learn the Nuances of HMOs, PPOs, and Other Common Health Insurance Plans" (Boston Globe Online, Sunday, November 1, 2009).
And another source that may help stop the information asymmetry between you and your clients, on the one hand, and those who want you and your Employers to buy their version of a Group Health Insurance Plan on the other hand: See "What Does That Mean?/Some Terms Used by Health Plans to Describe Their Costs and Services" (Boston Globe Online, Sunday, November 1, 2009).
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In a new development possibly affecting pending and future Insurance Coverage Claims, the Federal Centers for Disease Control has concluded that, at this time, Chinese Drywall "does not pose a health risk." See William E. Gibson and Paul Owers, "Evidence Lacking That Chinese Drywall Threatens Health, But More Tests Needed, Government Says" (South Florida Sun-Sentinel [Ft. Lauderdale], Thursday, October 29, 2009), a link which also includes a video feed from a television report of the news.
In addition, the Federal Consumer Product Safety Commission has apparently come to the conclusion that the current evidence is insufficient for it to conclude that Chinese Drywall causes injuries. Robert Trigaux's blog in the St. Petersburg Times Online has the story as of Friday, October 30, 2009.
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