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Started By
Message
re: Here are the details of the lead tort reform bill for the upcoming session.
Posted on 5/13/20 at 12:56 pm to brewhan davey
Posted on 5/13/20 at 12:56 pm to brewhan davey
quote:
These are pretty massive changes to our civil justice system that are based on pretty much a guess,” said Rep. Mandie Landry, D-New Orleans.
What the hell is a “guess” in this bill?
1
Posted on 5/13/20 at 1:03 pm to Oilfieldbiology
Insurance companies wouldn’t commit to a guaranteed rate decrease.
Posted on 5/13/20 at 1:26 pm to Carnifex
quote:
Don’t really agree with #3 - but really unsure of the solution.
Having been in a recent accident (not at fault) the first thing the hospital is going to ask is “Where you in an accident”. As soon as you say “yes”, say goodbye to your health insurance coverage. It will get flagged in their claims systems and all your med bills from the wreck will be rejected.
Just curious - Does your health insurance actually have an exclusion for auto accidents. Could you check and cite the verbiage.
I am no saying you are wrong, but have seen numerous cases where the health insurer has paid and subrogated .
Posted on 5/13/20 at 1:44 pm to tigersbb
Hospital won’t bill health insurer. Acadian Ambulance is notorious for this.
Posted on 5/13/20 at 1:57 pm to tigersbb
quote:
I am no saying you are wrong, but have seen numerous cases where the health insurer has paid and subrogated .
If you are a pre-existing patient, they will take insurance. If you are a new patient, then they will not take you as a patient unless you pay outside of insurance.
That’s why everytime you go to an ortho they make you fill out a sheet about auto and work related accidents.
Posted on 5/13/20 at 2:05 pm to Slippy
quote:
It (1) increases the prescriptive period for delictual actions to a two-year prescriptive period,
Good
quote:
(2) reduces the threshold for a jury trial to $5,000,
Bad
quote:
(3) provides for reduced damages for amounts paid or payable from collateral sources,
Against
quote:
and (4) repeals the right of direct action against an insurer.
Bad
quote:
HB 46 enacts new procedures for “expedited jury trials.”
I'll have to read up on this more.
quote:
HB 84 requires an automobile insurer to provide liability policy limits to a third-party claimant or his attorney within 30 days of receipt of a written request from the claimant or his attorney. It also requires the insurer to disclose: (1) the insurer's name; (2) the name of each insured; and (3) an indication of coverage limits or that the insurer did not issue a policy that provides coverage for the automobile accident.
Oppose.
quote:
HB 78 provides that evidence of force of impact may be used to determine the causation of an injury and nature and extent of any injuries sustained.
Good, but juries are going to struggle with the science behind it.
quote:
HB 79 requires that documentary evidence of past lost wages be produced and that failure to produce documentary evidence precludes the party from making a claim for past lost wages.
Good.
quote:
The first of two seatbelt bills, HB 39 authorizes the introduction of evidence of failure to wear a safety belt in order to establish both comparative negligence and damages, except when the operator or passenger is under 16 years of age, or when the tortfeasor is charged with operating a motor vehicle while intoxicated.
Dumb. Why exclude someone's comparative fault in DUI cases?
quote:
SB 12 allows consideration of evidence of failure to wear a safety belt in an action to recover damages arising from a motor vehicle accident as comparative negligence and removes provisions prohibiting its admission to mitigate damages.
I support but it will be interesting to see how those goes in terms of proving the reduced injury (or if there is just a standard mitigation)
Posted on 5/13/20 at 2:10 pm to AlxTgr
quote:
The bar guy, Scott Andrews, was an embarrassment. We really need to explode our bar assoc. and start over.
yep. from the article: "Scott Andrews, testifying in opposition to the ball for the Louisiana Bar Association, predicted that the bill could . . ."
Why in the ever living F is the bar association opposing this?
Posted on 5/13/20 at 2:16 pm to Carnifex
quote:
As soon as you say “yes”, say goodbye to your health insurance coverage. It will get flagged in their claims systems and all your med bills from the wreck will be rejected.
If this is true, you should file a claim with the LA Dept. of Insurance because that is blatantly illegal.
Posted on 5/13/20 at 3:59 pm to boosiebadazz
quote:
BCBS will pay what is presented and they’ll subrogate into the third party claim for what they’ve paid.
The problem is the medical providers will not bill BCBS and take the reduced rate when they can get 100 cents on the dollar from the third party claim.
The problem with this is the hospital can issue an exorbitant bill , and since the bill is not paid by a health insurer at the usual rates for similar services the full bill will become part of the liability claim.
For example a customer slips and falls on a wet floor in a restaurant and seeks emergency room examination for complaints of back, neck and shoulder pain. The contracted ER doctor does a physical exam and orders an MRI of the lower back, CT of the neck and xrays of the shoulder. The diagnostic radiology results are negative for any disc injuries or fractures. The diagnosis is
lumbar and cervical sprain / strain,
The hospital bill totals $8796.00 as follows:
Emergency room $ 1,650
MRI lumbar $ 2,800
CT cervical $ 2,400
X-rays $ 1,250
Miscellaneous $ 696
If the patient had simply fallen at home and had the same treatment the hospital would have been paid according to their charge master with the patient's health insure and accepted $2675 plus whatever co=pay was involved and witen off the rest.
There would be separate fees from the ER physician group of $650 and the Radiology group of $1400. Each bill will be added to the specials and inflate the claim costs.
Again if this was not a liability case the health insurer would pay much lower sums.
I believe the hospitals are required to bill all providers the same but can accept varied amounts as per their agreements or Medicare fee schedule.
Perhaps a suitable compromise would be to establish a fee schedule per procedure code as is in effect on workers compensation that would apply to personal injury claims. I know the argument would be there would till be a balance , but it is likely they would fall into line once tehe understand there are limit to what will ultimately be collected in damages.
Posted on 5/13/20 at 4:07 pm to boosiebadazz
quote:
Insurance companies wouldn’t commit to a guaranteed rate decrease.
They should not have to if the system works as it should. If their loss ratios are reduced then the criteria for rate increases should govern this . The insurance commissioner could set a benchmark, if losses fall below then rates could be reduced accordingly or the rate of increase slowed . The commissioner would have the burden of making those decisions and there would be documentary evidence of whether he or she protected the interests of the citizens.
This post was edited on 5/13/20 at 4:16 pm
Posted on 5/13/20 at 4:15 pm to AlxTgr
quote:How does this not add exposure the at fault party?
No.
Edit: I guess I have exposure currently for damages above my limits anyway. I'll have to ponder this, insurance is it's own language imo.
This post was edited on 5/13/20 at 4:35 pm
Posted on 5/13/20 at 4:16 pm to boosiebadazz
quote:I'm not comforted.
The idea is that somehow juries won’t award damages as high if they don’t know there is an insurance company in the suit with seemingly unlimited pockets.
Posted on 5/13/20 at 4:19 pm to White Bear
It didn’t seem as strong to me as the proponents put forth, but apparently there’s evidence it works in other states 
First question I’m asking a defendant is who is paying for his attorney to be here
First question I’m asking a defendant is who is paying for his attorney to be here
Posted on 5/13/20 at 4:20 pm to tigersbb
quote:
They should not have to if the system works as it should. If their loss ratios are reduced then the criteria for rate increases should govern this . The insurance commissioner could set a benchmark, if losses fall below then rates could be reduced accordingly or the rate of increase slowed . The commissioner would have the burden of making those decisions and there would be documentary evidence of whether he or she protected the interests of the citizens.
You’ll have to forgive me for not having much faith in Jim Donelon to safeguard the interests of the public over the interests of the insurance industry
Posted on 5/13/20 at 4:22 pm to Slippy
That Garofalo fellow stated this is the public's #1 priority right now. Pretty sure that's a bold faced lie
Posted on 5/13/20 at 4:23 pm to boosiebadazz
quote:
You’ll have to forgive me for not having much faith in Jim Donelon to safeguard the interests of the public over the interests of the insurance industry
Exactly why I stated if the system works as it should. If not it should be a referendum on the commissioner .
Posted on 5/13/20 at 4:23 pm to tigersbb
quote:
I know the argument would be there would till be a balance , but it is likely they would fall into line once tehe understand there are limit to what will ultimately be collected in damages.
Balance billing statute prevents going to get the adjusted amount from the third-party claim. You also are going to have a problem in that the proposed law says the defendant owes would what have been owed if submitted to health insurance. The hospitals and ambulances are not going to submit it, State Farm will pay the contracted rate, and Acadian Ambulance will lien the rest as the balance billing doesn’t apply if they aren’t a contracted healthcare provider who presented the claim to a health insurer. This will eat into whatever generals the Plaintiff is awarded.
You’re also going to run into a problem of plaintiff has BCBS, hospital won’t submit it, we disclose in discovery that Plaintiff has BCBs and presented card, and State Farm wants to subpoena BCBS for their contracted rates. That very proprietary for BCBS and each provider and I doubt they’ll want to give it up. See Trump’s recent proposal to bring transparency to medical billing and how hard the industry opposed it.
It’s going to be a clusterfrick and average Joe and Jane Citizens will feel the brunt of it
This post was edited on 5/13/20 at 4:45 pm
Posted on 5/13/20 at 4:50 pm to boosiebadazz
quote:
It’s going to be a clusterfrick and average Joe and Jane Citizens will feel the brunt of it
Yeah, I know there is no clean cut way to solve it.
Another interesting twist is attorneys declining medical payments for injured workers on workers comp claims where there is a third party tort feasor so they can claim the full medicals. This is the one area where collateral source is not applicable and the WC provider gets priority. Of course the sage attorney can apply the Moody rule to get his share of that recovery .
Posted on 5/13/20 at 5:02 pm to Carnifex
quote:
Think of it this way - If I choose to have a great heath plan and pay super high heath premiums where my heath plan pay 100% with no out of pocket expense - the defense gets off scott free for med bills cause I have a good health plan?
The responsible third party insurer will have to reimburse your health insurer when your claim is settled and paid. Any deductibles or co-payments you make is recoverable by you as part of your claim.
You could make a valid argument that your being ultra responsible saved the third party defendant insurer some costs , but in the final analysis you received the treatment you needed and were compensated for your injury.
This post was edited on 5/13/20 at 5:04 pm
Posted on 5/13/20 at 5:15 pm to tigersbb
I’m including my insurance premiums I now have to pay for State Farm’s benefit as an element of damages sought
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