Getting insurance companies to pay for individual
claims is a problem so common it's endemic. And the very real fear that our health,
disability, homeowners, and other insurance providers will not be there to pay
for claims in the event of catastrophic loss is widespread and well justified.
As San Francisco-based attorney Ray Bourhis found out, at least several giant
disability insurers-including the largest disability carrier in the world, UnumProvident-made
it company policy to cancel benefits in order to increase revenues by hundreds
of millions of dollars. These claims were rejected and the policies canceled regardless
of their validity. And for a company with some 25 million policy holders, the
abrupt termination of disability benefits meant that thousands of lives and millions
of dollars in benefits were put at risk.
case of Joan Hangarter, a single mother who bought a disability policy in 1990
to protect her should she ever fall seriously ill, the cancellation of her policy
led to personal devastation for both herself and her children.
had dutifully paid her annual premiums for nearly a decade. Yet after she became
disabled, her insurer UnumProvident, stopped paying her benefits. As a result,
Joan and her children were evicted from her home, and Joan was forced into bankruptcy
and onto welfare, leading her to fall and into deep clinical depression. All of
this happened to Joan as a result a cost-cutting measure: employees of UnumProvident
had "targeted" her for cancellation without ever having spoken with
a single doctor who had actually treated her. Eventually, with the help of her
attorneys Ray Bourhis and Alice Wolfson, Hangarter won a landmark $7.7 million
jury verdict against UnumProvident.
to Injury: Insurance, Fraud, and the Big Business of Bad Faith Bourhis uses
the dramatic story of Joan Hangarter's case-along with the cases of Susan McGregor,
Stuart Gluck, Alan Gross, John Tedesco, Laura Hindiyeh, Eugene Molfino, and others-to
show how insurance companies are getting away with denying valid claims, terminating
benefits, and destroying lives. Bourhis shows how insurance companies put profit
above the protection of those who diligently pay for their coverage month after
month and year after year. Bourhis exposes the comprehensive systems insurance
companies have for targeting and terminating expensive claims without just cause.
He reveals the back-room strategic mindset that drives these illegal practices,
how low-level employees are duped into unethical conduct, and how insurers manipulate
data in the few cases that do go to trial. He also explains the key regulatory
oversights that enable these kinds of practices to continue unchecked, and how
recent U.S. Supreme Court decisions and the inaction of the current majority in
Congress actually facilitate insurer fraud.
was not an isolated case, and her victory, while welcome, was singularly rare.
Unfortunately for us all, as Ray Bourhis points out, this single victory was not
enough to change the way these companies do business. To change this system, Bourhis
closes Insult to Injury with a roadmap for reforming the insurance industry,
so that cases like Joan's become a thing of the past. He also makes the case against
so-called "tort reform," showing why it is actually a gift to the monied
interests of large corporations and a threat to the legal rights of us all.