Highlands UnitedMethodist Church
3131 Osceola StreetCorner of 32nd Ave.and Osceola
303.477.5857
Highlandsumc32@aol.comwww.highlandsumc.com
Holy Week
Palm Sunday March 16, 10:00 AMMaundy Thursday March 20, 7:00 PMEaster Sunday March 23, 10:00 AMSinging of Hallelujah ChorusOpen Communion
Child Care Provided at all Services
Easter Egg Hunt March 22, 10:30 AM
Open HeartsOpen MindsOpen Doors
All are welcomeRev. Dr. Betty Bradford
March 7, 2008Page 13
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Colorado’s justices and judgeshave now hammered home the insur-ance mantra: any time you seek yourown benefits that you pay with yourown premiums, the claim process isnow considered to be adversarial.If you get hurt on the job and won-der why your workers compensationinsurance adjuster refuses to autho-rize care and you struggle to wonder why, this is how the Colorado courts want insurance to function.You can always sue the insur-ance company. Then you enduremonths of waiting for your trial, afterenduring “motions” filed by insur-ance company lawyers working tocloak in secrecy the very methodsby which the insurance companies“adjust” these claims.No insurance policy contains theterms “claims handler” or “claimsadjuster” or “claims supervisor” or inthe parlance of modern management“team leader.” Yet Colorado judgesembrace this practice called “disin-termediation” where invisible barri-ers to benefits get erected throughthis “adversarial” process.Even more, if you get hurt bysomebody else, the insurance com-panies maintain absolute controlover settling the case. But what if the insurance companies decide tolow ball?Nothing. Are they brought to jus-tice? No.Why? Because the courts neatlyconceal from the jury the fact that itis the insurance company behind theentire process. So who gets sued? The policyholder gets sued, eventhough the policyholder can do abso-lutely nothing to settle the case. If the consumer tries to settle the case,the insurance company can pull cov-erage, claiming interference with thecontract.Insurance companies conductbusiness in Colorado practically insecret. When they hire outside man-agement consultants, like McKinseyand Company, or Accenture, todevise plans to boost corporate prof-its, these business plans are notprovided to state regulators. They arekept secret. When policyholders findout about them, then the insurancecompanies relinquish parts of themonly if a “protective order” is enteredguaranteeing that these profit-maxi-mizing plans are concealed from thevery public and policyholders theyserve.So what can a Colorado consumerdo when the insurance company won’t pay? They can file suit andawait the months of endless delaysclever insurance lawyers contrive.Only rarely do courts sanction insur-ance companies or their lawyers fornot following the rules of civil pro-cedure. The courts reason that these“first-party actions” are adversarial innature. Anyone who wants what theypaid now learns to their sadness thatinstead of being treated neighborly with friendly hands they are sluggedas an enemy, as an adversary.Is this how Colorado wants insur-ance to work?If we want to live in a Colorado where you fight every single time you need insurance, then applaudthe adversarial approach embracedby Colorado’s judges. If you want tolive in a Colorado where insurancecompanies have to pay you what theyowe and not squeeze you for leverageto pay less than your limits, thencall someone who can change thesevalues.After all, didn’t you pay goodmoney to transfer the risk of loss ontothe insurance company? Why shouldthe insurance company, aided by theColorado Courts, be able to shift thatrisk back onto your shoulders?In some states, such as Montana,insurance companies have to actfairly, in good faith, to everyone. Notin Colorado. Short of actual fraud,insurance companies in Coloradoowe an injured person nothing. Andthat’s what Colorado courts and leg-islators think is fair.Because insurance companiesbank a profit the moment they col-lect premiums, based on the law of large numbers, insurance compa-nies have ample funds to pay forpredicted losses up to the full policylimits. While individual losses can-not be predicted, collective lossescan be predicted statistically throughthe laws of averages and of largenumbers.Insurance contracts are not ordi-nary run-of-the-mill agreements. They are almost considered contractsof adhesion where the consumer hasno choice but to take it or leave it.When do insurance consumers everget to bargain over the fine print? The consumers’ only option is to buythe policy or vote with their feet bygoing somewhere else and face thesame fine print.Only in “third party” cases doesthe insurance company owe an obli-gation to protect the insured fromfinancial loss and provide a qua-si-fiduciary obligation to help theinsured. This is like a banker holding your money but telling you it is notconvenient for the banker to release your money to you until you jumpthrough hoops the banker contrives.Who benefits from the delay and useof your money during this “float?”So what’s the matter withColorado? Who can afford uncollect-ible insurance? Who wants collect-ible insurance only after running theinsurance adversarial gauntlet?Colorado legislators and judges,that’s who. Their decisions favorthe insurance companies and thelawyers, of course, since to fight aninsurance company requires morelawyers and more lawsuits and more judges.What’s the matter with this pic-ture? Or just with Colorado?
Richard M. Kaudy is an expert in handling insurance and claim- handling matters both on behalf of insureds and insurers. He has provid- ed expert opinions in this field, where he donates fees from this service to various charitable causes includ- ing Mothers Against Drunk Driving (MADD). Rich has handled thousands of cases involving personal injuries and corporate misconduct including class-action lawsuits. In addition to litigating a variety of cases, Mr. Kaudy has taught numerous seminars and workshops in several states including Colorado, Texas, Oregon, California and Arizona. He has been a guest lecturer in law and medicine classes at the University of Denver College of Law and for CPCU classes.Mark A. Gould is an attorney who practices with Richard M. Kaudy and lives in North Denver with his wife,Therese, and their terrier, George.Mark’s practice focuses on insurance claims, car accident claims, bad-faith insurance claims, commercial insur- ance claims, and he also provides pro bono legal assistance to those who are unable to afford an attorney.If you have any questions or would like any reprints of this article (or oth- ers), you can reach Mark or Rich at: 303-623-1885 or mgould@kaudylaw.com (Mark) or rkaudy@kaudylaw.com (Rich).***
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Insurance justice in Colorado
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