Legislature(1997 - 1998)
04/02/1998 01:40 PM Senate L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 202 - MOTOR VEHICLE INSURANCE
CHAIRMAN LEMAN announced SB 202 to be up for consideration.
SENATOR DONLEY, sponsor, said the proposed committee substitute
made considerable progress. an insurance company could not
terminate a contract with an agent solely because the agent refused
to perform an unfair settlement practice or report such activities
to the Division of Insurance. The next change was because there
was concern that this would limit confidential communications
between attorneys and their insurance companies and a provision was
added to specifically exempt that type of communication as
confidential. Section Four, prejudgement interest, was moved into
AS 21.36 which regulates unfair insurance trade practices. Section
Four, payment of a loss, was also moved into AS 21.36 and clarified
language that the payment is due 30 days after a loss becomes
determinable, so it's clear they are not required to speculate and
make a payment which they can't determine. The required telephone
contact was moved into AS 21.36 also. Sections Five and 10 of the
original bill were deleted, because those appear in SB 158. The
arbitration award section makes it clear that if the arbitrator
awards the cost of the arbitration to the insurer, the insurer
could deduct the awarded fees from the amount due to the insured,
giving the insurance companies a way to recoup their costs.
The premium for short-term policies has been changed and a new
section specifies that policies of less than 30 days can't exceed
200 percent of the pro-rated premium charge for longer policies.
The purpose of this was that in 1986 Mandatory Auto Insurance Act,
a lot of people were concerned they couldn't get insurance for a
short period of time. That is why existing statutes require that
they offer policies for as low as seven days. This sets out for
the first time how much premiums can be for all insurance
companies.
The medical payments have been limited to allow the mandatory offer
to only occur at the initial time. Medical claims coverage has
been deleted because it's covered under Section Four, payment of
loss claims which has been incorporated in AS 21.36.
SENATOR DONLEY said he supported the committee substitute.
Number 491
SENATOR MILLER moved to adopt the CS to SB 202. There were no
objections and it was so ordered.
MS. TRISHA CONNORS, National Association of Independent Insurers,
Des Plaines, Illinois said her organization represents 49 percent
of the property/casualty market in the State of Alaska. She said
they are still opposed to CSSB 202. Their main concern is with the
payment of claims required within 30 days which places insurers in
an untenable position. She didn't see the problem that it was
trying to address other than to provide for another lawsuit for
trial lawyers to collect contingency fees on, because one of the
penalties is a bad faith lawsuit and to erase the agreed upon
policy limits on the underlying policy. She said their claims
adjusters for most all of their member companies are encouraged
and, in some cases, compensated for settling claims faster.
Performance reviews are based on whether and how many files they
can close in a year.
Under this bill if they get a claim they are going to have to
decide immediately if they have the time to order the records which
takes more than 30 days to receive and analyze them and negotiate
based on what they think is due or not due or pay right away which
could encourage fraud, because anything could be put forward as
their medical claim and companies would pay to save themselves from
the prospect of a second lawsuit and the penalties. There is
nothing to give them a way to fully analyze a claim and pay it as
they see fit. Surely, all this would do would be to raise costs.
Number 533
MR. JOHN GEORGE, National Association of Independent Insurers, said
it is appropriate that an insurance company pay every nickel that
they should pay, but not pay any more. We all pay higher premiums
if an insurance company pays out excessive claims, so they need to
give insurance companies an adequate time to determine what a fair
amount is. He knows that people are concerned about the premiums
they pay, so while they are trying to provide protection for a
person who has a claim, they also have to think about providing
protection for everyone else who is paying an insurance premium.
The required 800 number applies to insurers, but he recalls that
the definition of insurer in the Insurance Code includes agents and
brokers. Therefore, every insurance agent in the State would also
have to have an 800 number.
The law clearly says that rates for short-term policies should be
adequate, not excessive, and not unfairly discriminatory. By
definition, that means they need to charge the premium, the cost of
issuing the policy, and an appropriate amount for the risk of the
time period the policy covers. Two hundred percent may or may not
be right. It costs a fair amount to issue a policy by the time
paperwork is done. He ended by commending the work that Senator
Donley had done on meeting his concerns so far.
Number 570
SENATOR HOFFMAN asked on page 2, lines 26 - 28 if he needed more
time than 30 days and asked how much.
MR. GEORGE answered that he didn't know if there was a magic date,
but it could take maybe six months to get repairs done. Insurance
companies should be held to a standard, but not a specific number
of days. In any case, the director of the Division can say it's
been an unreasonable time and level penalties.
TAPE 98-19, SIDE B
MR. MIKE SCHNEIDER said he is an attorney in Anchorage. He said
when their constituents pay insurance premiums, they are not making
donations to the insurance industry, but expect something for their
premium. They expect what they have been promised which is prompt
and fair resolution of their claims. His comments are premised on
the notion that attorneys, doctors, and health care providers
generally do not work for free. A sum of $5,000 can easily be
exceeded in a fairly minor injury setting, but is a lot of money to
most of their constituents.
Medical coverage is supposed to pay reasonable medical bills; it
doesn't matter who is at fault. The way it works now is that a
constituent is in an auto accident of some kind, they go to their
doctor, follow his instructions, and submit their medical bills.
Their carrier may pay those bills or not. The time for payment of
these bills is in the hands of the carrier completely. If they
want to request records until hell freezes over, they can do that.
In the meantime, the doctor, who has a right to be paid, isn't
being paid. The constituent is risking damage to his credit
reputation as well as not getting needed treatment because the
insurance coverage is looking more theoretical by the minute. At
some point, there is a letter from an adjuster who says that they
have done a records review and don't know if all the stuff is
related and want the constituent to appear sometime in the future
at an "independent" medical evaluation. Under the terms of the
policy, the constituent has to show up and this all takes time.
They have the examination and then wait a period of time for the
results of the examination which might say that the treatment was
not all warranted and the whole bill shouldn't be paid.
In the typical medical payments insurance contract, there is an
arbitration provision which typically takes three lawyers. The
constituent needs a personal lawyer. If the lawyer charges him by
the hour, it's one more bill they can't pay. If the lawyer charges
a contingency fee and wins, he solves a part of their problem, but
the doctor wants all the bill paid, not just 75 percent. These
arbitrations are evidentiary proceedings that require the physician
to appear and provide testimony. So someone with a $5,000 problem
can't afford to resolve it, even if they win.
MR. SCHNEIDER said this bill would make the insurance industry put
its money where its mouth is. He referenced Ms. Connor's letter
for the flavor of the NAII's position which said, "As above, these
provisions simply make an insurers investigation of fraud too
expensive." He said when an insurance company accuses its
constituents of fraud and is ultimately able to prove it, nothing
harms the industry in any way. On the other hand, when the
constituents are accused of fraud and the accusation is, itself,
nothing more than a fraudulent effort to deprive the constituents
of what they are entitled to, the insurance industry should pay the
price of this sort of outrageous conduct. This bill does nothing
more than make the industry bear the burdens of its own sins.
Number 590
MR. MICHAEL LESSMEIER, State Farm Insurance, said they have about
31 percent of the automobile insurance market in the State of
Alaska. Last year they gave back to policy holders in the State
$6.6 million and reduced automobile insurance premiums. One of the
challenges they have is making insurance affordable. This bill, as
written, would be an absolute disaster for their policy holders
because it creates a new cause of action of third-party bad faith
liability. When it has been created in other states, claim costs
have exploded. He used the example of what happened in California
in 1978 and 1979 when they created a cause of action for third
party bad faith. For the 10 years following that, until they took
it away, the average automobile liability premium claim costs just
about tripled. This is their primary objection to this bill.
Number 472
MR. LESSMEIER said they remain adamantly opposed to the termination
provision saying their contracts with their agents have been a very
successful way of doing business and didn't see any reason to
change that. The prejudgement interest also still concerns them
because it's not clear whether it runs on the policy or some
projected verdict. They have a concern about changing the
arbitration provisions because the power of an arbitrator to award
his costs is within his discretion right now. The premium for
short-term policies, when they are artificially limited, end up
being subsidized by another sector of the market which isn't fair.
The real concern has to do with the payment provisions. There are
two reasons why claims are not paid: one is that there is a lack of
available information. This bill says an insurer has to pay claims
within a certain amount of time, but places no corresponding duty
on the other party to provide the information that is necessary to
evaluate that claim. He guaranteed that in almost every instance,
there will be litigation over the claim payment provisions. It is
unfair because the insured needs to have incentive to provide
information and there is no incentive under this bill. The second
problem is that the obligations in this bill are on one side and
not the other. They spent 10 years dealing with tort reform before
this legislature and one of the most important parts of that
package was the "offer of judgement" provision which says both
sides to litigation ought to be treated equally. This bill changes
that provision and makes it a one-way street which isn't fair. He
urged that they not revisit something on which they spent so much
time and effort working out a compromise that was fair to all
concerned.
Regarding Mr. Schneider's comments, he has been practicing in this
state for 19 years and had never seen an insurer dispute a $5,000
medical payments claim. He has never seen an insurer request an
independent medical evaluation for a $5,000 claim. When there are
disputes over those payments, most of the time it has to be a
significant dispute before someone is going to spend the time and
money necessary to create that dispute on both sides.
He pointed out that we already have an Unfair Claims Settlement
Practices Act in AS 21.36.125. There are extensive regulations
that were promulgated by the Division of Insurance that deal with
that and if the insurance company does not comply, they can be
penalized.
Number 413
MS. MARIANNE BURKE, Director, Division of Insurance, thanked
Senator Donley for accepting her help in making sure this
legislation meshed with other provisions. She suggested a three
word addition to page 2, line 15, under prejudgement interest. It
is her understanding that the sponsor intended this to apply not
only to first party, but to third parties as well. So she
suggested making that sentence read: "Prejudgement interest due an
insured or third party from an insurer as a result of a claim
covered under..." She said these are actual complaints filed by
Alaskan consumers.
MR. JOHN FERENCE, Staff, Division of Insurance, said in the most
recent 12-month period, they have received approximately 467
complaints involving the handling of claims. Of those,
approximately 60 percent are legitimately justified and 75 percent
of those involve unreasonable delays in claim payments.
CHAIRMAN LEMAN said he appreciated Ms. Burke's support in crafting
SB 283, but then Mr. Jeff Bush testified on the Administration's
position which was different from hers. He testified that they did
not want to take up another tort reform bill this year, and yet the
Committee hears that SB 202 is a retrenching of some tort reform
efforts made last year. He asked if she saw the two positions
being inconsistent.
MS. BURKE answered that she hadn't considered that question. She
explained that this bill has many sections that are not in any way
tort reform related. They are provisions that address specific
needs and addresses them appropriately. She has concerns about
whether or not the payment time frames will work in all cases, but
she also has evidence that there are unreasonable delays in claims
payments. She said she is not an expert in tort reform.
SENATOR HOFFMAN asked if she had any problem with the 30 days on
page 2, lines 26 and 28.
MS. BURKE answered that in most cases she thought it would be quite
workable and she strongly supported the prompt settlement of
claims. She felt this section was much fairer in that it does
recognize there will be a period of time necessary to accumulate
all of the data. The one area where that might be troublesome
might be where there are multiple claims that might exceed policy
limits. She didn't have an answer for the multiple claims
situation.
CHAIRMAN LEMAN said he wanted there to be some flexibility, but
having 30 days as a target was o.k. He asked if she had language
they could insert that would convey that.
MS. BURKE answered that she felt language saying after it's
determinable will handle the situation of parts coming in.
Number 303
SENATOR DONLEY said he thought the determinable trigger takes those
kind of factors into account. He said he discussed Section Four,
the prejudgement interest, with his attorneys and they said it was
clearly based on policy limits. He remains open to additional
suggestions about how to make that clearer.
He noted there was some argument that there was no corresponding
duty to pay a loss. But there is a duty, he said, obviously all
insurance contracts include a corresponding duty for the insured
and, also, since it says reasonably determined, if the insured
doesn't come forward with the information to make a reasonable
determination, they don't get paid. There is clearly an incentive
to provide.
He thought this legislation treated both sides equally to the
extent that's fair. He explained when you have one large corporate
party that's worth billions of dollars holding the money and
another single injured party trying to get the money, we can't
presuppose these parties are in any way equal in the beginning. If
they just hold the money back and don't have reasonable regulations
on when they should pay it, we can't consider them equal from the
start. There needs to be a balance, not just pure equality when
you are dealing with such disparate economic situations.
SENATOR DONLEY agreed with the Director that this bill doesn't deal
with tort reform and, in fact, it only deals with insurance reform.
We are just talking about how insurance companies pay their claims,
not the liability of the parties. The third-party section only
triggers if the Director of Insurance finds a violation.
He agreed with the Director's suggestion of inserting "or third
party."
Number 251
SENATOR MILLER moved to insert "or third party" on page 2, line 15.
There were no objections and it was so ordered.
CHAIRMAN LEMAN commented that he still wasn't comfortable with the
bill, but he would not stand in the way of reporting it. He
thought there may be unintended consequences and this would have to
be addressed before it moved from the next committee.
SENATOR MILLER said he was concerned, also, but would work with
Senator Donely to address them in Senate Finance, and moved to pass
CSSB 202(L&C) from Committee with individual recommendations.
There were no objections and it was so ordered.
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