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(Some Guy)   In a scorcher of a decision, the Supreme Court handed down a decision offering some clarification on the primacy of plans under ERISA, but left unclear the interpretation of the "equitable relief" provision and, uh, oh, god, this is dull   (about.bloomberglaw.com) divider line 37
    More: Misc, Employee Retirement Income Security Act, The Unanswered Question, supreme courts, judicial interpretation, equitable relief, Third Circuit Court of Appeals, torts, US Airways  
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1629 clicks; posted to Politics » on 16 May 2013 at 7:02 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-05-16 05:35:55 PM
Heh.  Page turners like this are the majority if what the Court does.  Exciting, ain't it?
 
2013-05-16 05:51:35 PM
24.media.tumblr.com
 
ZAZ [TotalFark]
2013-05-16 06:28:08 PM
This decision is important. It determines how hard an insurance company can screw you.
 
2013-05-16 06:32:14 PM
Pretty much they said the contract language of your company's health care plan is binding even if it really sucks.
 
2013-05-16 06:50:20 PM
The best part was at the end where they suggested lawyers could just stop asking for medical cost recovery.  Winning this case just might lead to losing a lot of money.
 
2013-05-16 07:13:13 PM
Is this the new Star Wars movie?
 
2013-05-16 07:27:38 PM
Well, Subby, I find ERISA interesting. So NYAH NYAH NYAH

/what tax boy might look like
static8.depositphotos.com
 
2013-05-16 07:52:27 PM

ZAZ: This decision is important. It determines how hard an insurance company can screw you.


I'm guessing so hard that even Max Hardcore would be ashamed.
 
2013-05-16 07:54:19 PM
So, can someone with a GED in law interpret this?  Did the guy have to reimburse the insurance company the full amount or not?
 
2013-05-16 07:59:41 PM

Lost_in_Korea: So, can someone with a GED in law interpret this?  Did the guy have to reimburse the insurance company the full amount or not?


You're just a tortfeasor.
 
2013-05-16 08:18:53 PM

Target Builder: ZAZ: This decision is important. It determines how hard an insurance company can screw you.

I'm guessing so hard that even Max Hardcore would be ashamed.


So they fark us up the ass with their stubby little white dicks but then they pee in our mouths before/during/after?

That sounds about right.
 
2013-05-16 08:44:00 PM
Boils down to read the fine print; don't get greedy and sue even if it means you have to pay extra costs out of pocket; and if you do, get a good lawyer who isn't working on a contingency fee.

Basically, the question here was whether an insured, covered under his insurance for another person's accident, is required to pay back the insurance company if he recovers against the third-party in tort, if the insurance contract contains such a clause. (Most insurance contracts don't) In the instant case, the plaintiff sued the defendant who injured him and won a judgment for $66,000, (actually $110,000, less the attorney fees) then the insurance company demanded repayment for their layout in the amount of $66,866; or just slightly more than what the plaintiff had received. The USSC basically said that so long as the insurance contract is "unambiguous", then the contract controls, no matter how unfair this may seem.

It's worth noting that although the poor plaintiff got screwed by the evil insurance company, the invisible lawyers in this mess made off with about $35,000, and nobody is even talking about them; although had they not gotten so much, Mr. McCutchen would have had a little left to play with. It's also worth noting that the dissenting judges would have sent the whole mess back to the 3d Circuit, on the grounds that the insurance plan WAS ambiguous or "not plain" and that should have been decided before it got to the Court.

Read the contract before you sign it, people.
 
2013-05-16 08:51:25 PM
davisw.files.wordpress.com
 
2013-05-16 09:20:55 PM

BarrRepublican: Target Builder: ZAZ: This decision is important. It determines how hard an insurance company can screw you.

I'm guessing so hard that even Max Hardcore would be ashamed.

So they fark us up the ass with their stubby little white dicks but then they pee in our mouths before/during/after?

That sounds about right.


Don't forget mouth farking you so hard that you puke on the cawk.
 
2013-05-16 09:33:35 PM
The lesson is, don't sue whoever injured you if you're in that guy's retirement plan.
 
2013-05-16 09:40:30 PM
Go away, 'batin!
 
2013-05-16 09:41:20 PM

potterydove: The lesson is, don't sue whoever injured you if you're in that guy's retirement plan.


No, the lesson is that your attorneys need to put the insurer who paid the medical bills on notice of the claim so that they know the insurer will be asserting its rights beforehand.
 
2013-05-16 09:58:41 PM
meetinthelobby.com
 
2013-05-16 10:04:32 PM

Gyrfalcon: Boils down to read the fine print; don't get greedy and sue even if it means you have to pay extra costs out of pocket; and if you do, get a good lawyer who isn't working on a contingency fee.

Basically, the question here was whether an insured, covered under his insurance for another person's accident, is required to pay back the insurance company if he recovers against the third-party in tort, if the insurance contract contains such a clause. (Most insurance contracts don't) In the instant case, the plaintiff sued the defendant who injured him and won a judgment for $66,000, (actually $110,000, less the attorney fees) then the insurance company demanded repayment for their layout in the amount of $66,866; or just slightly more than what the plaintiff had received. The USSC basically said that so long as the insurance contract is "unambiguous", then the contract controls, no matter how unfair this may seem.

It's worth noting that although the poor plaintiff got screwed by the evil insurance company, the invisible lawyers in this mess made off with about $35,000, and nobody is even talking about them; although had they not gotten so much, Mr. McCutchen would have had a little left to play with. It's also worth noting that the dissenting judges would have sent the whole mess back to the 3d Circuit, on the grounds that the insurance plan WAS ambiguous or "not plain" and that should have been decided before it got to the Court.

Read the contract before you sign it, people.


Yeah, most Health programs require subrogation (reimbursement by third party) if an alternate settlement is made.  When you think about it, it is fair.
 
2013-05-16 10:40:37 PM

Another Government Employee: Yeah, most Health programs require subrogation (reimbursement by third party) if an alternate settlement is made. When you think about it, it is fair.


I don't know enough about this particular case, but in general yes, it is fair.
 
2013-05-16 11:25:24 PM

ZAZ: This decision is important. It determines how hard an insurance company can screw you.


It's late. Does this decision screw me more or screw me less? And how does this decision change the life of a middle-class guy who wants EVERYONE to have decent healthcare? I'm tired and too lazy to RTFA.
 
2013-05-16 11:41:23 PM

Another Government Employee: Yeah, most Health programs require subrogation (reimbursement by third party) if an alternate settlement is made. When you think about it, it is fair.


True, but at least some plans do include some variation of the common fund doctrine -- where the insurer effectively pays a share of your attorney's fees if it gets a share of the judgement/settlement -- if only to encourage the insured to go after the guilty party at all in situations like this.

And situations like this can at often be avoided if your attorney just fires off a letter to the health plan's attorney before filing the suit. "Hey, we're looking at going after the bad guy here, but there's no point if you're just going to take all the money off the top. Let's get together at an expensive restaurant for a couple of billable hours and make a deal."
 
2013-05-17 12:05:09 AM
The USSC agrees that the insurer deserves to be reimbursed if you sue the party that created your health costs and you win (that's probably in your insurance agreement now). The USSC also states that the insurer should share in your legal costs when your agreement with your insurer is not clear on the issue (that's probably not discussed in your insurance agreement -- and that's the problem). Because you're doing all the biatchwork in trying to get damages paid the USSC thinks your insurer should be responsible for some share of those costs.
 
2013-05-17 12:08:16 AM
In a ruling that should surprise absolutely nobody, the Supreme Court reaffirms that big businesses can fark you over six ways from Sunday, peons.
 
2013-05-17 12:11:38 AM
So what you're saying is...I should be an insurance company and sign everyone up through me...so when I pay out for their expenses and they sue a third party...I sue them to get paid back for all my expenses...thus winning?  best part is that leaves the injured party possibly more injured that if they hadn't sued.  Its like gargamel himself wrote that policy.

upload.wikimedia.org
 
2013-05-17 12:22:40 AM
Insurance nerds...*high five*
 
2013-05-17 12:48:30 AM

FlashHarry: [24.media.tumblr.com image 500x390]


It didn't turn out well for him though.

www.humorlinks.com
 
2013-05-17 01:36:15 AM

KickahaOta: Another Government Employee: Yeah, most Health programs require subrogation (reimbursement by third party) if an alternate settlement is made. When you think about it, it is fair.

True, but at least some plans do include some variation of the common fund doctrine -- where the insurer effectively pays a share of your attorney's fees if it gets a share of the judgement/settlement -- if only to encourage the insured to go after the guilty party at all in situations like this.

And situations like this can at often be avoided if your attorney just fires off a letter to the health plan's attorney before filing the suit. "Hey, we're looking at going after the bad guy here, but there's no point if you're just going to take all the money off the top. Let's get together at an expensive restaurant for a couple of billable hours and make a deal."


Hell, doesn't everyone already do this? I don't even do tort cases, and even I knew that this was SOP. It is among my colleagues who do auto accident cases, anyway.
 
2013-05-17 03:54:49 AM

ZAZ: This decision is important. It determines how hard an insurance company can screw you.


Is that what they meant at the site about a "fully integrated tool"?
 
2013-05-17 04:25:28 AM

Gyrfalcon: Boils down to read the fine print; don't get greedy and sue even if it means you have to pay extra costs out of pocket; and if you do, get a good lawyer who isn't working on a contingency fee.

Basically, the question here was whether an insured, covered under his insurance for another person's accident, is required to pay back the insurance company if he recovers against the third-party in tort, if the insurance contract contains such a clause. (Most insurance contracts don't) In the instant case, the plaintiff sued the defendant who injured him and won a judgment for $66,000, (actually $110,000, less the attorney fees) then the insurance company demanded repayment for their layout in the amount of $66,866; or just slightly more than what the plaintiff had received. The USSC basically said that so long as the insurance contract is "unambiguous", then the contract controls, no matter how unfair this may seem.

It's worth noting that although the poor plaintiff got screwed by the evil insurance company, the invisible lawyers in this mess made off with about $35,000, and nobody is even talking about them; although had they not gotten so much, Mr. McCutchen would have had a little left to play with. It's also worth noting that the dissenting judges would have sent the whole mess back to the 3d Circuit, on the grounds that the insurance plan WAS ambiguous or "not plain" and that should have been decided before it got to the Court.

Read the contract before you sign it, people.


Why would he sue the defendant himself? Isn't that the insurance company's job?
 
2013-05-17 06:05:25 AM
evil saltine:

Why would he sue the defendant himself? Isn't that the insurance company's job?

I'm going to take a wild guess and throw out "greed".
 
2013-05-17 07:39:27 AM
Fark: it's either "ZOMG look at those boobs" or...whatever this is.
 
2013-05-17 08:53:27 AM

ShawnDoc: Another Government Employee: Yeah, most Health programs require subrogation (reimbursement by third party) if an alternate settlement is made. When you think about it, it is fair.

I don't know enough about this particular case, but in general yes, it is fair.


You'd think the lawyer would have pointed out to his client that he just might be screwed.

/nah, greedy fark got his 35 grand.
 
2013-05-17 09:19:19 AM

Gyrfalcon: the invisible lawyers in this mess made off with about $35,000, and nobody is even talking about them;


I know! Look at that bastard actually getting paid for his work, like some sort of monster!  I am glad and proud i never get paid to provide services!
 
2013-05-17 12:08:50 PM

Kibbler: Fark: it's either "ZOMG look at those boobs" or...whatever this is.


Objection.  Over simplification, your Honor.

/there's also "what it's like to be eaten by a bear"
 
2013-05-17 02:29:19 PM
PLEASE, TELL ME ABOUT THE FARKING GOLF SHOES!
 
2013-05-17 05:15:18 PM
One of my relatives works for the DOL and litigates ERISA cases, so I'm...
...actually able to follow along and understand.
 
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