Compassionate Help for Injured Workers

If you've been injured on the job, you know how it feels to be second-guessed. You're wondering if you'll be treated fairly or not. My mission is to make sure you know your rights and responsibilities and that you obtain all the benefits the law allows. Call me at 1-888-694-0174 or 334-702-0000.

Thursday, August 9, 2012

Insurance Myth #9: “Insurance Companies Are People Too.”

There is a quaint notion that insurance companies make sound decisions based on personal interactions with policyholders. But, big insurance companies have become highly automated, able to rely on digital profiling to underwrite and set rates, proprietary databases to compile customer information, and black box logarithms to underpay claims. Neighborhood agents, trained appraisers, and experienced claims adjusters are seeing their influence wane. Indeed, without proper oversight, we could be entering a Brave New World where machines compile, crunch, and calculate complex datasets to dramatically limit human influence on key underwriting, rating, and claims handling decisions.
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We value our privacy, but it’s growing harder and harder to protect ourselves as our information is sucked up, stored, and sold. In the field of insurance, carriers may move beyond claims histories – and even the controversial use of credit information – to summarily deem you a risk on the basis of your Facebook feed or penalize you for asking smart questions about your coverage. Technology makes this a rapidly changing space, and our public policy must stay ahead of the curve to ensure we are secure from unwanted intrusions and unfounded judgments that have a devastating financial impact on our future.
An entire industry has sprung up around collecting, analyzing, and selling personal information. One of the largest data aggregators, a company by the name of Acxiom, possesses data on half a billion people from around the world, including a whopping 96% of all Americans, with an average of 1,500 pieces of data on each person. Through a process known as data mining, companies like Axciom quietly amass details on a wide range of personal consumer information – everything from your Social Security number to your medications, finances, and web surfing habits. You are then profiled and segmented into one of 70 “clusters” within 21 “life stage groups.” Where you are pigeonholed on this limited spectrum may dictate if products and services are offered to you, and at what price. Weblining is the new redlining.
Insurance companies are figuring out how to get in on the act. Some insurers are looking at how to pry into your personal consumer data to guess about your risk level. The magazines you read, how much television you watch, and what type of purchases you make could determine whether a policy is offered to you, and how much you would have to pay for coverage. Your posts on Twitter, Facebook, and other social networking sites can be compiled into a social networking score by insurers, which could impact your premiums and coverage options. So, failing to keep up with Facebook’s ever-changing privacy settings could mean you pay more and get less. Early advice is to make a show of checking in on sites like Foursquare when you go the gym so that insurers see you are engaging in healthy behavior. The Big Brother tactics involved in data mining are a direct threat to our individual liberty.
If that isn’t bad enough, policyholders have to fear asking basic questions about their coverage lest their company overreact and count their inquiry as an actual claim. Insurers maintain comprehensive databases on claims – with records that reach back seven years. Our insurance marketplace is incredibly complex, and consumers should try to educate themselves about their coverage options. However, if you, as an informed consumer, call your company while shopping the market to ask if your policy would cover a particular peril, they may jump to the conclusion that you have suffered a loss and wrongly record it. As things stand today, anything you say to your insurance company can – and will – be used against you.
Finally, insurance companies now utilize proprietary software, like the program known as Colossus, to determine how much – or even whether – to pay on a claim. No longer are human beings making informed, big picture, common sense, final decisions about the damage that resulted from a car wreck. Experienced claims adjusters are overruled by computers. Data is plugged into a computer program that spits out a number on the other end. Even worse, the software can be manipulated or “tuned” by the insurance company to broadly underpay valid claims. Low balling victims is now as easy as pushing a button.
Gaping holes remain in our laws, and we must provide consumers with basic protections if our insurance market is to work for anyone but the carriers.
The Constitution protects us from spying by Big Government, but current federal laws are woefully inadequate to protect citizens from spying by Big Business. That means it is up to the states to guard their citizens’ personal information. The Texas Legislature must lead the charge to protect our liberty. 

Wednesday, August 1, 2012

Snakebitten at Work!

The small southeastern town of Opp, Alabama is known for its annual Rattlesnake Rodeo.  Recently a worker in southwest Alabama was seriously injured after being bitten by a rattlesnake.  Obviously rattlesnakes are dangerous.  Does it benefit your employer if you try to remove a snake from your workplace?  It depends.

Some will recall the words of Scripture, "The serpent was the shrewdest of all the wild animals the LORD God had made."  (Genesis 3:1)  A recent decision in an appeal of an Alabama workers' compensation claim involved a man who made a claim for benefits after suffering a serious injury while trying to catch a snake.  

The case is styled Mercy Logging LLC v. Odom, Alabama Court of Civil Appeals Case No. 2101061 (decided July 27, 2012)

Here is a brief synopsis of the case.  Johnnie Odom was a logger for more than 20 years. On September 24, 2009, he was working for Mercy Logging LLC and at the end of the day’s work, he and two co-workers were riding with their foreman back to where each of them had parked their vehicles at a gas station.  As they drove, the foreman noticed a diamondback rattlesnake in the road and he swerved the truck to try to run over the snake. One of the workers suggested they try to catch the snake rather than kill it. The foreman stopped the truck and one of the workers tried to catch the snake.  That worker apparently didn’t know how to catch a snake but Odom had caught as many as 100 snakes before so he took over. In the process, the large snake, measuring six fee three inches bit Odom on both hands.  Suffering serious injuries, Odom was in intensive care for 35 days and he now suffers disabling pain in his neck and back.  Odom sought workers’ compensation benefits and the court found him permanently and totally disabled.  The employer appealed.  On appeal, the Court of Civil Appeals reversed.  The Court’s rationale was that an injury is compensable when caused by an accident arising out of and in the course of employment.  Courts have held that an injury arises in the course of employment when it occurs within the period of the employment, at a place where the employee may reasonably be, and while he is reasonably fulfilling the duties of his employment or engaged in doing something incident to it.  Here, the employer provided transportation to its employees so Odom’s accident occurred within the period of his employment. The Court wrote that the more difficult question is whether Odom was “reasonably fulfilling the duties of his employment or engaged in doing something incident to it”  when he was bit trying to catch the snake.  The fact that Odom’s foreman stopped the truck so the workers could catch the snake created an inference that the employer impliedly consented to the snake-catching.  However, the Court wrote that the implied-consent rationale is limited by the requirement that he employer must receives some direct or indirect economic benefit from the activity before it becomes part of the employment.  Odom suggested he was making the job site safer by catching and removing the snake.  However, the Court noted that even assuming the job site was benefited getting rid of one dangerous snake, the potential benefit was outweighed by the potential detriment to the employer that resulted from losing the services of a valued employee who might have been seriously injured while trying to catch the snake.  The Court also considered whether the injury arose out of his employment and noted the injury did not occur while Odom was in the woods or engaged in logging. “The snake on the roadway posed no risk—occupational or otherwise—to Odom so long as he remained in the vehicle in which he was riding. . . .”