Four Oregon residents are accusing an insurance firm of elderly abuse in a federal class-action lawsuit recently filed in a Portland U.S. District Court. The lawsuit accuses Bankers Life and Casualty Co. of wrongfully increased premiums without enhanced benefits. They are also accused of delaying insurance claims and making their long-term care clients jump through hurdles and massive red tape. The company has long been the target of complaints and civil litigation in Oregon and was recently found to have breached a long-term care insurance contract with a client, who has since passed away.
The plaintiffs argue that Bankers routinely withheld and delayed payments for clients who applied for assisted-living expenses as allowed by their policies. Long-term care insurance is designed to help elderly or disabled individuals afford assisted living, nursing and home health expenses. The lawsuit, which accuses Bankers of intentional misconduct, negligence, fraud, breach of contract and breach of promises, is led by a married Oregon couple. However, it is currently seeking judicial approval to represent around 9,000 Oregon residents who have complaints about Bankers' policies regarding long-term care insurance.
According to information from the Oregon Insurance Division, Bankers saw the highest level of complaints among the state's long-term care insurance providers. It also ranked the highest in complaints in 2008, 2006 and 2005. Its parent company settled complaints with a number of insurance regulators in 2007, agreeing to pay $6.3 million in penalties and spend $26 million on improving its claims-management process. In 2012, the firm reached a $3.2 million settlement with five states after allegedly failing to abide by the terms of the 2008 settlement.
Cases like this, where an individual or group of people, feel as though they are being wrongfully treated or taken advantage of, are often prime candidates for civil litigation. A court will decide, based on the evidence provided to support the case, if Bankers' is deliberate in their actions that resulted in these complaints, or if their practices were fair and ethical.
Source: Oregon Live, "Bankers Life hit with Oregon class-action lawsuit over long-term care insurance," Brent Hunsberger, April 4, 2013