Reinsurers Sue AIG Alleging Claims Fraud; AIG Denies All Wrongdoing

By | August 1, 2005

  • August 1, 2005 at 7:53 am
    Mike says:
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    How are we supposed to recommmend AIG to prospects with stuff like this?

  • August 1, 2005 at 9:36 am
    Business as usual says:
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    Who excels in this department of adverse medical costs? none other than “Health Net Corporation.”

    Well, as usual I woke up this morning with no medical insurance, no job to go to, no immediate plans to much of anything but to wait by the telephone to hear from Heath Net’s great attorney’s at Lawlessness.

    Also, SINCE Health Net supported me with their Westing house seal of approval, at no cost to my employer “Black Angus Restaurant.” Who’d a thunk? that based on California Compensation Insurance Company’s doctor’s they would find injuries supportive evidence of a work injury.

    So, if there hadn’t been a family history of Asylum or Alcohol dependency in open access to insurance companies, they would not have known that as a high school student at Evergreen High School, in Vancouver Washington, angrily I was forced to go to a Veterans affairs Alcohol psychiatrist.

    This appointed Doctor by Cal-Comp used that information as a sticking point to inject the use of Nortriptyline, (for prescribed nerve pain) as a base line for their objective, psychiatric-psychosomatic reference to my neuropathy of the left elbow & C8.

    Talk about playing on people’s family history and stigma of mental heath. At first, I couldn’t figure out exactly where they were pulling this from: Got it now, exactly.

    With the facts known, but not allowed to be entered, in the real time medical properties, has turned into a missing ulna styloid process of the ulna, to NOW a chuck of bone cut out of my ulna bone to support Rheumatoid Arthritis. Oh, boy now I have 2 missing chunks, so pretty much along with the elbow joint shifting, to the shoulder, I am in a great position to provide financial support with that extraction of bone out of my left wrist.
    Not to be advanced with a little help from my friends “Tenet Healthcare, HCA” what first? would entry more applicable as “cream of wheat in her left distal radial Ulnar joint” then their unbelievable observational medical diagnosis shoved up my ***. Another concocted Bourbon Legends to decipher?
    So, Health Net what is going to take for you to get straight with patients? What will it take you to return a phone call? Does this all sound familiar? Do you think I enjoy waking up every morning 24-7 thinking of how you screwed my ability to support my son on wages? Do you think I enjoy fighting for which you stole from me? How about if we trade place’s and see if you would like the same conditions you imposed to my son and I? and still inclined too.

  • August 1, 2005 at 1:26 am
    Sue says:
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    Being an ex AIGer. I’m expecting more to come.

  • August 1, 2005 at 1:28 am
    GRobert says:
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    Try looking at this another way. The reinsurers on this are the same non payers as on over 30 other cases just like it from the WC Carve out era. They have been doing it for years. But they have finally bitten into a company they won’t be able to “outlast”

  • August 1, 2005 at 1:47 am
    FHall says:
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    I’m having a reinsurance problem myself with Castlewood (US) Inc., formerly International Solutions, handling the run-off of a treaty for Continental Insurance. Anyone else had a distasteful experience with Castlewood?

  • August 1, 2005 at 2:05 am
    They are good! says:
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    AIG knows how it works, as they set up some WEIRD transactions thourgh their own reinsurance company… NAT’L UNION.
    Let’s see, no real transference of risk, refunding of premiums when called on it by FLDFS… Maybe one day, someone will actually figure out that AIG did not get its numbers by doing it the hard-earned way… the plot thickens!!!!!

  • August 1, 2005 at 3:09 am
    David says:
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    I don’t know why everyone is surprized. AIG has done this dozens of times over the years, and NEVER had it questioned. They lived off the “backs” of reinsurers, and are the worlds largest buyer of reinsurance. Everyone slowly is coming to the realization that AIG is NOT an insurance company, they are a financial institution that survives on it cash flow and other financial manipulations. They are famous for denying, delaying, using litigation to force a low settlement, and when all else fails, drag out the process, and try to ‘bleed the filer’ dry. The idea of actually having risk is merely a marketing ploy.

  • August 1, 2005 at 4:21 am
    glenn says:
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    if aig was inflating future claims expenses this info goes to ncci that creates rates, exp mods, would not our customers be paying more?

  • August 2, 2005 at 4:43 am
    Longsuffering says:
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    TO: FHall – I might just be able to assist you in this!

    Please e-mail me your contact details and I will call you to discuss. Send to longsuffering@tiscali.co.uk

  • August 1, 2005 at 6:42 am
    GRobert says:
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    Not one of you guys has a clue what this is all about. Google John Hancock and see how many non-pay Carve out arbitrations they are involved in over the past 5 years. It is staggering and disgraceful. They created the problem, touted it to their shareholders and then shut payments down when they finally realized how bad it was.

  • August 1, 2005 at 6:56 am
    TPO says:
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    Another scandal at AIG! What a coincidence!
    Do you think the corporate culture has any thing to do with this?

  • August 2, 2005 at 8:58 am
    Can it be? says:
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    Well, I was just wondering if anybody has this before?

    A patient, not just any patient in particular but, most definitely not one in good standing with his or her compromised healthcare provision so far delivered.

    Patient is auto placed into welling form of the social security system for future benefits? Thing is, this was arrived at the end position of â€Åâ€Ŕclaim up” on your disability claim under the Voluntary Plan Administrator’s, self appointed by Black Angus Restaurant.

    In order to control, we have to continue jamming your claim as we see fit into the State of California Welfare System. Bottom line, If we can get this far and also have unlimited access to your medical records file, we believe that by cutting off any benefits hereon, does not disconnect us from any additional information provided off a claim of Supplemental Social Security Benefits.

    As a matter of fact, with the eyes upon that information, more power to the containment of information from our own appointed physicians who WILL have both a connection to Healthcare Corporation, (HCA) and the insurance carrier who conspired to deny your claim of injury.

    Further information not disclosed to you with be at your own expense and time to unwrap.

    Doctor’s who have prevailed to Regional Hospital, San Jose, CA are the in the same medical group that you will be examined by. How beneficial to both the worker’s compensation carrier and Good Samaritan Hospital affiliate hospital is that? Oh, did I mention that Foundation Health Systems (HMO) was the parent company of Cal-Comp, before Qual-Med, Healthnet before Superior National, before Insolvency, before the Quackenbush sandaled-Insurance Commissioner, Just another example of claims adjuster’s domineering harm from the willingness of their crime adjusters at hand.

  • August 2, 2005 at 4:22 am
    41144738 says:
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    Drum rolled in about 11:00 AM from the dark side of the moon. Health Net again backing their doubtfulness to settle the worker’s compensation claim filed in January 1996. Unaware again of the details of the injuries, but aware of un-needed surgery occurrences.

    Having a degenerative condition, most likely from the false medical records information obtained from Good Samaritan Hospital, San Jose, California? calling the missing ulna styloid process a â€Åâ€ŔCongenital defect”. This is an after affect finding, TILT should have come up on that ball heading in the wrong direction.

    Not to mention, Health Nets lack of defining understanding Anatomy relationship to Function. Rumor has it that the completely severed main ligament proportionate to the stability of my DRUJ is degenerative, not a function of anchor to weight distribution. Most likely not in their current issue of terminology locater is the word repetitive stress syndrome.

    How to defeat a ligament claim with the all-new persistent character scoring systems: reference, describe to terminologies lowest ranks. â€Åâ€Ŕthat of psychosomatic origin, and if this is bothering her, it has nothing to do with her employment at Black Angus Restaurant.

    That must be how surgeries of the un-needed happen. This is also how to not stand up and admit to employee’s, patients that what we did was wrong, an intense Corporate wrong doing that will not happen again in Medical Care, regardless of temptation over frontline, defensive,deception tactic’s to children and their Mom’s.

    Wouldn’t it be better if your scoring was aligned to a different beat? Truth, Honesty, Integrity, …………….

    My healthcare is still off in the distant horizons with the current influx thus inflicted.

  • August 6, 2005 at 7:13 am
    Statis of Patient, "Jacked" says:
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    How do you like it Health Net? Records go both ways, including your conditions of worker’s compensation denial of injury to my right wrist with accomplices to not have considered the point of injury and employment disadvantages. Remember Thanks for your cooperation.

    https://www.health.net/providers/disclosures/_content/pdf/Complete_Claim.pdf#search='Calcomp%20insurance%20identification

  • August 6, 2005 at 1:45 am
    State Farm is this ok to do? says:
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    SECTION 7. STATE DISABILITY INSURANCE (SDI)

    Confidential-unrepresented (Unit 32) employees have elected to participate in SDI. Benefits
    received from SDI shall be integrated with paid leave as follows:

    A. All employees eligible for SDI benefits shall use their available sick leave credits to
    supplement their SDI benefits so that the sum of the SDI benefits and sick leave credits
    used equals 80% of their gross salary.

    B. Employees eligible for SDI benefits may apply with the State of California for approval
    as soon as possible following the date of their eligibility for SDI benefits. Current
    eligibility begins on the eighth consecutive calendar day of an extended illness or injury.
    An employee must apply for SDI when illness or injury causes him/her to miss work
    for more than twelve consecutive calendar days.

    C. When an employee has used all available sick leave credits, (s)he may use any available
    overtime and/or holiday credits first and vacation second to supplement his/her SDI
    benefits up to 80% of gross salary.

    If during the disability period the employee reaches his/her Maximum Allowable
    Accrual for vacation, then the employee shall be allowed to use up to forty (40) hours
    of vacation time, prior to the use of sick leave, overtime and/or holiday credits, in order
    to supplement his/her SDI benefits up to 80% of gross salary.

  • August 6, 2005 at 1:54 am
    is SDI a Holding Company? says:
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    I’ve checked with Daniel G. Herns ESQ. and your denied worker’s compensation claim by the insurance Company Cal-Comp?

    and it’s been right thing all along, why stop the practice now.

    Any other questions you want to bring up 41144738?

  • August 6, 2005 at 4:35 am
    Does it matter? says:
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    Does it matter to you HCA, Good Samaritan Hospital, San Jose California to know the history of injury circumstance?

    So your made two decisions (NOT) to disclose the true condition of my Left forearm X-Rays on August 1988 and again either in January 1996.

    Would it have made a difference to you that a complete comparison studies, suggested by your own physician in 1988, would have been worth it to my son or I?

    Apparently, NO!!! Didn’t want to know the history of injury or how your life might be effected from hereon forward.

    Arriving at your facility and having evidence of fraudulent medical records is of no concern either.

    Having arrived at Hell in part by your deductions of true medical care is just exactly where you belong.

    â€Åâ€ŔNot in my Hospital” no self-pay patent is not going to drain resource’s at the expense of quality healthcare in 1988 or any other year.

    Might as well put a sign positing: Your healthcare hell has just begun without reliable medical records history you need.

    NOT FOR IMPLEMENTATION

    A patient classification scheme, which provides means of relating the type of patients a hospital treats to the costs incurred by the hospital, to determine quality of care and utilization of services in a hospital setting.

  • August 8, 2005 at 1:01 am
    Worker's Comp Problem says:
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    Jay Gellert,

    A Patient’s beam’s are on your records, does 03-13-** have any other meaning to you? My dad’s records, My Grandfather’s records?

    http://www.highbeam.com/library/doc0.asp?DOCID=1G1:78116126&refid=fdc_people

  • August 8, 2005 at 1:47 am
    1960 says:
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    How nice, what are the chance’s that the attorney and a crooked worker’s compensation carrier/Doctor would also be so close with:

    http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2004/03/01/BAGAF5AVRG1.DTL

    Number: 1-02-CV-811015
    Public Access Case information

  • August 8, 2005 at 2:04 am
    Notice of Denial says:
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    WC Carrier short on funds ($$$), or we cannot pay your claim based on Fraudulent Medical Records.

    http://allnurses.com/forums/showpost.php?s=13486640d18c8bee457ee2454be5276e&p=442862&postcount=1

  • August 9, 2005 at 8:01 am
    OhMyGod!!! says:
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    Hey, enough already with your friggin’ comp claim!!

    You may have a serious medical problem (but the order for you to see a psychiatrist in high school now seems downright prescient) and you may have been screwed by your health carrier, but enough already with your friggin’ comp claim!

    I don’t even know who you are, seems like you posted under about six different names, but, Dude — you’ve got to find a different forum to air your medical problems! OK? You completely hijacked this one with your barely readable rantings about how you’ve been wronged. I feel badly for you, but get off this forum and get some help — whatever kind you need!!!

    Good luck, and goodbye(I hope, but I’m not optimistic that we’ve heard the last from him….)

  • August 10, 2005 at 5:44 am
    2-29-60 says:
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    Damn straight you should NOT be optimistic that anybody should hear the last of me?

    And just because I don’t know English very well, What I do know about is MATH, acounting, coding.

    And, I aint no Dude. Who I am is nobody less important than any of you who read this:

    What is important to me: Is not to be forced by the HAND of corruption by Cal-Camp/Health net, and people who can’t SEE Corporate America’s: George Bush Insurance crooks, including Saudia Arabia, Pakistani MD’s.

    This goes way beyond a denied worker’s compensation claim.

    Who’s health care system is it:

    Who’s watching and tracking the current Hellhole offered by the CORRUPTION of Malik Hasan, MD. aka people who are part of the wrongdoing.

  • August 10, 2005 at 6:43 am
    Down to nothing: says:
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    Oh yeah. The system we have is magnificently efficient. Just not for delivering healthcare. Here’s what it is especially wonderful at doing:

    The 20 Highest-Paid HMO Executivesâ„¢ 2002 Annual Compensation, Exclusive of Unexercised Stock Options

    Norman C. Payson, M.D., Former Chairman and CEO, Oxford Health Plans, $76,010,825
    Leonard D. Schaeffer, Chairman & CEO, WellPoint, $21,765,532
    Allen F. Wise, President & CEO, Coventry, $21,664,330
    D. Mark Weinberg, Executive VP, WellPoint, $14,046,201
    R. Channing Wheeler, CEO, Uniprise UnitedHealth, $9,588,699
    William W. McGuire, M.D, Chairman & CEO, UnitedHealth, $9,457,403
    John W. Rowe, M.D., Chairman & CEO, Aetna, $8,927,005
    Thomas P. McDonough, Executive VP & COO, Coventry, $7,505,810
    Dale B. Wolf, Executive VP, CFO, Coventry, $7,451,391
    Larry C. Glasscock, President & CEO, Anthem, $6,857,839
    Joan E. Herman, Executive VP,, Senior Specialty WellPoint, $6,460,301
    B. Curtis Westen, Senior VP, General Counsel, Health Net, $6,150,970
    Ronald A. Williams, President, Aetna, $6,113,491
    H. Edward Hanway, Chairman & CEO, CIGNA, $5,976,890
    David J. Lubben, General Counsel, UnitedHealth, $5,698,793
    James G. Stewart, Former Executive VP & CFO, CIGNA, $5,191,809
    Robert J. Sheehy, CEO, UnitedHealth Care, $5,064,152
    Anthony M. Marlon, M.D., Chairman, CEO & President, Sierra Health, $4,745,988
    Charles G. Berg, President and CEO, Oxford Health Plans, $4,739,173
    Donald M. Levinson, Executive VP, Human CIGNA, $4,491,315

    Total Compensation for 20 top executives:, $237,907,917
    Average Compensation for these executives: $11,895,396

    The 20 HMO Executives with the Largest Value of Unexercised Stock Options in 2002

    William W. McGuire, M.D., Chairman & CEO, UnitedHealth, $529,986,971 [!]
    Stephen J. Helmsley, President & COO, UnitedHealth, $221,458,436
    Leonard D. Schaeffer, Chairman & CEO, WellPoint, $93,087,561
    Robert J. Sheehy, CEO, UnitedHealth Care, $39,152,576
    R. Channing Wheeler, CEO, Uniprise UnitedHealth, $34,012,480
    David J. Lubben, General Counsel, UnitedHealth, $29,131,986
    David C. Colby, Executive VP & CFO, WellPoint, $26,369,941
    Norman C. Payson, M.D., Former Chairman and CEO, Oxford Health Plans, $25,589,375
    John W. Rowe, M.D., Chairman & CEO, Aetna, $24,078,480
    Jay M. Gellert, President & CEO, Health Net, $23,477,657
    Thomas C. Geiser, Executive VP, WellPoint, $17,074,545
    Marvin P. Rich, Executive VP, Health Net, $14,585,577
    Howard G. Phanstiel, President & CEO, PacifiCare, $14,031,740
    D. Mark Weinberg, Executive VP, WellPoint, $10,689,518
    Allen F. Wise, President & CEO, Coventry, $10,099,038
    Joan E. Herman, Executive VP, Senior Specialty WellPoint, $9,292,358
    Larry C. Glasscock, President & CEO, Anthem, $9,038,474
    Ronald A. Williams, President, Aetna, $7,845,000
    Charles G. Berg, President and CEO, Oxford Health Plans, $7,758,078
    Joseph S. Konowiecki, Executive VP, PacifiCare, $7,104,900

    Total value of stock options for 20 top executives: $1,153,864,691
    Average value of stock options for these executives: $, 57,639,235

    In summary:
    The total of the twenty highest-paid executives in 2002 annual compensation, not including stock options: $237,907,917! Add to that the stock options: $1,153,864,691! Yes, that is a billion dollars! Together you are looking at $1.75 billion that went to twenty people in that industry in 2002 alone!!!!! (We can only imagine what they “earned” in past years, or how lucrative 2003 & 2004 will be for that matter.) That’s what ya call profitability!
    Plus, they all just got a big fat tax cut! Can you just imagine how difficult it must be to find a reasonably priced mansion in Aspen right now!

    For the complete report in PDF form go to: http://www.familiesusa.org/site/DocServer/Top_Dollar_report.pdf?-docID=1381

    For another interesting report on the drug industry,
    http://www.consumersunion.org/pdf/medicare-603.PDF

  • August 11, 2005 at 7:01 am
    Integrity Control or Out of says:
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    Doctors for Integrity in Policy Research (DIPR) has focused on how public
    money — _your_ money — has been used to subvert your inherent, irrevocable
    rights through the use of politicized “science.” Virtually every level of
    government uses your tax money to propagandize restrictive gun laws and other
    fundamental tenets of authoritarian control, of collectivism, of socialism
    (sometimes eumphemistically “liberalism”). Increasingly it has become
    apparent to us that consumers’ money — _your_ money — has also been used to
    subvert your inherent, irrevocable rights. Your health care dollars, whether
    being paid directly by you or indirectly by you through your employer or
    union, are being funneled into health care insurance companies that are
    increasingly funding “non-profit educational foundations” that propagandize
    for the end of our constitutional republic. Currently, with resources
    approaching $1 BILLION, California Wellness Foundation is the deepest of
    these “pockets,” but increasing numbers of health insurance companies are
    becoming so involved. [We expect to report on the activities of Kaiser
    Foundation/Permanente Medical Group in the future]. Ms. Sarah Foster
    conducted an extensive investigation of California Wellness Foundation and
    has written the following article. If you read this article and are angered
    or frightened by the activities of California Wellness Foundation, recall
    that Health Net fathered this ******* child. If you have Health Net
    insurance coverage, let your views be known — to your insurance agent, your
    employer, your union, _and_ the executives of Health Net and California
    Wellness Foundation. Do not let your money be used against you and your
    family for generations to come. Let your legislators know that, despite its
    pleasing sounding name and mission, California Wellness Foundation is an
    enemy of our rights and of our constitutional republic. Ms. Foster’s report
    refers to issues other than gun bans in which California Wellness Foundation
    is active. Please distribute her report to people, organizations, and
    newsgroups with interest in those other issues. Please support Capital
    Research Center that has made this and other important reports available.

    Edgar A. Suter MD
    National Chair, Doctors for Integrity in Policy Research

  • August 11, 2005 at 5:42 am
    HN do you like audits? says:
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    Pre-existing Medical Record shows a prior worker’s compensation claim of injury to right wrist. (Bogus)

    Records Location: El Camino Hospital, Mountain View, California.

    Health Net, is there not anything you would do to deny a claim?

    http://216.109.125.130/search/cache?p=exam+Business+Insurance+Group+Delaware&sm=Yahoo%21+Search&toggle=1&ei=UTF-8&vst=0&vs=www.dora.state.co.us&b=11&u=www.dora.state.co.us/insurance/mcexam/pci01.pdf&w=exam+business+insurance+group+delaware&d=F4CAE9F3AA&icp=1&.intl=us

  • January 11, 2006 at 3:38 am
    DAVID says:
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    I WAS COVERED BY AIG BACK IN 2004 FOR AUTO INSURANCE WITH COVERAGE RANGING FROM 100,OOO/300,000 FULL COVERAGE IN THAT YEAR MY WIFE WAS IN AND ACCIDENT AND WE WHERE TOLD THAT THE COVERAGE OF THE VEHICLE SHE WAS DRIVING DIDNT HAVE FULL COVERAGE .NOW THEY SAY OUR COVERAGE IS ONLY 20,000/40,000 WE ARE APPEALING

  • March 18, 2009 at 8:36 am
    o.williams says:
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    To every lawmaker residing in the United States dept.of law.Please fix this problem of theft and bribery of the evils
    which has bound this great country.Each lawmaker is obligated to do their part,first,round up the thieves and show their faces to the American people,I feel these guys may not be true humans,or worse
    they may be the terroists we all fear to take over our country.Aliens are also to be consideed to be without a heart,therefore it’s important that they
    are found and exterminated.Also we the people deserve better since we have allowed every country and every undeveloped form of man to come in and find refuge,God truly BLESSED America!Please do your part and rescue our ecconomic crisis now”in due time we can be back to normal and human beings will be able to enjoy the wonders of life in a real society,not that of a third world”.
    I beg you to catch the thieves now’before they spend the money and cry they no longer have it,lock up the crooks as we know is the normal procedures in our great XCountry.God is watching over us and he only can fix this demonic evil.



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