The Fall Back Position

"TM" <[email hidden]> a écrit dans le message de news:
[email hidden]...

Quoted message said:

"trg" <[email hidden]> wrote in message
news:[email hidden]...
Why is your sister claiming frozen dinners and tree limbs?

Her house was in a hurricane. Her trees came down and smashed her roof. and
are strewn across the yard, garage, car, etc. The electricity went out and
caused the spoilage of many hundreds of dollars of food. And she purchased
insurance against storm/wind/flood damage which cover those things. Then
when it's time for the company to pay up, they make her go through hoops to
get the money. You don't think that the tree removal service doesn't have
enough to do without individually itemizing each limb that came down and
waiting for it to be approved? And then she's gonna have to argue with them
literally limb from limb to get them to pay. You call that good faith?

Quoted message said:

Quoted message said:

Take a look at ADP biased reports used by many insurance companies to
reduce MedPay claims.

Take a look at all the times insurance companies have forced insured to
sue in order to get their benefits due. And how many times it ends with
the insured receiving less than the owed amount because it would just be
too expensive or drawn out to bring the case through the court system.

Well again, I could just say the opposite and it would mean as much.

No it wouldn't. In addition to the anecdotal evidence there are surveys and
reports and studies that show this. For instance, look at the non-profit
http://www.badfaithinsurance.org/ . Then go ahead and show me evidence that
supports the opposite view.

Quoted message said:

Quoted message said:

We're not talking insurance companies refusing to pay because a customer
has filed a fraudulant claim, but because it makes business sense not to
pay.

Well, we are talking armstrong and we are talking about fraud.

This is RBR. I'm shocked to see that this thread has strayed to something
not directly related to cycling 🙂

Quoted message said:

And why we're talking about armstrong and court, perhaps you could explain
to me why he hasn't sued L'Equipe like he has every other paper that
accussed him of drug use?

What other papers has he sued for accusing him of drug use???

"trg" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

What other papers has he sued for accusing him of drug use???

Not many have your sense of humor!

TM said:

"trg" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

The fact that CSA doesn't want to pay out shouldn't come as a shock to
anyone. That's pretty much SOP. Insurance companies are happy to take your
money, but put up as many hoops as possible for you to jump through when
it comes to trying to claim any of it.

Insurance companies pay claims on a regular basis and only go to the trouble
of contesting claims when they suspect that have a better than 50-50 shot of
proving fraud.

snip

I'm with trg on this one. Very often I've seen very straightforward
claims delayed, delayed, delayed. It may well be simple incompetence,
but I'm cynical enough (and experienced enough) to know that if the
insurance companies make it difficult enough, a certain number of people
will not persist to see that legitimate claims are paid. This is sure
for medical claims, and for sure it's true for any type of liability
insurance.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Dans le message de
news:[email hidden],
B. Lafferty <[email hidden]> a réfléchi, et puis a déclaré :

Quoted message said:

"trg" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"B. Lafferty" <[email hidden]> a écrit dans le message de news:
[email hidden]...

Quoted message said:

"trg" <[email hidden]> wrote in message
news:[email hidden]...
> "B. Lafferty" <[email hidden]> a écrit dans le message de news:
> [email hidden]...
>>
>> "trg" <[email hidden]> wrote in message
>> news:[email hidden]...
>>>
>>> <[email hidden]> a écrit dans le message de news:
>>> [email hidden]...
>>>> Yes he does...He'll have to give his (insured) bonus money back
>>>> after they sue him (and win). He'll lose spokesman/sponsorship
>>>> duties that otherwise would have kept him in the dough for the
>>>> next few years.
>>>
>>>
>>> Not at all certain. As long as the relavent cycling bodies say
>>> he won, it's complete conjecture today to say that he won't get
>>> his bonus without knowing the terms of the contract and Texas
>>> law. How does the contract define win? One could reasonably
>>> assume that it relies on either ASO or the UCI. And with those
>>> bodies in possession of all the information that CSA has, but
>>> still declaring Armstrong the winner, AND no relavant doping
>>> authority claiming Armstrong won because he doped, CSA will have
>>> a hard time proving otherwise. The fact that CSA doesn't want to
>>> pay out shouldn't come as a shock to anyone.
>>
>> SCA has already paid Armstrong $4.5 million, IIRC
>> The legal issue is fraud in the inducment.
>>
>
> From their side, from Armstrong's side it's the refusal to pay the
> rest of the bonus. Might as well throw everything into the mix.
>
>>> That's pretty much SOP. Insurance companies are happy to take
>>> your money, but put up as many hoops as possible for you to jump
>>> through when it comes to trying to claim any of it. He'll only
>>> lose spokesman/sponsorship duties if a lot of bad publicity
>>> continues in the US. The best way for it to continue is if HE
>>> and his lawyers keep raising a stink after the story has died.
>>> That's why the important part of the press conference (which
>>> Brian, with eyes wide shut, overlooks) isn't his lawyers are
>>> blowing smoke about legal action (i.e. spinning the situation
>>> for the US market), but his annoncement that he's definitively
>>> retired. As he said, if he continued to ride, all this stuff
>>> would still be out there. I wouldn't be surprised if CSA is pressing
>>> their case not
>>> because they expect to win, but because they hope to settle out
>>> of court for a lower amount than the full sum (also SOP) with an
>>> Armstrong willing to accept less money in order to make the bad
>>> publicity go away (and stop paying for his lawyers' new yatchs).
>>> Anything Armstrong plans to do in the future (Cancer fight,
>>> politics, tv personality, ...) depends on his image in the US.
>>> That's where he's the most vulnerable and that's the lens
>>> through which these actions need to be regarded.
>>
> Heck if you are rufusing to pay the guy, you're might as well
> through in the money you already paid out into the picture.

If there's a determination that they don't have to pay this bonus
due to fraud in the inducement dating prior to the contracts for
the other bonuses, then they probably will go after that too. It
isn't like Armstrong doesn't have the money to repay them.

It's not like they don't have the money to pay Armstrong.

Correct. The $5 million is in escrow.

I left all this in to correct some misperceptions. The money is not
necessarily in escrow, unless mandated by a court order, or posited in an
interpleader action (I didn't read the pleadings). It is posted in the
reserves against claims by the insurer(s) and reinsurers, as part of all
litigation set-asides. That money, and all the money in reserves is
regularly supervised by the financial authorities that have jurisdiction.
You should take a little time to actually understand how things work, rather
than to citing advocacy group sites. You could always inquire of the
insurance commissioners. I don't know they read this newsgroup.

The point, lost in all this, is that insurance is a contract, and upon the
representations of the contracting parties, it is dealt with under the
appropriate legislation. There are very few cases where liars win and the
poor folk get screwed. If your lottery system (scusi !! - plaintiffs'
advocates' forum) has a problem, it ain't with international insurance, it's
with the liars and cheats. Frequently their own clients.

Finally, a tiny point, so lost in the details - when a government commands
action, which affects behaviour, then it is a typical insurance policy
exclusion - force majeure - which relieves the obligation of payment. So
the night in the hotel is excluded.

The real stuff you (trg) seem to be missing is that cheating is not
rewarded, usually, by capitulation to public relations guys. New Orleans is
something a whole community (the world) gets involved in. Armstrong is
something not too many people care about, really. Just here.

Don't play amateur insurance genius, if you don't want to be shown up
lacking.
--
Bonne route !

Sandy
Verneuil-sur-Seine FR

"Mark & Steven Bornfeld" <[email hidden]> wrote in message
news:R2XWe.861$265.512@trndny07...

Quoted message said:

I'm with trg on this one. Very often I've seen very straightforward
claims delayed, delayed, delayed. It may well be simple incompetence, but
I'm cynical enough (and experienced enough) to know that if the insurance
companies make it difficult enough, a certain number of people will not
persist to see that legitimate claims are paid. This is sure for medical
claims, and for sure it's true for any type of liability insurance.

The difference is you have switched from talking about the armstrong case to
talking about insurance in general. I'm sure you can find examples of an
insurance company acting poorly just as you can find examples of cyclists
doping.

Just because one cyclist doped does not make armstrong guilty just as one
insurance company acting wrongly does not make armstrong's insurance company
guilty in this case.

That's what was said, to me... the only reason armstrong is being sued by
his insurance company is because all insurance companies are scum. If
you're with him on that point then I hold a different opinion.

"Sandy" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Dans le message de
news:[email hidden],
B. Lafferty <[email hidden]> a réfléchi, et puis a déclaré :

Quoted message said:

"trg" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"B. Lafferty" <[email hidden]> a écrit dans le message de news:
[email hidden]...
>
> "trg" <[email hidden]> wrote in message
> news:[email hidden]...
>> "B. Lafferty" <[email hidden]> a écrit dans le message de news:
>> [email hidden]...
>>>
>>> "trg" <[email hidden]> wrote in message
>>> news:[email hidden]...
>>>>
>>>> <[email hidden]> a écrit dans le message de news:
>>>> [email hidden]...
>>>>> Yes he does...He'll have to give his (insured) bonus money back
>>>>> after they sue him (and win). He'll lose spokesman/sponsorship
>>>>> duties that otherwise would have kept him in the dough for the
>>>>> next few years.
>>>>
>>>>
>>>> Not at all certain. As long as the relavent cycling bodies say
>>>> he won, it's complete conjecture today to say that he won't get
>>>> his bonus without knowing the terms of the contract and Texas
>>>> law. How does the contract define win? One could reasonably
>>>> assume that it relies on either ASO or the UCI. And with those
>>>> bodies in possession of all the information that CSA has, but
>>>> still declaring Armstrong the winner, AND no relavant doping
>>>> authority claiming Armstrong won because he doped, CSA will have
>>>> a hard time proving otherwise. The fact that CSA doesn't want to
>>>> pay out shouldn't come as a shock to anyone.
>>>
>>> SCA has already paid Armstrong $4.5 million, IIRC
>>> The legal issue is fraud in the inducment.
>>>
>>
>> From their side, from Armstrong's side it's the refusal to pay the
>> rest of the bonus. Might as well throw everything into the mix.
>>
>>>> That's pretty much SOP. Insurance companies are happy to take
>>>> your money, but put up as many hoops as possible for you to jump
>>>> through when it comes to trying to claim any of it. He'll only
>>>> lose spokesman/sponsorship duties if a lot of bad publicity
>>>> continues in the US. The best way for it to continue is if HE
>>>> and his lawyers keep raising a stink after the story has died.
>>>> That's why the important part of the press conference (which
>>>> Brian, with eyes wide shut, overlooks) isn't his lawyers are
>>>> blowing smoke about legal action (i.e. spinning the situation
>>>> for the US market), but his annoncement that he's definitively
>>>> retired. As he said, if he continued to ride, all this stuff
>>>> would still be out there. I wouldn't be surprised if CSA is pressing
>>>> their case not
>>>> because they expect to win, but because they hope to settle out
>>>> of court for a lower amount than the full sum (also SOP) with an
>>>> Armstrong willing to accept less money in order to make the bad
>>>> publicity go away (and stop paying for his lawyers' new yatchs).
>>>> Anything Armstrong plans to do in the future (Cancer fight,
>>>> politics, tv personality, ...) depends on his image in the US.
>>>> That's where he's the most vulnerable and that's the lens
>>>> through which these actions need to be regarded.
>>>
>> Heck if you are rufusing to pay the guy, you're might as well
>> through in the money you already paid out into the picture.
>
> If there's a determination that they don't have to pay this bonus
> due to fraud in the inducement dating prior to the contracts for
> the other bonuses, then they probably will go after that too. It
> isn't like Armstrong doesn't have the money to repay them.

It's not like they don't have the money to pay Armstrong.

Correct. The $5 million is in escrow.

I left all this in to correct some misperceptions. The money is not
necessarily in escrow, unless mandated by a court order, or posited in an
interpleader action (I didn't read the pleadings).

My understanding, which could be incorrect, is that the money has benn
placed in an escrow account of some sort independent of SCA to be paid when
and if an arbitration award is confirmed by the court. Either way, the money
is set aside and will be paid if that is the result of litigation.

Quoted message said:

It is posted in the reserves against claims by the insurer(s) and
reinsurers, as part of all litigation set-asides. That money, and all the
money in reserves is regularly supervised by the financial authorities
that have jurisdiction. You should take a little time to actually
understand how things work, rather than to citing advocacy group sites.
You could always inquire of the insurance commissioners. I don't know
they read this newsgroup.

The point, lost in all this, is that insurance is a contract, and upon the
representations of the contracting parties, it is dealt with under the
appropriate legislation. There are very few cases where liars win and the
poor folk get screwed. If your lottery system (scusi !! - plaintiffs'
advocates' forum) has a problem, it ain't with international insurance,
it's with the liars and cheats. Frequently their own clients.

Finally, a tiny point, so lost in the details - when a government commands
action, which affects behaviour, then it is a typical insurance policy
exclusion - force majeure - which relieves the obligation of payment. So
the night in the hotel is excluded.

The real stuff you (trg) seem to be missing is that cheating is not
rewarded, usually, by capitulation to public relations guys. New Orleans
is something a whole community (the world) gets involved in. Armstrong is
something not too many people care about, really. Just here.

Don't play amateur insurance genius, if you don't want to be shown up
lacking.
--
Bonne route !

Sandy
Verneuil-sur-Seine FR

Perhaps you'd like to explain to everyone how Armstrong was so much
faster in 2000 and on then in 1999 but that he needed EPO to win in
1999?

Oh, wait, you're going to tell us that a system so corrupt that they
could test the B samples without permission and then somehow ferret out
the code numbers and hand it all over to the media is trustworthy
enough to believe they had a faultless security on the sample CONTENTS.

I do find it interesting that Brian is a lawyer and somehow reveals why
he can't remain employed so often. You'd think that someone with his
training would be able to hide his extreme biases better than that.

If you want to know how to sabotage this perfectly it's very easy. You
only need to shoot yourself with EPO, wait a day, pee into a bottle and
then put a single drop into each sample you want to test positive.
There is essentially no way to detect such a method.

You ought to really look at most of these cases. Insurance companies
don't like to pay for treatments that cost millions and have the effect
of lengthing a person's life by a month or a year. If you look at
cancer treatments and outcomes now you have to realize that many people
are living more than 5 years and then dying of the same sort of cancer
that they were originally treated for. Because it's past 5 years they
are declared "cured" and the reoccurence considered a "new" cancer.

If you're going to live another 5 years it might well be worthwhile but
it takes that long for the fear of the treatments to recede far enough
back in your mind for the look of despair to leave your eyes.

Perhaps HALF of all major medical expenses now go to treatments which
scientifically are considered to be marginally effective.

Now I agree that this isn't something that an insurance company should
be deciding, but you certainly ought to think about that when they tell
you that they can "treat" your advanced lung cancer "agressively". Ask
pertinent questions like - what life extention can I expect to get from
this treatment?

"Tom Kunich" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Perhaps you'd like to explain to everyone how Armstrong was so much
faster in 2000 and on then in 1999 but that he needed EPO to win in
1999?

How do we know Lance didn't dope in 2000 too?

JF

--
http://spaces.msn.com/members/flomblog/

"Tom Kunich" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Perhaps you'd like to explain to everyone how Armstrong was so much
faster in 2000 and on then in 1999 but that he needed EPO to win in
1999?

.... that is, assuming he really did dope in 1999, which I am asserting for
the sake of argument.

JF

--
http://spaces.msn.com/members/flomblog/

Jim Flom said:

"Tom Kunich" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Perhaps you'd like to explain to everyone how Armstrong was so much
faster in 2000 and on then in 1999 but that he needed EPO to win in
1999?

... that is, assuming he really did dope in 1999, which I am asserting for
the sake of argument.

JF

--
http://spaces.msn.com/members/flomblog/

There you go being rational again! That's exactly the problem is that
no matter what happens we are going to have nothing solid to go on.
Reminds me a lot of the Robert Blake mess. It'd be pretty kind to call
everyone involved with that one "questionable", and it seems to be the
same here at this point.
Bill C

"Bill C" <[email hidden]> wrote...

Quoted message said:

There you go being rational again! That's exactly the problem is that
no matter what happens we are going to have nothing solid to go on.
Reminds me a lot of the Robert Blake mess. It'd be pretty kind to call
everyone involved with that one "questionable", and it seems to be the
same here at this point.

Shame on me. I put Robert Blake in there with O.J. Lance IMHO is harder to
pigeon-hole. Do I care much one way or another? Not really. It would be
great if he won them all clean -- we all -- well, most of us -- want to
believe we watched honest history in the making. If he doped, oh well.
Tyler Hamilton I have a harder time believing doped, just based on personal
experience. I read the dissenting opinion of the three-man arbitration
panel and found it raised enough reasonable doubt about his guilt. I mean
that not in any legal sense, just a practical sense. Then the other guy
gets busted in Phonak and soon the doctor is history. Makes me wonder of
the doctor screwed up without Hamilton's or the other rider's knowledge.
Haven't heard much about that though, just mostly about fetal twins.

JF

--
http://spaces.msn.com/members/flomblog/

Jim Flom said:

"Bill C" <[email hidden]> wrote...

Quoted message said:

There you go being rational again! That's exactly the problem is that
no matter what happens we are going to have nothing solid to go on.
Reminds me a lot of the Robert Blake mess. It'd be pretty kind to call
everyone involved with that one "questionable", and it seems to be the
same here at this point.

Shame on me. I put Robert Blake in there with O.J. Lance IMHO is harder to
pigeon-hole. Do I care much one way or another? Not really. It would be

Lance is probably in the same pigeonhole as William Shatner...

On 19 Sep 2005 06:47:35 -0700, "Tom Kunich" <[email hidden]>

Quoted message said:

If you look at
cancer treatments and outcomes now you have to realize that many people
are living more than 5 years and then dying of the same sort of cancer
that they were originally treated for. Because it's past 5 years they
are declared "cured" and the reoccurence considered a "new" cancer.

If you're going to live another 5 years it might well be worthwhile but
it takes that long for the fear of the treatments to recede far enough
back in your mind for the look of despair to leave your eyes.

its far more complicated than that. OTOH, every major insurance
company has qualified nurses that review practically every major
reimbursement case.

The major issues are that some cancers are not being cured in any
significantly better rate, but are simply discovered earlier -
automatically extending the period a person survivies.

Some cancers have a significantly improved real survival rate from
just a decade ago.

And some are pretty much a short term death sentence still. OTOH,
those that will sign on for risky treatments may be that one pipeline
that delivers a cure. My sister-in-law, herself a degreed medtech
pretty much knew she had maybe a year to live and knew too well the
results that she read several times a week, but she was willing to try
a trial treatment, It didn't work. But it was a chance at the time.

FWIW, I don't know many oncology nurses and doctors that declare
people cured of cancer. Most need a gun at their heads before they
will use much other than remission. They're happy with a ten year
remission without any mention of a cure.

And since I know about 30 or so cancer survivors personally and have
met a few hundred, this idea that they are walking around like the
living dead with some kind of haunted eye syndrome is a bit much. I'm
guessing you're like the rest of us - you don't have a clue how many
survivors walk past you every day, looking pretty normal and more
worried about gas hitting $ 4.00 a gallon than going back into chemo
treatments.

Curtis L. Russell
Odenton, MD (USA)
Just someone on two wheels...

"Curtis L. Russell" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

On 19 Sep 2005 06:47:35 -0700, "Tom Kunich" <[email hidden]>

Quoted message said:

If you look at
cancer treatments and outcomes now you have to realize that many people
are living more than 5 years and then dying of the same sort of cancer
that they were originally treated for. Because it's past 5 years they
are declared "cured" and the reoccurence considered a "new" cancer.

If you're going to live another 5 years it might well be worthwhile but
it takes that long for the fear of the treatments to recede far enough
back in your mind for the look of despair to leave your eyes.

its far more complicated than that. OTOH, every major insurance
company has qualified nurses that review practically every major
reimbursement case.

The major issues are that some cancers are not being cured in any
significantly better rate, but are simply discovered earlier -
automatically extending the period a person survivies.

Some cancers have a significantly improved real survival rate from
just a decade ago.

And some are pretty much a short term death sentence still. OTOH,
those that will sign on for risky treatments may be that one pipeline
that delivers a cure. My sister-in-law, herself a degreed medtech
pretty much knew she had maybe a year to live and knew too well the
results that she read several times a week, but she was willing to try
a trial treatment, It didn't work. But it was a chance at the time.

FWIW, I don't know many oncology nurses and doctors that declare
people cured of cancer. Most need a gun at their heads before they
will use much other than remission. They're happy with a ten year
remission without any mention of a cure.

And since I know about 30 or so cancer survivors personally and have
met a few hundred, this idea that they are walking around like the
living dead with some kind of haunted eye syndrome is a bit much. I'm
guessing you're like the rest of us - you don't have a clue how many
survivors walk past you every day, looking pretty normal and more
worried about gas hitting $ 4.00 a gallon than going back into chemo
treatments.

To tell you the truth Curt I don't know how you managed to get that out of
my postings. I've known perhaps a couple of dozen cancer victims. I worked
in the medical instrument business for some time and had to haunt
hostpitals. And many relatives succumbed. Perhaps you are so close to cancer
patients that you don't realize how frightened they are for so long after
cancer treatment but I certainly have seen that.

I will admit that lately things seem considerably different though. A couple
that I cycle with both had cancer and both are in remission. And the woman
cycled right though both her radiation treatments and the chemo. She would
get tired at the metric century mark but otherwise I wouldn't have known if
they hadn't told me. So perhaps modern radiation and chemo isn't making them
as sick and weak as it used to. And maybe the fear today isn't as bad as it
was a decade ago.But don't tell me that it didn't exist. Don't belittle
people frightened for their lives and afraid to face their next treatment.
And then worried for years that they'll have to go through that again.

Hell, didn't Lance say in his biography that it wasn't until the 5 year mark
that he relaxed?

That wouldn't create nearly enough EPO to constitute a 'positive'.

On Wed, 21 Sep 2005 01:25:14 GMT, "Tom Kunich" <[email hidden]>

Quoted message said:

Don't belittle
people frightened for their lives and afraid to face their next treatment.
And then worried for years that they'll have to go through that again.

I didn't belittle them - that would come from your claim that they
walk around frightened. And I'm not the one that is close to them,
other than some are friends and many are acquantances. My wife is the
one that they walk up to meet.

OTOH, she has run encounter groups off and on for either churches or
hospital oncology units for years and I get info heavily filtered.
Sure, some are frightened all the way through the treatment and
beyond. And some get through their fears as they confront the
possibilities in the process of treatment. Not my opinion - what with
me being pretty much a person that alternates between oblivious and
otherwise lacking in empathy. Guess that's why I'll trust my wife's
assessments, as I would probably get it wrong if I were there...

I've heard too much to think that any of them have it easy. One of my
wife's patients recently committed suicide from the end results of
oral cancer, what with losing his job, losing his ability to eat much
that didn't come from cans and about to lose his wife. Unfortunately
he also killed his wife. Young mothers walk up and you find out they
have an unresponsive cancer.

OTOH, you also find out clueless you are, as many of these people I
know at least socially. If my wife wasn't part of their treatment,
they could walk past me up to a couple of weeks before their final
visit to the hospital and I wouldn't be the wiser. I don't claim
expertise, just a bit more experience in the difference between what I
think I know and what I really know. I'm now grateful whenever the two
are reasonably close.

And I know (I think) that unless they are wearing a knit hat as the
only cover of their baldness, you probably don't know whether someone
is or has taken chemo.

Curtis L. Russell
Odenton, MD (USA)
Just someone on two wheels...