ILNews

Lawsuit claims Indiana’s high-risk insurance pool hoards cash

Back to TopCommentsE-mailPrintBookmark and Share

Health care providers who’ve been rejected by private malpractice writers turn to a state-run insurer that typically charges two to three times more for coverage. A class-action lawsuit claims the high-risk pool owes its policyholders a $31 million surplus.

More than 1,000 providers from family doctors to specialty practice groups have been covered since the year 2000 by the Indiana Residual Malpractice Insurance Authority, plaintiffs attorneys say. Marion Superior Civil Division 7 Judge Michael Keele in April certified the class-action suit in which plaintiffs argue IRMIA’s own auditors say the fund has more cash on hand than it could possibly spend to pay claims or cover expenses.

“If IRMIA were a private company, that money would be distributed to shareholders. It’s a profit, but IRMIA wasn’t set up to make a profit,” said James K. Wheeler, a partner with Coots Henke & Wheeler P.C., in Carmel. Wheeler’s firm, with Cohen & Malad LLP of Indianapolis, was appointed as class counsel.

Notices to class members began after Keele approved an order May 23 giving potential members 30 days to opt

out of the proposed class. The suit is Larry J. Ley, et al. v. Stephen W. Robertson, in his capacity as Commissioner of the Indiana Department of Insurance, and the Indiana Residual Malpractice Insurance Authority, 49D07-1203-PL-9386.

IRMIA was created by statute in 1998 and under I.C. 34-18-17 covers practitioners who have been rejected by two or more private carriers, commonly because of prior malpractice suits. The state argues in its response that IRMIA has done no wrong and that its policyholders aren’t entitled to refunds.

Tina Korty, general counsel for the Department of Insurance, referred requests for comment to the Office of the Indiana Attorney General. The office responded to questions about the IRMIA surplus with a statement from spokesman Bryan Corbin.

“We are not able to comment on financial details of the IRMIA fund but will respond in court to the plaintiffs’ legal assertions at the appropriate time. As the lawyer for state government, the Attorney General’s Office will vigorously defend its state clients: the Department of Insurance, Commissioner Robertson and IRMIA itself,” Corbin said.

“Our office opposed the plaintiffs’ motion for class certification arguing that the plaintiffs did not meet their burden on the elements necessary for class certification. Having represented state government previously in various other unrelated class actions, our office now will move forward into this new phase of the case, and we respect the ruling of the court,” he said.
 

irwin levin Levin

Cohen & Malad managing partner Irwin Levin said the money IRMIA lists on its balance sheets as “undistributed funds” represents “tens of millions of dollars more than they will ever, ever need to pay claims, according to two separate actuaries hired by IRMIA.
“I have no idea why IRMIA insists on holding on to the money,” he said. “It should go back to the people who paid it. … All they’re doing right now is hoarding money, and it should be put back into the economy.”

Levin said the suit doesn’t challenge IRMIA’s premiums or the methodology the authority uses to set them. “They can charge whatever rates they deem reasonable,” he said, but IRMIA doesn’t have a right to hold a “big pot of cash sitting in a cave they keep adding dollars to.”

The suit also alleges that IRMIA has failed to segregate surpluses for investment as required by statute under I.C. 34-18-17-8, and it asks the court to mandate compliance.

Barring a ruling of summary judgment, resolution through court-ordered mediation or other settlement, the matter is set to proceed to trial on Feb. 3, 2014.

Terre Haute lawyer Michael Sacopulos, of the firm Sacopulos Johnson & Sacopulos, has defended IRMIA claims for the state in southwest Indiana. He believes the authority could face a challenge in justifying its balance sheet.

“It seems to me that this is a knowable type of equation that’s used in the amount of money that you hold in reserves,” he said, noting IRMIA’s coverage limits and the often years-long maturity horizon for malpractice claims in process give the authority a good level of claims predictability. “You cannot hold excessive amounts.”

At the same time, Sacopulos said IRMIA may be able to prevail on its posture as a carrier of last resort. “Is it a reasonable amount given their exposure? … Pools of the physicians (IRMIA compared to those privately insured) are not apples-to-apples,” he said. “Higher-risk pools, not just in Indiana, but nationally, if you’ve been sued, statistically you’re more liable to be sued again.”
That’s in line with some of the 22 affirmative defenses proffered by the state in response to the suit. “But for IRMIA, Plaintiffs would have been significantly limited in their ability to practice medicine in Indiana, and, accordingly, Plaintiffs have received significant benefits including, without limitation, all income remuneration that they have earned during the periods of time that they were covered by IRMIA,” the response says.

But Levin and Wheeler said IRMIA has accounted for all known risks and costs of coverage and has built a surplus that climbed from nothing around 2000 to $7 million in 2007 and $16 million in 2009. IRMIA’s most recent balance sheet from Dec. 31, 2011, shows a total of $31,790,424 in undistributed funds. The authority’s total of reserves, liabilities and undistributed funds for 2011 was $64.3 million.

“Indiana is different from almost every other state,” Wheeler said of its malpractice pool. Because IRMIA covers only the first $250,000 of a practitioner’s liability per claim with an annual aggregate limit of $750,000, its worst-case scenarios are known.

“That makes it easier for the actuaries because of the limits of liability in the state of Indiana,” Wheeler said.

Meantime, attorneys are still unraveling the exact number of practitioners covered by IRMIA policies. In 2012, there were 135 policies, the fewest since 2001, but there have been as many as 664 in prior years. Wheeler said because many of the insured were in the pool for five years or more, compiling a complete list of those insured by the fund since 2000 has been difficult.

Wheeler believes that IRMIA may have over collected premiums in the early 2000s during what he described as a national malpractice scare. Fewer claims than expected may have resulted, producing the surplus. “As claims matured into the later 2000s a

 

malpractice

nd went away, that’s what caused this number to grow,” he said.

The richness of the fund also might say something about practitioners who’ve found themselves with no place else to go for coverage, Wheeler hypothesizes. “I think doctors who got put into the fund ended up being a better risk,” he said.

“I think they got the bejeezus scared out of them and probably were more careful.”•

ADVERTISEMENT

  • ads
    Hi, Who can I speak to regarding advertising today? Thanks, Gary

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. Actually, and most strikingly, the ruling failed to address the central issue to the whole case: Namely, Black Knight/LPS, who was NEVER a party to the State court litigation, and who is under a 2013 consent judgment in Indiana (where it has stipulated to the forgery of loan documents, the ones specifically at issue in my case)never disclosed itself in State court or remediated the forged loan documents as was REQUIRED of them by the CJ. In essence, what the court is willfully ignoring, is that it is setting a precedent that the supplier of a defective product, one whom is under a consent judgment stipulating to such, and under obligation to remediate said defective product, can: 1.) Ignore the CJ 2.) Allow counsel to commit fraud on the state court 3.) Then try to hide behind Rooker Feldman doctrine as a bar to being held culpable in federal court. The problem here is the court is in direct conflict with its own ruling(s) in Johnson v. Pushpin Holdings & Iqbal- 780 F.3d 728, at 730 “What Johnson adds - what the defendants in this suit have failed to appreciate—is that federal courts retain jurisdiction to award damages for fraud that imposes extrajudicial injury. The Supreme Court drew that very line in Exxon Mobil ... Iqbal alleges that the defendants conducted a racketeering enterprise that predates the state court’s judgments ...but Exxon Mobil shows that the Rooker Feldman doctrine asks what injury the plaintiff asks the federal court to redress, not whether the injury is “intertwined” with something else …Because Iqbal seeks damages for activity that (he alleges) predates the state litigation and caused injury independently of it, the Rooker-Feldman doctrine does not block this suit. It must be reinstated.” So, as I already noted to others, I now have the chance to bring my case to SCOTUS; the ruling by Wood & Posner is flawed on numerous levels,BUT most troubling is the fact that the authors KNOW it's a flawed ruling and choose to ignore the flaws for one simple reason: The courts have decided to agree with former AG Eric Holder that national banks "Are too big to fail" and must win at any cost-even that of due process, case precedent, & the truth....Let's see if SCOTUS wants a bite at the apple.

  2. I am in NJ & just found out that there is a judgment against me in an action by Driver's Solutions LLC in IN. I was never served with any Court pleadings, etc. and the only thing that I can find out is that they were using an old Staten Island NY address for me. I have been in NJ for over 20 years and cannot get any response from Drivers Solutions in IN. They have a different lawyer now. I need to get this vacated or stopped - it is now almost double & at 18%. Any help would be appreciated. Thank you.

  3. I am in NJ & just found out that there is a judgment against me in an action by Driver's Solutions LLC in IN. I was never served with any Court pleadings, etc. and the only thing that I can find out is that they were using an old Staten Island NY address for me. I have been in NJ for over 20 years and cannot get any response from Drivers Solutions in IN. They have a different lawyer now. I need to get this vacated or stopped - it is now almost double & at 18%. Any help would be appreciated. Thank you.

  4. Please I need help with my class action lawsuits, im currently in pro-se and im having hard time findiNG A LAWYER TO ASSIST ME

  5. Access to the court (judiciary branch of government) is the REAL problem, NOT necessarily lack of access to an attorney. Unfortunately, I've lived in a legal and financial hell for the past six years due to a divorce (where I was, supposedly, represented by an attorney) in which I was defrauded of settlement and the other party (and helpers) enriched through the fraud. When I attempted to introduce evidence and testify (pro se) in a foreclosure/eviction, I was silenced (apparently on procedural grounds, as research I've done since indicates). I was thrown out of a residence which was to be sold, by a judge who refused to allow me to speak in (the supposedly "informal") small claims court where the eviction proceeding (by ex-brother-in-law) was held. Six years and I can't even get back on solid or stable ground ... having bank account seized twice, unlawfully ... and now, for the past year, being dragged into court - again, contrary to law and appellate decisions - by former attorney, who is trying to force payment from exempt funds. Friday will mark fifth appearance. Hopefully, I'll be allowed to speak. The situation I find myself in shouldn't even be possible, much less dragging out with no end in sight, for years. I've done nothing wrong, but am watching a lot of wrong being accomplished under court jurisdiction; only because I was married to someone who wanted and was granted a divorce (but was not willing to assume the responsibilities that come with granting the divorce). In fact, the recalcitrant party was enriched by well over $100k, although it was necessarily split with other actors. Pro bono help? It's a nice dream ... but that's all it is, for too many. Meanwhile, injustice marches on.

ADVERTISEMENT