(WXYZ) - First she saw a car hit and drag her five-year-old. Then she had to sue the insurance company to get them to pay for her daughter’s care. Why is a local mom having to fight for coverage when she paid her premiums?
You have insurance to take care of you and your loved ones, but in Michigan paying your premiums doesn’t guarantee you’ll get the coverage you need. It’s one of four states where insurance companies can deny or delay legitimate claims with little consequence.
Kecia Milliner: “I was just screaming, Jesus, Jesus, and praying…”
Kecia Milliner’s daughter Taylor was just five years old when a car hit her.
Kecia Milliner: “…lacerations to the liver, spleen, kidney, severe road burns on her forehead, cheek and chin, severely broken..."
But the worst injury is the brain trauma that Taylor still suffers from. Her care is constant and costly.
Kecia Milliner: “…cognitive therapy, speech therapy, academic therapy, it is very expensive.”
The Milliner’s auto insurance company, Bristol West, covered Taylor’s care for awhile. But then it stopped. And so did Taylor’s progress.
Kecia Milliner: “I was getting complaints from her teachers that her behavior had changed, her academic progress had changed. I was so angry…”
Mike Simpson: “In 1993, my daughter was diagnosed with lung cancer, and within nine months I buried my daughter.”
State Representative Mike Simpson says he paid his health insurance premium, but his carrier stopped paying his daughter’s medical bills.
Mike Simpson: “During the nine month fight, I sold everything I owned. You’d sell your soul to save your child. But it wasn’t enough, and ultimately, it bankrupted my family, it crushed us.”
Simpson shared his story at a press conference in Lansing. There he announced that he and other lawmakers are proposing legislation to put Michigan in line with 46 other states that have stiff penalties for insurance companies.
Mike Simpson: “I never wanted to see this happen to another family.”
In Michigan the law says insurance companies can be fined $500 for denying or delaying to pay a legitimate claim. If the proposed bills pass, companies could be fined up to $1 million. And CEOs who foster wrongful delays or denials of legitimate claims at their companies could be charged with a felony and fined.
Mike Dabbs is president of the brain injury Association of Michigan, and he says he gets calls every day from people who say their claims are getting denied.
Mike Dabbs: "When we have companies that pull stunts like we’ve seen with denying people the care they’re promised, then we got to take some action.”
It’s not just personal injury and health claims that insurance companies are accused of delaying or denying.
Jo Ann Katzman: “We were told to keep our claim numbers low.”
Jo Ann Katzman is a former All State adjuster who handled homeowner claims. Katzman says she and others were encouraged to have customer claims investigated for fraud, a strategy to delay paying them.
Katzman: “I’ve seen personally where it’s led to them losing their homes.”
All State says they can’t comment on former employees. But they did tell us that their practices “are sound, compliant with state laws, and effective at giving customers and claimants fair payments in a timely manner.”
Pete Kuhnmuench: “Many of our member companies strive to make sure their customers are treated fairly and quickly.”
Kuhnmuench is the executive director of the Insurance Institute of Michigan. he says the proposed laws will only encourage more lawsuits.
Pete Kuhnmuench: “There are legitimate disagreements sometimes that need to be resolved. But I don’t think the problem is anywhere near what the proponents of this legislation make it out to be.”
Kecia Milliner says she has had to sue twice to get her daughter’s coverage re-instated. The company agreed to continue Taylor’s care uninterrupted for three years. But she wants the law changed.
Kecia Milliner: “It’s not just about me and my child because this could happen to anyone at any time."
Bristol West is owned by Farmers Insurance. They tell Action News that they have worked closely with the Milliners and are expending whatever necessary to help resolve their claim and will continue to do so.
