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Former Insurance Commissioner Poolman: "Lacked Credibility" PDF Print E-mail
Written by Chet   

Found this doozy recently.  North Dakota's former Republican Insurance Commissioner Jim Poolman isn't getting much for props from a Federal Court judge in Nevada. It's so bad that even I almost feel bad for Poolman.  I'll try to give you a very brief summary of the background of the case, but I'll leave it to you to do the real legwork.

  • An assortment of insurance companies -- Paul Revere Life Ins. Co and UnumProvident (d/b/a Unum Life Insurance Company of America and Provident Life and Accident Insurance Company) -- were sued by a man named G. Clinton Merrick, a partner in a venture capital firm. 

  • "In 1994, Merrick made a claim for disability coverage with Paul Revere, which agreed there was "significant impairment"  and began paying the claim.  Several months later, a Paul Revere representative offered to settle Merrick's claim for the equivalent of four months of disability benefits.  After Merrick declined the offer, the insurer enlisted an independent medical examiner, who concluded Merrick's fatigue was caused by depression, not [chronic fatigue syndrome] or Lyme disease.  The insurer interpreted the reports as finding significant impairment and implying Merrick could not return to work.  After an extensive review and another settlement offer, Paul Revere denied Merrick's claim on the ground that its review showed no objective medical evidence supporting an inability to perform the duties of his occupation.  The company rejected follow-up reports from Merrick's doctors."  (This is directly quoted from http://www.justice.org/lawreporter, but you need a membership to get at it.)

  • At the end of the first trial, a jury awarded Merrick $11.65 million, including $2 million in punitive damages against Paul Revere and another $8 million against UnumProvident.  The decision was appealed, the findings were affirmed, generally, but on August 31, 2007, the case was sent back for a new trial on the punitive damages award because of some procedural glitches (bad jury instructions).  

  • It wasn't just this one guy the insurance companies were shafting.  The insurance companies had engaged in a "fifteen year scheme to cheat disabled people" out of the insurance disability benefits they were entitled to under their insurance contracts.

  • In the second trial (same case; just straightening out problems with the damages award), the defendants -- Paul Revere and UnumProvident -- brought in a new, fresh, young expert witness to help provide a defense to their "fifteen year scheme to cheat disabled people."  The expert had just come off of a stint of serving as North Dakota's Insurance Commissioner.  His name?  Jim Poolman. 

  • Poolman apparently didn't do so well at trial.  Here's how the trial judge perceived Poolman's testimony:
[The defendants p]resented expert testimony concerning the regulatory process with respect to these Defendants which was simply not credible for several reasons. Defendants’ regulatory expert, Mr. Poolman, had no first-hand knowledge of the regulatory process as applied to these Defendants. Mr. Poolman admitted that he did not participate in the process, did not know what documents, if any, beyond claim files, that examiners had access to, admitted that he had not even read most of the documents Defendants provided to him, and was seemingly unaware of other regulatory actions taken against Defendants by both the State of California and the State of Georgia. Even Mr. Poolman’s testimony concerning the Multistate regulatory process and how it was settled, the testimony which he was retained to provide, lacked credibility.
Federal Court Decision (at p. 24 of 39) (link after the jump.)
  • Ouch.  That could leave a mark.

  • Keeping in mind the jury had awarded just under $12 million in the first trial, in the second trial -- after Poolman was brought in to defend these companies' scheme to cheat disabled people -- the jury awarded... 

  • Wait for it...  

(click "read more" to continue reading...)

DrEvilSixty million dollars. 

The trial judge had to reduce the total damages award to $50 million.  In doing so, he wrote this:

No award that his Court can make will force Defendants to disgorge all the improper profits that they obtained. As described below, these profits were obtained at the expense of physically, mentally, emotionally, and economically vulnerable individuals, through repeated actions systematically applied to deprive them of disability insurance benefits in their time of need. Defendants have engaged in such conduct both with respect to Merrick and to their other insureds for an extended period of time. Such conduct leads to the conclusion that these Defendants engaged in highly reprehensible conduct.

Federal Court Decision (at p. 28 of 39) (read this)

Former Insurance Commissioner Jim Poolman has decided to take his experience and credibility as North Dakota's former top insurance regulator and go to bat for companies that engage in a systematic scheme of "reprehensible conduct" against the least among us, and he'll do it all for the low, low price of $600.00 per hour.  Yes, Virginia.  Poolman charged these companies $600 per hour to go to Nevada and serve as an expert witness in defending their reprehensible conduct.  [Page 82, line 1, of the trial transcript; a fun read (call me if you doubt it).]) 

Here's what's troubling about this case:  Poolman holds himself out as being an advocate for consumers here in North Dakota, and our lazy, press-release-regurgitating media ignores what he did with the model viatical bill and North Dakota's law, etc., and spews it out like so many sheep. 

Now it's been confirmed that Poolman is a...

well...

He's a...

Darn it.

I already used that word once today, so I won't use it again.  Let's put it this way:  Now Poolman has shown himself to be willing to do things for money.  Dirty things.  Naughty things.  For money, Jim Poolman is willing to go to bat to help big insurance companies avoid accountability for their reprehensible conduct in harming some of the most vulnerable people.  For $600 per hour, Poolman will provide testimony that "lacks credibility" in defense of reprehensible corporate conduct.  It's sad.

But what's troubling is that you'll never read about this in a North Dakota newspaper.  You'll never see the Fargo Forum acknowledge it made a mistake when it gushed about Poolman's advocacy for insurance consumers.  The Tribune has had nothing but nice things to say about Poolman, too.  Big "consumer advocate."  Jim Poolman is their boy.  He's John Hoeven's boy.  That's more important to our media than reporting facts. That's more important to them than reporting the news.

That's what's troubling.

(For more on this click here and click here.)


Comments (12)add comment

What the Heck said:

Can't help but wonder
If those reprehensible companies demanded a refund from Poolman. This story has familiar elements. Reprehensible, disability, ND, insurance, denying those in time of need.
 
November 26, 2008
Votes: +4

S. Fred Wood said:

Poolboy
Don't you love a judge that does not suffer fools gladly?

Cheers.
 
November 26, 2008
Votes: +2

Big Jake said:

...
Makes me proud to be a North Dakotan.

The election proves that we haven't had enough of this yet.
 
November 26, 2008 | url
Votes: +2

iwofndadvocates.com/blog said:

Do you think.......
Since WSI hired Conolly for about $400 an hour they might splurge and hire Poolman for $600 an hour to discredit injured workers? With this kind of record injured workers might have a chance with him standing up against them. I bet a few of them wouldn't mind a 50 million dollar payout for their suffering at the hands of WSI.
 
November 26, 2008 | url
Votes: +1

doug d.riley said:

...
First off i would like to thank Chet for stepping back in and giving us some much needed heads up-more than likely furness or hoverson wrote the letter that on the BT-now why the bt lets that lying crap on their site with out researching the facts is just embarrassing now lets see just how many folks out there really want the truth and for that the can go to the workers compensation review committee and start reading the meetings minutes and agendas 2007-08--you will find out how the truly injured workers are treated and what wsi truly thinks about them-i think that out of about seven injured workers four or five where made to be telemarketers this is how a multi million dollar organization is run-there is no rehab there is no fast and sure relief-just look at my minutes that sept.16th an 17th-my continuing jurisdiction was denied because i had filled out the wrong form-it was found in time an when hoverson was asked to approve it he said no-with the new evidents that was brought before the committee-thats from winning a alj judge case an even shes saying for wsi ti reinstate my benefits-three hours of setting in the committee-let me print something from tim wahlin-tim wahlin said in the case of mr.riley,wsi has not gone back to reevaluate an earlier determination and has not fully evaluate this new evidence.he said there is not significant value in wsi considering this new evidence because he does not have any chance in changing the posture of mr.rileys case !! at the very last paragraph representative keiser asked wahlin if wsi will be accepting his application for continuing jurisdiction -representative keiser said the current status is that wsi has DENIED his APPLICATION-now you don't see anything wrong wsi the way wsi workers and how the injured worker is treated....thanks folks for your time-p.s. you can believe whats in the bt or you can belive the mimutes of the legislature committee...
 
November 26, 2008
Votes: +1

Chet said:

Two things
Two things pointed out to me by people who've called me about this: (1) there are some things that are legal in Nevada that are illegal in most of the rest of the country/world. It's been suggested to me that Poolman was just exercising his right to do a perfectly legal business in the state of Nevada. I have no comment in response to that; and (2) There is a looming series of questions that remains here in North Dakota: Does Unum/Paul Revere do any business here in North Dakota? If so, have any North Dakota insurance consumers been wrongfully harmed by these companies' reprehensible conduct? If so, has our Insurance Commissioner taken any action to sanction them? I don't know. Maybe I'll look into that after Thanksgiving.

Though I appreciate your comments, I wish you guys would just post your comments here rather than calling me with them. I've got work to do.
 
November 26, 2008
Votes: +2

40 Years in the DemNPL said:

Reminds me of Pedro Munoz
A lackluster and overpaid Twins hitter from the distant past. I was compelled to holler from the cheap seats in centerfield, "Hey, Pedro, if we pay you another million, will you run out your weak grounders?"

Maybe Jim just needs $900 an hour to read the defense briefs and provide credible testimony.
 
November 26, 2008
Votes: +0

nimrod said:

qualifications?
What is troubling to me is that the former ND Insurance Commissioner was not competent to provide credible testimony in federal court concerning the insurance regulatory process. It seems an understanding of the regulatory process might be one of the qualifications for being the State Insurance Commissioner. How many other Hoeven appointees don't have enough of an understanding of the regulatory process involved within their areas of responsibility that they could not provide credible testimony about the regulatory process in front of an federal judge.
 
November 26, 2008
Votes: +1

What the Heck said:

You don't need much regulatory experience
in ND. Let's face it. There's little to no meaningful regulation. That's the real problem.

This may be a side tangent, but...has anyone considered the implications of potential discrimination by a government agency for age-related conditions in administering an employee benefit program? Isn't WC an employee benefit? Aren't the WC insurers administering benefits on behalf of the employer? Does it matter who pays the premium? Aren't employees protected under Title VII against age discrimination, as well as the Age Discrimination Act? Isn't that a federal issue? Why would IW's need to jump through the ALJ and various WSI hoops to pursue a federal matter, if it is one? And can the employers be sued for discrimination? I don't understand how a state law to exempt the employer from being sued for an injury-related claim can prevent being sued for an age discrimination claim. Or a state government entity who of all organizations, should be accountable to uphold federal laws. I'm not a lawyer so maybe I'm all wet on this.
 
November 27, 2008
Votes: +1

Chet said:

...
Poolman got some ink today in a Nashville newspaper. One of his big political donors from New York... er... Tennessee is buckin' for one of them partisan political appointments. Here's the link.
 
December 08, 2008
Votes: +0

S. Fred Wood said:

Spelled his name right.
Man you can't buy advertising like that. I'm sure his phone will be ringing off the hook.
 
December 09, 2008
Votes: +0

What the Heck said:

Public service?
Pataki, Poolman, viaticals, campaign contributions, GOP. Just follow the money. Investing in the hope that a hasty death means a better return. Disgusting. I suppose someone will post a comment about how this helps the poor family who needs the money to pay bills. That's what accelerated death benefits are for.
 
December 09, 2008
Votes: +0

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