Louisiana to get $12M in Health Net case

National News

The Louisiana Supreme Court has ordered Health Net Inc., a major health maintenance organization, to cover more than $180 million in claims by consumers, health care providers and creditors in Louisiana, Oklahoma and Texas.

Louisiana Insurance Commissioner Jim Donelon told The Advocate that Louisiana will get the smallest portion of the payout.

"We have about $12 million coming to us to policyholders, providers and general creditors, meaning companies who sold them supplies or that rented them space," Donelon said.

Donelon said the unanimous ruling, issued Friday, will reimburse all of AmCare Louisiana HMO's members, providers, and creditors for any losses caused by Health Net's conduct.

Health Net sold health plans in the three states to AmCareco Inc. in 1999. In 2002, the troubled health plans were placed under state supervision. Each of the state's insurance departments sued AmCareco and Health Net, alleging fraud, negligence, conspiracy and breach of fiduciary duty.

In 2005, a state district court jury awarded the Texas plaintiffs around $100 million in damages. In 2005, a state judge in Baton Rouge issued similar verdicts against Health Net and awarded $30 million to the Louisiana and Oklahoma plaintiffs.

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Does a car or truck accident count as a work injury?

If an employee is injured in a car crash while on the job, they are eligible to receive workers’ compensation benefits. “On the job” injuries are not limited to accidents and injuries that happen inside the workplace, they may also include injuries suffered away from an employee’s place of work while performing a job-related task, such as making a delivery or traveling to a client meeting.

Regular commutes to and from work don’t usually count. If you get into an accident on your way in on a regular workday, it’s probably not considered a work injury for the purposes of workers’ compensation.

If you drive around as part of your job, an injury on the road or loading/unloading accident is likely a work injury. If you don’t typically drive around for work but are required to drive for the benefit of your employer, that would be a work injury in many cases. If you are out of town for work, pretty much any driving would count as work related. For traveling employees, any accidents or injuries that happen on a work trip, even while not technically working, can be considered a work injury. The reason is because you wouldn’t be in that town in the first place, had you not been on a work trip.

Workers’ compensation claims for truck drivers, traveling employees and work-related injuries that occur away from the job site can be challenging and complex. At Krol, Bongiorno & Given, we understand that many families depend on the income of an injured worker, and we are proud of our record protecting the injured and disabled. We have handled well over 30,000 claims for injured workers throughout the state of Illinois.

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