Kreidler achieves settlement with health insurers - approves 10 more Exchange plans

Kreidler achieves settlement with health insurers - approves 10 more Exchange plans

Insurance Commissioner Mike Kreidler has reached settlements with Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest and approved their 10 plans for sale in Washington’s Health Benefit Exchange, the Washington Healthplanfinder.

 Consumers in Washington will now have 41 choices in the Exchange when open enrollment begins Oct. 1. Community Health Plan of Washington (CHPW) will have three plans available in 26 counties.

 Kaiser will offer an additional seven plans in Clark and Cowlitz counties.

 Kreidler said the additional 10 plans meet the same high standards held for the other approved companies. They also ensure continuity of care for Medicaid enrollees and create more competition in the marketplace.

 The Exchange set an initial July 31 deadline for the Insurance Commissioner’s review and approval of plans for inclusion in the Exchange, where subsidies for health coverage will be offered as part of the federal Affordable Care Act.

“We had 31 health plans approved by the Exchange’s deadline. Washington consumers now have an additional 10 quality plans to choose from,” Kreidler said.  “We took the initial deadline seriously, but we also followed our own legal process and it worked. The Exchange cannot delay any further. It must take action and approve these plans by Sept. 5.”

Production of SIU Documents

Production of SIU Documents

When seeking production of documents from a non-party, it is important to remember that it is not sufficient to only show relevance; it must also be unfair to proceed to trial without the documents.

In Boucher (Litigation Guardian of) v. Charles, 2013 ONSC 3120 (S.C.J.), the plaintiffs brought a r. 30.10 motion to obtain documents from a non-party, the Special Investigations Unit (SIU).  The action arose out of an accident between a cyclist and a police motor vehicle.  The SIU conducted an investigation and concluded there were no grounds to lay criminal charges against the officer.

In a r. 30.10 motion for production of documents from a non-party, the moving party must satisfy a two-part test: 1) the document must be relevant to a material issue in the action and, 2) it would be unfair to proceed to trial without having discovery of the document.  The test sets a high bar and is permissive rather than mandatory (i.e. if it is met, the Court may order production).

The SIU conceded relevance of all of its documents except for statements from two civilian witnesses who did not witness the event.  Master McAfee held that the documents were relevant, but the plaintiffs were not able to meet the second part of the test.  The witnesses had not consented to release of their statements, and the statements of witnesses given to police officers had been produced in the police file.  Master McAfee also considered the public interest.  The efficacy of the SIU's investigative process and its ability to discharge its mandate depends on maintaining the confidence of witnesses. 

Master McAfee ordered production of a statement by a deceased witness as he would not be available to testify at trial or to provide consent to release the statement.  The plaintiffs were not able to show that they would be prejudiced by proceeding to trial without the remaining documents.

New online tool shows you what individual health insurance costs next year in WA

We've built a new online tool to help you find out what health care plans will cost next year. Simply click on the map -- premiums vary by where you live -- and it will tell you which insurance carriers are offering coverage in your area. You can click on each company to see its rates, which vary based on your age.

A couple of caveats: These rates are mainly for the individual market, meaning people who have to buy insurance for themselves, and don't get it through an employer, Medicare, etc.

Also, the rates do factor in the subsidies that will be available to some people. Those subsidies will reduce the cost of coverage substantially for many people. You can estimate how much you'll pay, with subsidies taken into account, by using this online calculator from the Washington HealthPlanFinder.

Lastly, the list of health plans is likely to grow over the next couple of months. We are still reviewing plans, for example, for multiple insurance carriers that have filed to sell coverage outside the state exchange. And some plans that were rejected for the Exchange have filed appeals. So stay tuned.

Foods to Increase Platelets

Platelet function in our body part is essential for the process of blood coagulation. A normal platelet count is 150,000 to 450,000 but different diseases can cause levels fall can cause internal bleeding. A low platelet count is a serious matter that requires medical supervision, but in your diet you could find extra help. In here we give you a list of foods to increase plateletsand improve your health.
Foods to Increase Platelets
Low platelets can be caused by severe infections, diseases such as dengue, diseases of the spleen, hemolytic anemia, vitamin K, and most serious diseases like leukemia or the result of chemotherapy treatment, the important thing is to keep the situation under control and try as far as possible to upload more platelets in your body.

Depending on the disease that has caused the decline in platelets a change in diet may be beneficial. It is important to know that in more serious cases such as leukemia these foods do not provide a significant change, however in cases of dengue, anemia or other infections and diseases will markedly.

Faced with a decline of platelets is necessary to eat foods with a high content of vitamins and minerals that help our body to produce more plateletsand thus to recover our health.

In cases of anemia is necessary to increase the consumption of iron quickly, because low platelets cause fatigue and drowsiness. You should be included in the diet foods like spinach, the canons, lentils, red pepper, liver and guava, which in Europe can be found in juice.

The carrot, beet and celery are known for its properties to raise plateletsin our blood. The best way that you can consume it raw in a salad, as well get maximum of vitamins, however in cases of diseases such as dengue or severe infections where patients are too weak, the best way to eat them is in broth or vegetable cream.

Garlic is also an ideal food to increase platelets, prepare garlic soup or add it to the cream you suggest vegetable (celery and carrots for example).

The vitamin C is a great ally to increase the platelets you can get it from fruits like kiwi, strawberries, orange, and lemon. A good suggestion for patients who are weaker is administered in a refreshing juice.

In addition to your diet there are other steps you can take to improve your knowledge about blood platelets and if after a blood test your plateletscount has gone altered should consult a specialist immediately to determine the source of the decline.
An open letter from Mike Kreidler about insurance plans filed for Washington's exchange

An open letter from Mike Kreidler about insurance plans filed for Washington's exchange

An open letter from Insurance Commissioner Mike Kreidler

In January, the biggest changes under health care reform – or “Obamacare” – will take effect. Many health plans, which now have to comply with federal standards, will be significantly better. And hundreds of thousands of low- and middle-income Washingtonians will qualify for subsidies to help pay for coverage.

This fall, Washington’s new Health Benefit Exchange will open for business, giving consumers an easy way to compare health plans, sign up, and see if they qualify for the subsidies.

Many kinds of insurance policies, before they can be sold, must be reviewed and approved by my office. This is a very important consumer protection, designed to ensure that prices are fair and that insurers can deliver on their promises.

I’m pleased to report that based on state and federal law, we were able to approve 31 health insurance plans, from four carriers, for the Exchange. People shopping on the Exchange will have broad choice and significantly better coverage, starting Jan. 1, 2014.

Unfortunately, we had to reject applications from five other insurance carriers. These were not decisions I made lightly. I am a strong supporter of competition and consumer choice, and a longtime supporter of health care reform.

As the state’s insurance regulator, however, I have a duty to protect consumers and to hold all insurers to the same standards. There were substantial problems in the plans we rejected.

Health insurers must have adequate networks of doctors and other health care providers. And there were major problems with the networks of most of the rejected plans. One didn’t offer any pediatric hospital.

Another had no approved retail pharmacy. Certain plans didn’t have adequate access to transplant surgeons, or to HIV/AIDS specialists.

One network would have required people to drive more than 45 miles to see a cardiologist, and more than 120 miles to see a gastroenterologist. That would be like living in Tacoma but having to see a doctor in Bellingham.

These were not minor technicalities. They were major problems.

Some people have pointed out that three of the carriers whose plans were rejected are currently serving people on Medicaid. They worry that people whose incomes rise, making them ineligible for Medicaid, will have difficulty moving to a regular commercial plan, or would lose important continuity of care offered by the community clinics. Many of these community clinics offer important services, such as language assistance or transportation.

Rest assured: The plans I approved for the Exchange include a substantial number of community clinics throughout the state. In many cases, Medicaid patients who want to remain with the same clinic will be able to.

The Affordable Care Act requires all carriers participating in the Exchange to contract with an adequate number of “Essential Community Providers,” or ECPs. These are defined as health care providers that serve high-risk, special needs and underserved individuals. Many Sea Mar clinics, for example, have contracts with the commercial carriers who were approved for the Exchange.

My staff and I worked very hard to try to get all carriers and all plans across the finish line in time. We had dozens of meetings, and 14 webinars to try to walk them through the process. I called one CEO after another, laying out the key issues and timelines. On the final night, July 31, we had staff waiting at their desks until midnight, in order to give the companies every possible minute to succeed.

But some carriers – particularly those new to the commercial insurance market -- simply couldn’t meet the standards this time.

We knew this first big year of health reform implementation would be a bumpy ride, and it has been. But I remain optimistic about the future. We will continue to work with all carriers to help them get ready for the next year, when I fully expect more insurers to succeed.

In the meantime, consumers have a broad number of choices. The insurance is meaningful, the networks robust, the subsidies significant. Again, the process has been bumpy. But it’s a very promising start.

Mike Kreidler
Insurance Commissioner
DOL Teams Up With Vermont on the Latest ERISA Preemption Attack

DOL Teams Up With Vermont on the Latest ERISA Preemption Attack

The practice of individual states enacting laws that arguably infringe on ERISA preemption is not new.  In fact, some states have become increasingly creative in poking and prodding at the limits of this federal law, which has raised obvious concerns among those involved in the self-insurance marketplace.  (See previous blog posts commenting on the Michigan health care claims tax.)

A new twist worth reporting on is the fact that the Department of Labor has apparently decided to take a more hands-on (political) role in shaping the evolving legal landscape, positioning the agency as a powerful accomplice in the effort to make self-insurance a more challenging risk management strategy.

 This intent was demonstrated last month by the DOL’s decision to file an Amicus brief in the case of Liberty Mutual Insurance Company v. Susan L. Dorgan, in her Capacity as the Commissioner of the Vermont Department of Regulation.  The case is currently pending in the United States Court of Appeals for the Second Circuit

 At issue is whether Vermont’s Health Care Database” statute is preempted by ERISA.  Among other things, the statute requires health insurers, providers, facilities and government agencies to “file reports, data, schedules, statistics, or other information determined by the commissioner.”  The term “health insurer” is defined broadly to include any administrator of a self-insured group health plans, including third party administrators and pharmacy benefit managers.

The purpose of these requirements is to enable the state to build a comprehensive database it believes is necessary in order to effectively carry out health care administration functions.   Liberty Mutual, a self-insured employer, refused to provide the requested data.  The company subsequently sued the state, arguing that the collection and reporting of the requested data created administrative burdens for the plans, therefore triggering ERISA preemption.

Siding with the state, a federal trial court judge granted summary judgment, finding that the Vermont law did not affect ERISA plan administration and further concluding that it was appropriate for the state to regulate in this area.

Admittedly, ERISA preemption law can be complicated and highly technical in many cases.  In this regard, to be charitable, we suppose that a good faith argument could be made the requirements set forth  in this stature do not, in fact, affect plan administration so criticism of the state should be put in proper context – a disagreement on legal and policy grounds.

The DOL’s participation is another matter.  By putting its large thumb on the scale, an ambitious political agenda is exposed for those who care to notice.

As the agency primarily responsible for administrating and enforcing ERISA, DOL has historically defended the law’s broad federal preemption provisions.   But with its provocative interpretation that Vermont is essentially regulating the business of insurance (the key exception to ERISA preemption), DOL has clearly signaled it has changed course, presumably to support the Administration’s implicit objective of squeezing the private health care marketplace when possible and where few people are watching.

We commented recently that Tom Perez’s nomination as secretary of DOL portended a more political agency.  Given that he was subsequently confirmed after this Amicus brief was filed, his fingerprints aren’t on this one but it can be reasonably concluded that under his watch the DOL will continue to back Vermont if the case is ultimately heard by the U.S. Supreme Court. 

And so it goes.  A huge federal bureaucracy quietly imposes the Administration’s political will in ways too nuanced to attract attention.  But that’s where the real action is.
The Onus at Status Hearings

The Onus at Status Hearings

The decision of Master Hawkins in 1745361 Ontario Ltd. v. St. Paul's Investments, 2013 ONSC 4642 (S.C.J.) reminds us that the onus at a status hearing is on the plaintiff.

In this case, there was a delay of between 13 and 25 months, depending on whether or not the plaintiff had served an affidavit of documents (the parties disputed whether it had been served).  The plaintiff also failed to comply with the Master's Order that it deliver material for a status hearing.

Master Hawkins emphasized that Rule 48.14(13) places the onus on the plaintiff to persuade the court that the action should not be dismissed for delay.  The plaintiff must demonstrate that he, she or it has an acceptable explanation for the delay, and that if the action is allowed to proceed, the defendant will suffer no non-compensable prejudice.

The plaintiff's affidavit used at the status hearing provided no explanation for the delay and was silent on the issue of prejudice to the defendant.  On the contrary, the defendant delivered an affidavit setting out that two critical witnesses had disappeared.  Accordingly, the plaintiff had failed to discharge its onus under r. 48.14(13) and the action was dismissed.

Although the onus is on the plaintiff, one has to assume that the affidavit filed by the defendant setting out the prejudice it suffered as a result of the delay was helpful to the Court.

8-Year Old Doesn't Age Due to Rare Condition

Gabby Williams is 8 years old but has the skin of a newborn and only weighs 11 lbs. An ultra-rare genetic condition, for which doctors have no discernible explanation, keeps Williams from physically aging and has her parents caring for her nearly the same as the day she was born.

Williams shares her rare condition with only a handful of people around the world, including a 29-year-old man from Florida who has the body of a 10-year-old and a 31-year-old Brazilian woman who appears no older than two. While the medical community hasn’t yet established a cause for Williams’s or the others' conditions, research into the genetic disorder has promising implications for overcoming the inertia of aging.

"In some people, something happens to them and the development process is slowed," said medical researcher Richard F. Walker. "The rate of change in the body slows and is negligible."
8 Anti-Aging Foods That Help Fight Cancer And Heart Disease

The Science Behind Gabby's Agelessness

Walker has been researching Williams’ condition for the last two years. Retired from the University of Florida Medical School, Walker now performs his research at All Children's Hospital in St.

Petersburg. He reports having spent his entire career studying the causes of aging. The patients he deals with live with other conditions such as deafness and the inability to walk, eat, or even speak. But most notably, they all age at one-fifth the rate of a normal person.

Williams’ case is particularly noteworthy given her feature spot in the 2012 TLC documentary, “My 40-Year-Old Child.” Since the show aired, Williams’ parents told ABC News, their daughter has stayed relatively the same.

"Gabrielle hasn't changed since pretty much forever," said her mother, Mary Margret Williams, 38. "She has gotten a little longer and we have jumped into putting her in size 3-6 month clothes instead of 0-3 months for the footies.”

“Last time we weighed her she was up a pound to 11 pounds and she's gotten a few more haircuts,” she said, but other than that, things have remained the same.

Walker attributes Williams’ lack of aging to what he calls decreased “developmental inertia.” Her body’s normal physiological changes and maturation haven’t occurred because of the genetic condition. Normally when people age, their bodies mature until age 20 or so, and then begin to erode, or succumb to developmental inertia.

"If we could identify the gene and then at young adulthood we could silence the expression of developmental inertia, find an off-switch,” said Walker, adding that “when you do that, there is perfect homeostasis and you are biologically immortal."

Scientists Turn Off Down Syndrome’s Extra Chromosome In New Experiments

What Does 'Aging' Really Mean?

Part of the reason humans can’t live forever is that as chromosomes split during cell division, the telomeres capping the chromosomes begin to shorten. Scientists often liken telomeres to the plastic tip on the end of a shoelace, as they keep the frayed ends of the chromosome from fusing together and degrading the cell’s blueprint.

Broken DNA is dangerous, and because of this a typical cell has the ability to repair chromosomal damage. Without telomeres, the cell would mistakenly sense broken DNA in the frayed chromosome. Doing so would cause the chromosome to stop dividing along with the rest of the cell and eventually die.

The result of overcoming developmental inertia isn’t living forever. It simply means old age wouldn’t come with greater risks of cancer, disease, and illness.

“You wouldn't have the later years,” Walker said. “You'd remain physically and functionally able.”
Aging isn’t only a process of telomere-shortening. Scientists include other factors such as oxidative stress, glycation, and chronological age.

Oxidative stress, like glycation, is the compounding pressure put on DNA and lipids from oxidants. Glycation differs in that glucose is the main culprit, binding to and inhibiting DNA, proteins, and lipids. Chronological age refers to the number of years a person has been alive, and it reflects an increased risk for disease and illness.

In Gabby Williams’ case, her chronological age has little bearing on her outcome, although doctors cannot say with confidence how long they think she will live.

Devout Catholics, her parents accept their daughter’s fate however God intends it.
"When He is ready to take her back, it will be sad," her mother told ABC News. "But what a glorious thing it will be for Gabby to go to heaven one day. I know it will happen, but I am not hoping it's any day soon."
Excess Insurance

Excess Insurance

Excess insurers may be interested in the recently reported decision of ACE INA Insurance v. Associated Electric & Gas Insurance Services Ltd., [2012] O.J. No. 6500 (S.C.J.).

ACE insured Toronto Hydro, which was sued over an explosion that occurred in the underground parking of a high-rise apartment building.  AEGIS was the excess insurer.  Although there was no explicit duty to defend under the AEGIS policy, ACE brought an application that AEGIS had a duty to pay defence costs pursuant to the doctrine of equitable contribution.

The AEGIS policy was an "indemnity policy" rather than a "liability policy".  Under its policy, AEGIS limited its indemnity obligation where there is other insurance, and limited its duty to indemnify to defence costs incurred by the insured, not those incurred by a third-party such as ACE.  Defence counsel had been appointed by ACE rather than the insured.  AEGIS's obligation was only to indemnify defence costs at the end of the litigation, where the costs were not covered by other insurance.    

Justice C.J. Brown rejected the argument that AEGIS had an equitable duty to contribute to defence costs despite the clear wording of the policy.  There is no equitable obligation to defend where an excess policy precludes a duty to defend.  In addition, a relevant factor was that any defence costs paid by AEGIS would reduce the policy limits available to the insured so there was potential prejudice to Toronto Hydro. 

Throat cancer and your health

Throat cancer is one of the most common, and although detected early healing expectations are 90% in most cases the disease takes to be discovered, so it is important to know a little more about it, your symptoms and risk factors. Here explain what the early signs of throat cancer are and give you all the basic information about this disease.

The throat cancer can start in this area and extend to the vocal cords, larynx, esophagus, the lower part of the neck, etc. Once you leave this area and is spreading to other organs of the body the prognosis becomes more complicated, hence the importance of detecting it early and stop their advance.

A major risk factor in this type of cancer is the habits and environmental factors. Smoking and chewing snuff and excessive alcohol consumption are decisive, but also the Human Papilloma Virus or HPV is a major cause of this cancer. Transmitted through oral sex is a major factor.

Most throat cancer patients are men over 50 years. Eliminate consumption of snuff, regular alcohol intake, eating a healthy diet and using protection during oral sex are the main recommendations to prevent it, however if you are active or passive smoking annually is recommended to go to a doctor for a review of discarding.

The main symptoms of throat cancer are:

  • Loss of voice or hoarseness that does not improve after 1 to 2 weeks of treatment 
  • Sore throat, even after taking medication does not improve after 1 to 2 weeks 
  • Pain and discomfort in the neck that may be accompanied by lumps in the area 
  • Cough may become bloody at times 
  • Strange sounds and difficulty breathing properly do so can cause fatigue and tiredness 
  • In more advanced cases difficulty swallowing and weight loss

A significant number of cases of throat cancer is complicated by not being detected in time, hence the importance of reducing or eliminating risk factors, comprehensive health checkups once a year and visit a doctor at any sign or symptoms.
Auto insurance and pizza delivery

Auto insurance and pizza delivery

We get a lot of calls from parents -- and usually those calls are after the fact, unfortunately -- about whether their child delivering pizzas needs additional auto coverage.

Sorry, but the answer's usually yes. Most personal auto insurance policies won't cover you if you're getting paid to use your own car to transport people or property for business purposes.

In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.

If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.
Expert Evidence at Trial

Expert Evidence at Trial

The Divisional Court has released an important decision with respect to expert evidence.  In Westerhof v. Gee (Estate), 2013 ONSC 2093 (Div. Ct.), a jury awarded the plaintiff $22,000 in general damages and $13,000 for loss of income.  The trial judge, however, dismissed the claim on the basis that it did not meet threshold.  The plaintiff appealed, arguing that the trial judge erred by restricting the plaintiff's expert witnesses.  A number of treating practitioners were not permitted to give evidence about diagnosis or prognosis, two accident benefits assessors were not permitted to give opinion evidence, a neurologist was not permitted to give evidence regarding psychiatric or psychological issues, and opinions contained in MRI reports were redacted.

The appeal was dismissed.  The Court discussed a number of cases dealing with r. 53.03 and r. 4.1.01, which provide a framework for the duties of experts.  The key distinction is whether the evidence is factual or opinion evidence; if it is opinion evidence, compliance with r. 53.03 is required.  As a result, it was correct for the trial judge to exclude the evidence.  A treating physician could offer evidence with respect to observations of the plaintiff or the treatment provided, but once such a witness seeks to offer opinions on the cause of the injury, its pathology or prognosis, the evidence enters into the realm of opinion evidence requiring compliance with r. 53.03.

Westerhof provides much-needed guidance regarding expert witnesses.  It will be interesting to see whether the number of treating practitioners testifying decreases as a result of the ruling.  The plaintiff's treating practitioners will now be held to a higher standard, and there may be an opening to argue that a practitioner is an advocate rather than impartial witness.
Health insurance questions: Preventive colonoscopies and polyps

Health insurance questions: Preventive colonoscopies and polyps

Until fairly recently, when consumers had routine preventive colonoscopies, they often faced a substantial bill for surgery if a polyp was discovered and removed during the procedure. But current guidelines from the U.S. Department of Labor, under the Affordable Care Act, protect consumers from these extra charges for polyp removal.
Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy? 
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.
In addition, the federal guidelines help people with a family history that put them in a high risk group for certain diseases. They will now be able to get more frequent preventive care without additional costs.
Q7: Some USPSTF recommendations apply to certain populations identified as high-risk. Some individuals, for example, are at increased risk for certain diseases because they have a family or personal history of the disease. It is not clear, however, how a plan or issuer would identify individuals who belong to a high-risk population. How can a plan or issuer determine when a service should or should not be covered without cost-sharing? 
Identification of "high-risk" individuals is determined by clinical expertise. Decisions regarding whether an individual is part of a high-risk population, and should therefore receive a specific preventive item or service identified for those at high-risk, should be made by the attending provider. Therefore, if the attending provider determines that a patient belongs to a high-risk population and a USPSTF recommendation applies to that high-risk population, that service is required to be covered in accordance with the requirements of the interim final regulations (that is, without cost-sharing, subject to reasonable medical management).
If you're having problems with your health insurer over these sorts of issues and you live in Washington state, feel free to contact our consumer hotline at 1-800-562-6900 or email us
WA Supreme Court: Insurer can be held liable for agent's actions

WA Supreme Court: Insurer can be held liable for agent's actions

In a case that’s been closely watched by the insurance industry, Washington’s State Supreme Court on Thursday affirmedthat insurers are liable for the illegal actions of their agents.

“The ruling is a big win for consumers,” said Insurance Commissioner Mike Kreidler, whose decision the case was challenging. “If you allow someone to do business on your behalf, it only stands to reason that you can be held responsible for what they do.”

The case involved violations of the state’s insurance laws in 2006 and 2007 by an insurance agency appointed by Chicago Title Insurance Company. That agency, Land Title Co. of Kitsap County, Inc. repeatedly offered illegal inducements to get business. The violations included illegally “wining and dining” real estate agents, builders and mortgage lenders with free meals, donations for a golf tournament, monthly advertising, and Seattle Seahawks playoff game tickets.

Although Land Title was Chicago Title’s exclusive agent in the Washington counties at issue in the case, Chicago Title argued that it was not responsible for its agent’s actions. In a consent order signed in 2009, the company agreed to pay a $48,334 fine if it did not prevail in court.

“Chicago Title’s arguments were contrary to a century of insurance law,” said Kreidler. “In order to effectively regulate insurers and protect consumers, it’s important to hold insurers responsible for the actions of their agents.”

Title insurance practices have long been a concern to Kreidler, whose office in 2005 scrutinized 18 months of employee expense reports and ledgers for the largest title companies in King, Pierce and Snohomish counties. The examination found many cases in which the companies were providing gifts, golf tournament sponsorships, parties, ski trips, sports tickets, meals and other inducements to get business.

“Few people shop for title insurance, although they certainly can,” said Kreidler. “It tends to be included in the large stack of documents that homeowners are handed to sign. So title companies and others in the industry are positioned to steer business to particular insurers.”

New rules took effect in March 2009, clearly outlining what can be given. There are limits on advertising, donations to trade associations, meals, training, leasing workspace and gifts.