He's in there somewhere....

[Gob]

GREENWOOD VILLAGE, Colo. (CBS4)– The man whose home was destroyed during a standoff with police believes officers took extreme measures when they tried to capture the suspect.



“This is a para-military action, done by para-military thugs. This is not a police force,” said homeowner Leo Lech. “To blow holes in every side of this house for one suspect with a handgun.” Robert Seacat was holed up in the Greenwood Village home for nearly 19 hours before officers were able to take him into custody on Thursday.




Lech is upset at how Greenwood Village police treated his home during the standoff that began Wednesday afternoon and ended about 9 a.m. Thursday. Seacat, 33, barricaded himself inside Lech’s home after seemingly running into it at random. “If you look at the photos of Osama Bin Laden’s compound I would say his house looks better than mine does,” said Lech.

Lech does not agree with police tactics used that included a robot, explosives and a breaching ram that punctured exterior walls. “The home is still a crime scene at this point,” said Matt Cohrs, Assistant to the City Manager of Greenwood Village. According to police, just after 1:30 p.m. Wednesday there was a shoplifting reported at a Walmart on East Hampden in Aurora. The suspect, believed to be Seacat, fled in a vehicle to a light rail station where he ditched the vehicle and was seen with a gun. Police attempted to chase him but were unsuccessful in apprehending him.



Police said Seacat somehow made his way to Greenwood Village where he entered Lech’s home with a 9-year-old boy inside. The boy managed to call 911, safely leave the home and was reunited with his mother. That’s when the standoff began. Cohrs said they are working to determine who will be responsible for the home’s repairs.

“These incidents don’t happen every single day. Every incident is different and that’s why there’s a process that you follow and referring it to our insurance carrier already and beginning the work through that process,” said Cohrs. Police sources at other local agencies told CBS4 that they too, would have used similar tactics to remove an armed suspect and that they didn’t feel the approach was excessive.

Those sources also said homes can be rebuilt but human lives cannot, whether its a police officer or a citizen. Lech wants his home fixed but said some things cannot be repaired. “There are things in there that can’t be replaced. You’ve destroyed a family’s life for nothing, absolutely nothing, due to poor decision making on the part of government officials,” said Lech.

Lech said his homeowner’s insurance company has warned him there is a small chance his policy won’t cover the damage because of a clause for “incompetent goverment” action.

[rubato]

"...
Lech said his homeowner’s insurance company has warned him there is a small chance his policy won’t cover the damage because of a clause for “incompetent goverment” action.

Really. I've never heard of that before.

Meade; do those insurance thieves companies really put clauses like that in HO policies?


yrs,
rubato

[Long Run]

If the City is at fault, then the homeowner's insurance should not pay as someone else is responsible for the damage. It does sound like the City is going to pay for the damages, and the family gets a staycation at the Best Western.

[MajGenl.Meade]

"Lech said his homeowner’s insurance company has warned him there is a small chance his policy won’t cover the damage because of a clause for “incompetent goverment” action.

Really. I've never heard of that before. Meade; do those insurance thieves companies really put clauses like that in HO policies?
yrs,
rubato

Well I do believ so, rubato. Typical HO3s all exclude coverage for damage caused by:

Governmental action, such as the destruction, confiscation or seizure of covered property by any governmental or public authority.

That would just about do it all right! I suppose an insurance company cannot subrogate against sovereign entities such as a city government. Is that true? (Maybe I should say, can't sue them after they ignore the subrogation).

Everybody - check your policies carefully. HO3 covers all things that are NOT specifically excluded.

[Sue U]

I suppose an insurance company cannot subrogate against sovereign entities such as a city government. Is that true? (Maybe I should say, can't sue them after they ignore the subrogation).

That is true here in NJ (the state Tort Claims Act includes a specific anti-subrogation provision); I suppose it depends on what each state's TCA allows in its exceptions to the general rule of sovereign immunity.

[MajGenl.Meade]

Thanks. I wasn't aware of specific clauses like that one in immunity laws - but then, I'm not aware of much

[Sue U]

59:9-2 Judgments, interest, limitations.

***
e. If a claimant receives or is entitled to receive benefits for the injuries allegedly incurred from a policy or policies of insurance or any other source other than a joint tortfeasor, such benefits shall be disclosed to the court and the amount thereof which duplicates any benefit contained in the award shall be deducted from any award against a public entity or public employee recovered by such claimant; provided, however, that nothing in this provision shall be construed to limit the rights of a beneficiary under a life insurance policy. No insurer or other person shall be entitled to bring an action under a subrogation provision in an insurance contract against a public entity or public employee.

I happen to be litigating a related issue right now, i.e., where a claimant obtains a tort recovery from a public entity, may his insurer assert a reimbursement claim against him? Seems to me that allowing an insurer to assert such an action merely makes the injured claimant a straw-man for obtaining the prohibited result, seeking to get through the back door of "reimbursement" what is prohibited by direct "subrogation" against the public entity.

It's an issue that bugs me.

[Gob]

I happen to be litigating a related issue right now, i.e., where a claimant obtains a tort recovery from a public entity, may his insurer assert a reimbursement claim against him? Seems to me that allowing an insurer to assert such an action merely makes the injured claimant a straw-man for obtaining the prohibited result, seeking to get through the back door of "reimbursement" what is prohibited by direct "subrogation" against the public entity.

It's an issue that bugs me.

It's all in English I agree, but did you just choose words at random from a dictionary?

[Sue U]

It's all in English I agree, but did you just choose words at random from a dictionary?

Right, then, for the hard-of-reading:

Say you fall on the crumbling steps of the town library, breaking your ankle and requiring surgery with plates and screws implanted to keep the bony bits in place. Your health insurance company covers the cost of the medical care. You go on to sue the town for its negligence in maintaining the steps, which resulted in your injury. Because of the statute quoted above, you can collect compensation from the town for your pain, suffering, disability, lost wages, etc., but not for any losses that are covered by you own insurance -- such as medical expenses. Similarly, neither can your health insurance company make a claim against the town for recovery of the medical expenses it paid. However, in this case, the insurance company is instead seeking reimbursement of its medical expenses from you, since you got a settlement from the town -- regardless of the fact that the settlement did not and could not include compensation for covered medical expenses.

Get it now? (This is one of the serious drawbacks of having a private health insurance system rather than nationalized healthcare.)

[wesw]

thank you sue. much more pleasant to read that way. and I learned something!

[Gob]

Get it now? (This is one of the serious drawbacks of having a private health insurance system rather than nationalized healthcare.)

You could have just used that sentence.

[MajGenl.Meade]

Well, I thought it was clear the first time, Sue. One thing that I got from it is the very sensible reason that a Homeowner policy would have the exclusion for government action.

If the HO policy covered all the damage to that chap's house, then the at-fault party gets away scot-free. In essence, the man's insurance policy provides a safety blanket for the government as well. So it's excluded; his policy doesn't cover it; and he can have at the torty stuff and make those naughty city folks pay!

The insurance company has a natural reluctance to provide liability coverage for an uninsured party! Just as policy holders have natural reluctance to pay premiums to cover that risk in addition to all the others.

[wesw]

the at fault party would be the police, no? a reasonable police force could find a better way to search a house, I would think

[Long Run]

Get it now? (This is one of the serious drawbacks of having a private health insurance system rather than nationalized healthcare.)

You could have just used that sentence.

Yeah, we won't even try to describe ERISA subrogation and the make-whole doctrine.

[Gob]

Well, I thought it was clear the first time, Sue.

Yeah but you've lived in Loopystan, your're used to their odd ways.

[Sue U]

Yeah, we won't even try to describe ERISA subrogation and the make-whole doctrine.

Don't get me started. See also: How an Insurer Is Taking Money From the Fan Beaten at Dodger Stadium:

***
Four years ago, Bryan Stow was a strapping paramedic who spent his days off biking with his son and daughter. That was before March 31, 2011, when he and three friends made the mistake of wearing San Francisco Giants garb to an Opening Day game against the rival Los Angeles Dodgers at Dodger Stadium. They were harassed and threatened in the stands. Afterwards, two Dodgers fans beat Stow so savagely in a parking lot that doctors had to induce a coma to save him. He was hospitalized for seven months.

The damage to Stow, 46, remains unmistakable. A scar runs from the left side of his forehead to the back of his head. On the right side, a shunt used to drain fluid from his brain protrudes from his skull. The thick black hair he once fussed over is now patchy and thin. Special stockings on his legs prevent life-threatening blood clots.

The beating of Stow drew national attention to sports hooliganism. It’s also brought to light a virtually unknown aspect of the legal system that cuts compensation to victims. In effect, Stow was sucker-punched twice: first by his assailant and then by his health insurer.

Although a Los Angeles Superior Court jury awarded Stow $18 million from the Dodgers and his assailants last year, he has yet to receive any money. And, in a bizarre twist, the Dodgers’ liability insurer, ACE Property and Casualty Insurance Company, stands to net $1.6 million from a side deal in the case.

It’s all because Stow’s health insurer is entitled to a huge slice of the settlement, even before Stow is paid. A growing body of federal law, including a recent U.S. Supreme Court case, gives insurers power to recoup medical costs caused by a third party—in the face of state laws that specifically prohibit it. “This is what people pay premiums for,” says Stow’s ex-wife, Jacqueline Kain. “To worry about some insurance company taking what is his is absurd.”

The concept is known as subrogation. The modern version dates back to the American Revolution and was applied in areas such as property insurance. An insurer, for instance, might seek to be repaid by the maker of a faulty furnace that caused a fire in a building the company covered. In recent years, subrogation has mushroomed into a multibillion-dollar source of offsetting costs for private health insurers as well as Medicare and Medicaid. Medicare reaped nearly $2.5 billion last year, aided by a 2007 law that requires the federal insurer for the elderly to be notified of any legal settlements paid to its beneficiaries so it can subrogate the funds.

Such medical liens have reduced and delayed compensation in several cases—from the thousands of patients who suffered heart attacks or strokes from diabetes drug Avandia to the 1,000 Montana residents sickened by asbestos from a mine. “It is extremely frustrating for people who are sick, or dying, or who have loved ones who have died and are desperately in need of money,” says Allan McGarvey, an attorney representing some of the asbestos victims.

The liens have spawned companies and law firms that identify cases and, representing the interests of medical insurers, pursue patients who have received court settlements. A unit of Xerox recovered more than $1 billion for health-care clients in a recent three year period. Optum, a company owned by insurance giant UnitedHealth Group, is a major player.

Insurers and employers say getting back money in these cases helps lower premiums for all members of a group plan. University of South Dakota law professor Roger Baron disagrees. He says research shows the recovered money does little to reduce insurance rates while increasing executive pay and shareholder payouts. “It would be wrong to think that the insureds benefit from subrogated recoveries, because they don’t,” says Baron, who has consulted for injured people facing health-care liens.

All but two states either ban subrogation outright or limit how much insurers can collect. Unfortunately, many employers provide health insurance as an employee benefit under the Employment Retirement Income Security Act, or ERISA, which is a federal law. Congress specifically designed ERISA to supersede any state statutes related to employee benefit plans. More than 90 percent of workers with medical coverage at the largest U.S. corporations are insured this way, according to the Kaiser Family Foundation. Hailed at its passage in 1974 for safeguarding employees’ pension plans, ERISA now helps deny or reduce compensation to workers injured through someone else’s negligence.

Stow received his health insurance through an ERISA plan. So did James McCutchen, a US Airways mechanic badly injured in a highway wreck in 2007. When US Airways demanded repayment of $66,866 it spent on his medical treatment—a figure slightly exceeding the $66,000 he netted in a settlement after paying his lawyer—McCutchen refused to pay. He argued that the US Airways lien was unfair because he had not been fully compensated for his injuries. A federal appeals court agreed, calling it a “windfall” for the airline.

In 2013 the U.S. Supreme Court sided with US Airways, ruling that as long as the health plan’s contract with employees specifies that it can be reimbursed for medical costs in these situations, it has a legal right to collect. Most employees have no idea these provisions exist.

More at the linky above.

[Gob]

That's pretty sick. Has no one thought about burning down the insurance offices? Personally, if my insurers did that to me, I'd find out the fucker responsible and run him down.

[liberty]

Gob, this did happen in Australia right? What did the police have to fear, at most all they would have to do is break down the door walk in the house.

[MajGenl.Meade]

Uh, lib... the first two words in the OP

GREENWOOD VILLAGE, Colo

What's your best guess as to whether that's in Australia or not?

Well the Greenwood police website is pretty cool:

The men and women of the Village Police Department are committed and passionate about serving their community. The Village Police Department is a progressive police organization with an outcome based policing philosophy. Outcome based policing is derived from the Village’s outcome based management system. It is an expansion of traditional policing to include problem solving, intervention, partnerships and community based policing as a means to prevent crime, fear of crime, and social disorder. The Village Police Department is focused on providing consistent, high quality police service.

[Guinevere]

Don't forget, a police department is immune anyway as an entity of the sovereign government. So there is no liability as a matter of law. Sovereigns can be liable for negligence only when they agree to allow to be sued (as in most state and the federal tort claims act), but that negligence is limited in scope and damages are capped.