What is the insurance company's role in home repairs?

It’s common for consumers to call us with their concerns about their home repair or home rebuild claims and the insurer's involvement in oversight of the work. The insurer’s duty is to pay according to the terms laid out in the policy. Unless your insurance policy contains a provision, or unless your insurer has given you assurances, that obligates them to manage a covered home repair or rebuild, it is your responsibility to oversee the project with your contractor, and when applicable, your lender.


However, if you using an insurer’s recommended (sometimes called “preferred”) contractor, then you should expect assistance from the insurer in answering your questions about the contractor’s actions and performance.

Read more about homeowner insurance.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Year-end LinkFest

Sliding in just under the wire:

■ Given this:

"According to the Obama administration, more than two million people have enrolled in health insurance plans through the federal and state exchanges"

Here's the $64,000 question: How many have actually, you know, paid for their coverage?

Here's a hint:

"[O]fficials could not say how many Americans had actually paid for such coverage."

■ So you say you want a revolution? Best not tick off one of your core constituencies:

"A video advertisement released shortly before Christmas by Out2Enroll, which features four young buff men wearing tight underwear and not much else ... This cynical ad betrays the depths Obamacare advocates will sink to in order to pad their pathetic enrollment numbers”

Ooops.

■ And something else about the ObamaTax really bites:

"Within a few years, private dental care with a trusted and known practitioner may be limited ... The [ObamaTax] requires dental-care coverage for children through age 18. This expansion appears to be a good device for improving healthcare generally. Yet, as private health plans move in this direction, the cost of dental insurance for adults will increase"

Smile!

And all of us at InsureBlog wish you and yours a very Happy New Year!

New car? Call your insurance agent

If you take advantage of a good end-of-the-year deal on a new vehicle, be sure to report it to your insurance company right away, and don’t forget to ask them for a quote for Debt Payoff Coverage. This coverage will pay off the outstanding loan balance if your vehicle is destroyed in a covered claim and its current market value is less than your outstanding loan. Your agent and insurer can answer your questions and provide more detail on how the coverage works.

Learn more about auto insurance in Washington state.

Insurance statistics in Washington state

Each year, the Insurance Information Institute, an industry-backed research group, compiles data on the insurance industry in each state.

From this year's Washington edition:

• Number of people working in the insurance industry in Washington state: 49,445.
• Their payroll: $3.2 billion.
• Premium taxes paid: $406 million
• Premiums: About $19 billion.

The report includes a lot of other information, including details about which companies write the most insurance, losses incurred, etc.

FSCO Releases Standard Benefit Statement Form

Another anti-fraud measure is being introduced by FSCO effective September 1, 2014.  

Recommendation #17 of the Anti-Fraud Task Force recommended that insurers itemize the list of invoices they have received when they provide a benefit statement to a claimant every two months.  Ontario Regulation 14/13 amended the SABS to include a number of changes recommended by the Task Force including providing the Superintendent with authority to issue a standard form that insurers must use when issuing bi-monthly benefit statements.

The Superintendent has now released the Standard Benefit Statement form that insurers must use. 

Insurers have eight months to perform the necessary system and operational changes in order to begin producing Statements beginning September 1, 2014. 

 

 Subsection 64 (2) of the SABS authorizes delivery of Statements by multiple methods, e.g., by ordinary mail, or by email if the claimant has agreed to delivery by email.

 

The new form can  be found here.

Insurance News - Tuesday, December 31, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, December 31, 2013:

• The NAIC reports that New Jersey had the highest auto insurance rates in 2011 with average premium of $1,302.  FSCO reports that the average premium in Ontario in 2012 was $1,551.
• OSFI releases new draft Minimum Capital Test guideline for property and casualty insurers.
• Manitoba Public Insurance says its fraud investigations saved ratepayers $8 million last year.
• Michigan becomes the 4th state to approve self-driving car research on public roads after California, Nevada and Florida. 
• New Hampshire increases speed limit on interstate highway to 70 mph.

Important change may affect business owners’ insurance

Business owners carry commercial insurance policies to protect their financial interests in their property and to cover their liability arising out their business operations. One of the important liabilities that is covered is in the event that a business is sued. The typical commercial insurance policy includes a clause called “duty to defend,” which means the insurance company is required to defend the business if it is sued and it will pay the associated legal costs. However, some commercial policies are being changed to require businesses to repay legal defense costs if the insurer later determines a claim is not covered.

How will you know if your insurance company will require you to repay legal costs? Read your policy or talk to your agent , broker, or with the insurer. Insurers may be adding the clause to new policies or to renewing policies, so it’s important to know what your policy says.

It’s also important that you promptly report lawsuits to your insurance company. Reporting this information to the insurer too late can impede the insurer’s ability to defend your business against the lawsuit. 

More information:

• Read more about the duty to defend and repaying legal costs.
• Who needs business insurance?  
• Things to consider before buying business insurance.

Questions? Contact our consumer advocates online or at 1-800-562-6900.

Insurance News - Tuesday, December 30, 2014

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, December 30, 2014:

• Bill 15 changes to prejudgement interest calculations will become effective on January 1, 2015.
• Many ride-sharing drivers are perplexed by the mixed messages that they receive and therefore opt for silence when it comes to informing their insurers. The situation is becoming problematic as ride-sharing programs expand and drivers are having accidents.
• As Uber collects a mountain of data from its ride-sharing app, it is very likely that the information will be used to expand into services, such as moving goods not just people.
• Once you get passed the rhetoric, what has become clear is that Uber has exposed flaws in taxi services in Canadian cities. Consumers look forward to reforms.
• California’s Department of Motor Vehicles will miss a year-end deadline to adopt a new set of rules for driverless cars and other cars of the future because there’s still no certainty that driverless vehicles are safe.

Year-end chat with DOI

In an InsureBlog exclusive, we present a year-end wrap-up of some of the ACA-related issues being dealt with by the Ohio Department of Insurance. Public Information Officer Robert Denhard was kind enough to answer some of our questions:

What are you hearing from insurers regarding receiving data on the back-end that allows individuals to actually pay for insurance?

We are hearing there are still problems but that the situation is better than it was. Either way, we're concerned about any impact on consumers if information is still wrong come Jan. 1.

Have you had any feedback from carriers about missing/incorrect 834's? What are they telling you?

Anecdotally we are hearing that there continue to be issues that need worked out.

How is ODI planning to handle the continuous influx of new plans that carriers will have to submit in order to stay within the narrow parameters of actuarial value? That is, since this will require plan changes each year going forward?

We will work with companies as we did last year to review plans as necessary.

With so many folks in the individual market opting to keep their plans until December 2014, what impact do you think that will have on 2015 Exchange rates? 

It is too early to try to predict rates since we do not even know yet what enrollment will ultimately look like and what the risk composition of those enrollees will be.

We’ve had a lot of questions about Navigators. How many Navigators have actually been certified in the state of Ohio?

Information about the number of certified navigators is available here [ed: that takes you to the Ohio Agent Locator page, from which Navigator information is available. At the time of this post, there are but 70 for the entire state].

Has ODI had any (many?) complaints about Navigators? If so, what kinds of issues have been raised?

We have not received any complaints about navigators.

This seems to be an issue at the national level, would be interested to know: how many Medicaid sign ups in OH vs Exchange plans? That is, how many have (been) enrolled in Medicaid as opposed to signed up for actual insurance policies through the Exchange?

A total of 5,672 people had signed up for the exchange as of Dec. 1, according to the U.S. Department of Health and Human Services (HHS). You will have to check with the Ohio Department of Medicaid for their enrollment numbers.

Finally, do you have a sense of the percentage of agents who’ve been Marketplace certified?

Agents who are marketplace certified is information officially maintained by HHS.

Thanks, Robert!

Lynnwood auto repair shop charged with insurance fraud

A Snohomish County auto repair shop has been charged with insurance fraud after charging for repairs it didn't do and parts that it never installed.

Northwestern Collision, of Lynnwood, was charged Dec. 14 in Snohomish County Superior Court. Arraignment is set for Jan. 9.

In 2009, Farmers Insurance investigators inspected 11 vehicles that had been repaired by the shop between 2007 and 2009. Of the 11, 10 "had substantial and specific" deviations from the repair estimates that Farmers had agreed to.

Among the problems: parts missing and not replaced, repairs not performed, and repairing items that were supposed to be replaced.

On Dec. 8, 2010, officers from the state insurance commissioner's Special Investigations Unit, the State Patrol and the Snohomish County Sheriff's Office served a warrant at the company's Lynnwood office. They gathered up paper files on 10 of the 11 vehicles.

The records indicated that in some cases, new parts that were supposed to be installed were instead returned to the parts dealer.

The insurer was overcharged nearly $11,000, and had to buy one customer's car, which had been rendered unsafe to drive, for another $15,446.

Happy New Year!

I'm away at the Jersey shore and won't be posting again until January 7th.  I will likely still be using my Twitter account.  Wishing everyone a happy and prosperous New Year and a some NHL hockey.

Willie

Cease and desist order issued to TracGuard Services

The Washington state insurance commissioner's office has told a Florida-based vehicle service contract provider to stop selling unauthorized contracts in Washington state.

TracGuard Services LLC, Jose L. Terry and Alberto Tudela, all of North Miami, have been ordered "to immediately cease and desist from engaging in or transacting the unauthorized business of insurance" in Washington.

Neither the company nor the two men are authorized to solicit or transact insurance in the state. They have not registered as a motor vechicle service contract provider in Washington.

The three have been ordered to notify all Washington residents who have purchased a service contract from them. It also warns that, pursuant to Washington state law, unauthorized insurers "shall remain personally liable for performance of the contract."

Cease and desist order issued to Mill Creek man

A Mill Creek man and company have been ordered to stop selling unauthorized vehicle service contracts.

The order names Scott L. Stevens and RVProtection.net, Inc., both of Mill Creek, Wash. In August of 2010, they sold a consumer a vehicle service contract offered by Genuine Warranty Solutions, Inc.

The problem: Genuine Warranty Solutions, Inc. is not a registered vehicle service contract provider in Washington.

The Dec. 19 order took effect immediately. Stevens and the company have the right to appeal the order.

Did a furry new family member join you this holiday season?

If Santa brought you or someone in your household a puppy or kitten, you may be thinking about purchasing pet insurance.

Pet insurance is relatively new in the insurance world. It helps pay veterinary bills for preventive care or if your pet is ill or gets hurt. Most plans limit coverage to dogs and cats, so you can stop reading now if you got a new bearded dragon or bunny. Most also require a health screening to make sure your dog or cat is healthy; if you have an older pet, it likely won’t qualify for coverage.

Be a smart shopper – make sure the insurer is licensed in Washington, compare plans’ coverage, deductibles, copayments, coverage limits and exclusions.

Read more of our tips on pet insurance.

Aetna fined $1 million for insurance violations

A Connecticut insurance company has been fined $1 million by Washington State Insurance Commissioner Mike Kreidler for multiple violations over several years.

Aetna Life Insurance Company has agreed to pay the fine. The violations include issuing unapproved insurance policies, failing to file legally-required documents with the state and charging unapproved rates.

“All insurers must comply with state law, and most of them do,” said Kreidler. “I hope that this fine and compliance plan resolves these problems with Aetna.”

Among the violations:

• Starting in 2005, Aetna issued health, disability or life insurance policies to more than 4,400 people that did not comply with state law. Among the violations: The policies had not been filed for approval with Washington state.

• Also starting in 2005, the company issued health policies that did not include all Washington state health care mandates. Nor did they describe Washington’s appeals and grievance process, as required by law.

• For more than three years, Aetna continued to sell a health policy that had been disapproved.

• Starting in 2009, Aetna issued other health, disability and life policies that had not been filed with the state. Some of those health policies that did not include all Washington state mandates. Nor did the company have an approved appeals and grievance process for those plans.

• In 2010 and 2011, Aetna issued medical and dental plans for more than 100 Nordstrom retirees that had not been approved by Kreidler’s office, as required by law.

The company has also agreed to a compliance plan designed to prevent similar problems in the future.

Fines issued by Kreidler’s office do not go to the insurance commissioner’s office. The money collected goes to the state’s general fund.

Hasta la VISTA, baby!

Perfect:

"The Obama administration has told Vista volunteers and other AmeriCorps workers that their government-provided health coverage does not measure up to the standards of the [ObamaTax], and that they may be subject to financial penalties unless they obtain insurance elsewhere."

So the government itself can't provide an ObamaTax-compliant plan, and is now dumping, er, providing alternate access to well-meaning victims folks whose only crime was trusting that the government that employed them would have a clue as to what it was actually doing.

Yeah, that wasn't ever going to have a happy ending.

Yak insurance vs. yakking about insurance

Nepalese herders, tired of losing their livestock to snow leopards, have come up with an insurance plan to compensate them when a leopard kills a yak.

The herders pay about $1.50 a year to cover each yak, and are paid about $50 if the yak is killed by a snow leopard.

(On a side note, we're betting that this story is driving a significant amount of traffic to insuranceyak.com, which is a blog devoted not to yak insurance, but to yakking about insurance.)

My new article is up...

at Answers.com:

"When a business must temporarily close its doors due to damage to or destruction of business property, Business Interruption insurance coverage pays for business income lost while the property is rebuilt. This coverage is intended to help keep the company in business while recovery is underway."

Insurance News - Thursday, December 27, 2012

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, December 27 2012:

• New Alabama law and online insurance verification system targets uninsured drivers starting Jan 1.
• EU gender price ban raising insurance costs for women but not giving men corresponding lower rates.
• Progressive Insurance in the U.S. reports a 30% increase in single vehicle claims on New Year’s Day.
• Police across the country struggle as Twitter users reveal impaired driving checkstops.
• Progressive Insurance releases terms for usage-based insurance licensing program.

Overseas ObamaTax Conundrum

So, had a client stop by yesterday with a very intriguing question:

His daughter is a US citizen, but is a full time student in, and permanent resident of, Italy. He is himself Italian, but has lived in the US for over 40 years. He's also retired and on Medicare, so she can't be on his plan.

He came by because he'd been reading about "this new law" that required all US citizens to have insurance, and he wasn't sure what to do about his daughter. She's a citizen, but she doesn't live here, so would she be in trouble? Could we even write a plan for her if it was necessary?

All good questions, and I promised to find the answers. As I explained to him, I am very blessed to have built up quite a large circle of insurance experts over the years, friends and colleagues all over the 58 states on whom I can call for help and advice, and it was to this august group that I threw out my questions.

I was not disappointed; within just a few minutes, Louise Norris wrote back with a link to the relevant IRS notice, which included this Q&A:

12. Are US citizens living abroad subject to the individual shared responsibility provision?

Yes. However, U.S. citizens who live abroad for a calendar year (or at least 330 days within a 12 month period) are treated as having minimum essential coverage for the year (or period). These are individuals who qualify for an exclusion from income under section 911 of the Code. See Publication 54 for further information on the section 911 exclusion. They need take no further action to comply with the individual shared responsibility provision.

So it would appear that she (and her father) are in the clear, at last for now. But one wonders how many other ex-pats and the like will be caught up in the ObamaTax net as the full force of the law comes online next week.

OIC hiring program analysts to work with insurers, consumers

The Office of the Insurance Commissioner is hiring two Functional Program Analyst 3 positions, one in Rates and Forms and the other in Consumer Protection.

OIC’s Rates and Forms Division regulates insurance companies that do business in Washington. The person in that position is responsible for reviewing insurance policy forms to ensure they comply with state and federal laws and rules and working with insurance companies. It requires customer service experience, good communication skills and ability to work timely and accurately. This position is open until filled. Read more about the position and salary.

Our Consumer Protection Division helps consumers who have complaints about insurance companies. The person in this position will staff our consumer hotline and enter calls into our consumer protection database. They also research and resolve consumer complaints, including analyzing whether insurance companies’ solutions to consumer complaints comply with insurance rules. This position closes Jan. 12. Read more about the responsibilities and salary.

Did you miss the deadline for health insurance coverage in January? You still have time to get covered by February.

The deadline for applying for medical insurance under the Affordable Care Act for coverage that starts in January was Dec. 23. If you did start your application, you have until Jan. 15 to select a plan and pay your premium for coverage that back-dates to Jan. 1.

If you were unable to do that, open enrollment closes March 31. You can still obtain coverage starting in February or March, depending on when you sign up. For February coverage, the deadline to enroll is Jan. 23.

If you qualify for a subsidy or Medicaid, you should obtain medical insurance through the Washington Healthplanfinder, our state’s health benefit exchange. If you do not qualify for a subsidy, you can buy a health plan directly from an insurance company. Here’s a list of the plans that are available in Washington.

Interactive ObamaTax Premium Map

While Ms Shecantbeserious & Friends continue flailing around with the train-wreck of a website, and keep extending deadlines like there's no tomorrow [ed: heh], the folks at PricewaterhouseCoopers (PwC) have produced an interactive map of actual premiums. As they note in email:

"In just over half of states, that newly insured [27 year old] will pay between $195 and $250 a month for the second-lowest cost silver plan. In five states, that person will pay more than $320 a month ... This newly insured [50 year old] will pay more for coverage, typically about 70% more than the 27-year-old."

So, sticker shock at both ends. In any case, it's interesting to click around to see the variation in premiums from place to place, and age to age:

[CLICK HERE FOR INTERACTIVE  VERSION]

[Hat Tip: PwC HRI]

Thoughts about the President's enrollment in Obamacare

The Washington Post reported that on Monday, December 23 President Obama enrolled in a Bronze-level Obamacare plan. 

Obama promised early on that he would enroll in Obamacare, and apparently expects the public to view his enrollment as an act of leadership.  But keep in mind Obama and his family are covered by another, better, federal plan and so none of them needs Obamacare.  In other words, his Obamacare enrollment is a meaningless act that signifies nothing.   It’s empty showmanship, not “leadership.”

However, it’s important that everyone at least read down to the 4^thparagraph of the Washington Post article.  You will find that Obama did NOT enroll Michelle or either of their two children. 

Besides not needing Obamacare, I think there's another reason Obama decided not to enroll his family.  Obama knows everyone's personal information on the government websites is ridiculously vulnerable to hackers.  So of course he chose to protect his family members’ privacy.  Given his situation, that’s a simple choice. 

But Americans who qualify for subsidized premiums thru an Exchange don't have a simple choice not to enroll family members.  These Americans only have the "choice" (1) to buy subsidized insurance they can afford - and expose their whole family’s health, financial, and tax information to hackers - or (2) stay out of the Exchanges and be unable to find insurance they can afford.

Some choice.

Attention Obamacare Shoppers

Having difficulty signing up for #Obamacare? You aren't the only one.

“Somebody who’s not waiting in line to enroll is the president of the United States. We learned today from the White House. Initially, they said he signed up for what they called a bronze plan, paying about four hundred dollars a month in premiums. But, then they came back to us and said – ‘Well, wait. He didn’t actually enroll. They said his staff did it and that’s because of his unique circumstance obviously, as commander-in-chief, that his personal information is not in various government databases, so Healthcare.gov could not actually verify his identity, oddly enough. So, he had to do it in person this weekend, so he was signing up for the D.C. exchange, but his staff did it.”

World Net Daily

Oops!

Signing up by proxy? Isn't that illegal?

You are probably wondering what kind of information is required to apply for coverage?

What was the problem? His Social Security number?

On Sept. 12, 2011, WND reported the Social Security Number being used by Obama did not pass a check with E-Verify, the electronic system the U.S. Citizenship and Immigrations Services of the U.S. Department of Homeland Security created to verify whether or not prospective employees have the required authorization to work legally in the United States.

Makes you wonder doesn't it?

You can be "hired" to run the country but can't pass the E-Verify requirement to work at McDonalds.

Happy Holidays!

A happy and safe holidays to all my followers and their families.

Consumers who had trouble with Washington Healthplanfinder have a second chance to enroll

The Washington State Health Benefits Exchange has announced a special enrollment through Feb. 23, 2015 for people who have experienced trouble enrolling in a health plan for 2015 through the state’s exchange, Washington Healthplanfinder.

“I am pleased that Washington consumers who have had trouble with Washington Healthplanfinder have an option for getting coverage effective Jan. 1,” said Insurance Commissioner Mike Kreidler. “I encourage affected consumers to act sooner rather than later.”

The special enrollment applies to people who made an effort to receive health coverage through http://www.wahealthplanfinder.org/ before the Dec. 23 deadline, but who were unable to complete their applications due to a technical error associated with the Washington Healthplanfinder system.

Starting at noon today, affected consumers should fill out an online request form for coverage retroactive to Jan. 1 at: https://petition.wahealthplanfinder.org/. If customers need assistance or do not have Internet access, they can call the Exchange’s Customer Support Center at 1-855-923-4633. Each request will be reviewed and customers will receive a notification of their special enrollment through email or mail.

The Exchange also posted a list of frequently asked questions about the special enrollment period.

Order approving Amerigroup WA acquisition by WellPoint

We've gotten a number of calls from analysts about this: Here's the final order approving acquisition of Amerigroup Washington Inc. by WellPoint, Inc.

For the full history and the rest of the documents, see this page and scroll down to "Amerigroup Washington Inc."

Public notices and hearings: Change of incorporation, proposed acquisition, etc.

Notices and upcoming hearings from our public notices web page:

Proposed acquisition: Humana is proposing to become the sole owner of Arcadian Management Services and its affiliates. We've completed our review of the application for acquisition of control. No hearing's been scheduled yet, but will be soon.

Incorporation change: The Safeco Companies have requested approval to have New Hampshire be their state of incorporation. The companies, which were acquired by Boston-based Liberty Mutual in 2008, say the change would not affect any Washington policyholders, and that there would be no interruption in coverage. A hearing is scheduled for Jan. 10, 2012 at 10 a.m. in our Tumwater office, which is at 5000 Capitol Blvd. Annual reports and other documents re: the request are posted here.

Change in port of entry/redomestication: Industrial Alliance Pacific Insurance and Financial Services have filed documents to change their port of entry/redomestication to Texas. A hearing is scheduled for Feb. 1, 2012 at 1 p.m. at our Tumwater office, which is at 5000 Capitol Blvd. Documents re: the request are posted here.

Merry Christmas from InsureBlog

Still Sneaky

So the stealth deadline extension was apparently put in place to facilitate the President's own enrollment:

"According to a White House official, the president enrolled in the District of Columbia marketplace and selected from among the lowest-cost options available."

Well of course: it's his money, not ours.

Unsurprisingly, even this modest claim had to be immediately walked back:

"Obama made the selection while on vacation in Hawaii, though his staff signed him up in person in DC"

So how did we miss this awesome money-making opportunity:

"For hire: ObamaTax signer-uppers. For a modest fee, we'll assume your identity and sign you up for coverage."

How about: because it's illegal? "Legal, shmegal, we've got more important things to do."

Import from The Sceptered Isle?

Last Friday (Dec 20) David Prior,  the chairman of the NHS Care Quality Commission, said NHS quality and patient service are “wholly unsatisfactory.”  

Among other things, Prior emphasized that NHS can no longer be treated as a “national religion” in which service reached the brink of crisis because it was “too powerful” to be criticised.   He said parts of the NHS were “out of control” because honest debate about the weaknesses of the health service was not tolerated.

On the other hand, Paul Krugman asserts that when Americans hear stories about failures within NHS, we should know that “these stories are false.”

So, who do you believe? 

Americans who look to the U.K.’s National Health Service as a model for how government-run health care ought to work, should perhaps be looking more carefully at how government-run health care actually works.

The increasingly impersonal NHS is quite obviously responsible for more and more frequent personal medical care disasters.  Will Obamacare bring the same failures here?  It's not looking so good right now, is it? 

Americans must not hesitate to voice our objections to known failures of Obamacare and other clear weaknesses that threaten our personal health.  And we must not back down when we see our own government officials trying to stifle, deflect, or ignore criticism of Obamacare - and disparaging anyone who dares criticize it.

My opinion of Obamacare? We are finding out what is in it.  And we are appalled.  If you are not worried about this, you’re not paying attention.

Sneaky (as usual) [UPDATED]

Even when they're doing something "good," the Obamastration just can't do things honestly. To wit:

"...without any public announcement, Obama administration officials have changed the rules so that people will have an extra day to enroll"

If it's such a great, altruistically-driven idea, then why the subterfuge?

I think we all know the answer to that.

UPDATE: (via Ace of Spades) Here's the official photo of the ObamaTax Situation Room as this latest decision is reached:

Insurance News - Tuesday, December 23, 2014

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Tuesday, December 23, 2014:

• Over $1 million in stolen vehicles recovered and 7 people charged as police investigation nabs international car theft ring operating in Toronto, York Region and Durham Region.
• It appears Uber may be telling its California drivers that personal rather than commercial auto insurance is sufficient leaving them uncovered and driving illegally.
• Google unveiled its first prototype of a fully-functional, driverless car which has actually been built on a patchwork of auto parts.
• Not a surprise that Google is also seeking an auto industry partner to develop its driverless car because it does not want to be a car maker.
• The Nova Scotia government has changed its position on a controversial lawsuit to clawback a settlement award for an catastrophic claim involving a young woman with a severe brain injury.

Deadline Day

 

[Click picture to embiggen]

[Hat Tip: FoIB Holly R]

Insurance News - Monday, December 23, 2013

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Monday, December 23, 2013:

• The Ontario government is consulting with representatives from the towing, municipal, insurance, policing, legal, leasing and financing sectors to look at options for towing industry oversight. 
• The Ontario government has announced that it has now taken action to address 18 of the 38 recommendations made by Ontario's Auto Insurance Anti-Fraud Task Force.
• This is why the 2000 Honda Civic SiR two-door gets stolen more often than any other vehicle in Canada.
• The New York Department of Financial Services has approved a telematics program that allows policyholders to install a free device in their cars that prevents teens from texting or calling while driving.
• Robots, self-driving cars—what's Google doing?

Obamacare Pitchman?

Obamacare is ailing. Young invincibles are not signing up. Old and sick are opting for coverage in droves. Michelle is promoting Obamacare in your Christmas stocking instead of candy.

Talk about getting a lump of coal.

Now comes word about the latest push for #Obamacare enrollees.

Washington’s new health insurance exchange dispatched a sign-up envoy to one of the city’s gay clubs one recent night to get out the word about Obamacare. It envisioned men mingling on the dance floor, a cocktail in one hand and enrollment information in the other.

But the brochures about DC Health Link, as the exchange is called, weren’t snapped up as quickly as the free condoms provided by a local clinic.

Politico

Condoms or Obamacare.

Tough choice.

Either way you are getting screwed.

Judge issues insurance fraud ruling...in the form of a poem

And now for something completely different:

A Pennsylvania judge has issued a ruling in an insurance fraud case. What's unusual is that the judge issued his ruling in the form of a poem. From the Associated Press:

Justice J. Michael Eakin, writing for a 4-2 majority, concluded in six-line stanzas that a man's attempt to deposit a forged check appearing to be from State Farm didn't constitute insurance fraud.

"Sentenced on the other crimes, he surely won't go free, but we find he can't be guilty of this final felony," Eakin wrote. "Convictions for the forgery and theft are approbated — the sentence for insurance fraud, however, is vacated. The case must be remanded for resentencing, we find, so the trial judge may impose the result he originally had in mind."

A 3-page dissent by another judge, AP writer Marc Levy noted, did not rhyme.

Does insurance have to replace my entire roof?

Here's a consumer question related to winter weather: My insurer will repair a portion of my roof that was damaged, but won’t replace the entire roof to match. Can they do this?

This is a common question and it's a frustrating issue for consumers. The short answer is yes, insurers can do that. Home insurance policies cover direct physical damage to the roof, like a tree branch falling in a wind storm and poking a hole in the roof, or blowing a section of your shingles off and allowing water to enter. The insurer will repair the damaged portion of the roof and any resulting water damage. The insurer would not pay to repair any sections of your roof that are not damaged. 

If you decide you want the entire roof replaced, you would have to pay for replacing all non-damaged areas of the roof.

Read more about homeowner insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

My new article is up...

At Answers.com:

"Buy-sell agreements are tools businesses use to ensure that there is a smooth transition should one of the owners die: an orderly transfer of ownership, a mutually agreed upon sales price and terms of sale, and stability for customers, staff and creditors."

GEICO fined $100,000 for overcharging customers in WA; company will also refund $7.5 million

A Maryland-based insurance company has been fined $100,000 after overcharging thousands of its Washington state customers.
The insurer, GEICO, is also refunding $7.5 million – plus 8 percent interest -- to the 25,267 affected auto insurance consumers by the end of the year.

“A computer database error caused the problem, which the company reported to us promptly,” said Washington State Insurance Commissioner Mike Kreidler. “GEICO has also agreed to a two-year compliance plan that includes multiple audits.”

An additional $50,000 fine was suspended, on the condition that the company abides by the terms of the compliance plan.

The refunds, many of which have already been paid, will average roughly $300. The company has been contacting active and former customers affected by the issue and expects to have all refunds paid by the end of the year.

On May 26, 2011, GEICO representatives self-reported the computer error, which resulted in 7 percent of the company’s Washington customers being overcharged for insurance between Aug. 24, 2009 and June 2011.

Fines collected by the insurance commissioner’s office do not go to the agency. The money is deposited in the state’s general fund to pay for other state services.

The complete order is posted at: http://www.insurance.wa.gov/oicfiles/orders/2011orders/11-0273.pdf.

Before you rent a car or loan out yours, consider a few things

Will you need to rent a car during your holiday travels? Does your brother want to borrow your car while he’s home from college? Here are a few things to consider.

What should I know about rental car insurance?

If you are renting a car while you travel, you will likely be offered insurance by the rental car company. Before you decide, check with your agent to find out if your personal auto insurance policy covers damage to cars you rent. Many policies do not cover costs that aren’t directly related to damage, such as the daily fee charged by the rental agency for each day the car is out of service being repaired. In that case, you may want to consider buying coverage from the rental agency.

Read more about rental car insurance.

If I loan my car to someone and they cause a wreck, can my auto insurance increase even if I wasn’t driving?

It’s likely, since your insurer will have to pay a claim under your policy. We recommend you contact your agent to find out for sure. Unless you have a restricted policy that only covers you as a listed driver, a standard auto policy will typically cover people whom you allow to drive your vehicle. If the wreck involves a crime—fleeing the scene, driving under the influence or using the car to commit a crime – then your coverage would not extend to their use.

In general, unless you have a restricted policy or you didn’t authorize the use of your car, when you loan your car, you loan your insurance.

Read more about what most auto insurance policies cover.

Insurance News - Thursday, December 20, 2012

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Thursday, December 20 2012:

• Supreme Court won’t hear appeal of Deering sisters car crash case.
• Letter to the Editor: Independent medical examinations provide "necessary check and balance."
• Insurance companies among top GTA employers on CI Top Broker.
• Insurance safety group releases car ratings based on new crash test.
• Sudy shows that traffic accidents are the leading cause of high-severity workers’ comp injuries.
• A look at new US insurance laws taking effect in 2013.

Stupid Government Tricks [UPDATED & BUMPED]

[Please scroll down for update]

From the Now-They're-Just-Making-(Stuff)-Up Department:

So yesterday, with 4 days to go until "The Deadline" (until they change it again, natch), the folks in Capital City have declared that those sub-par plans are okay, after all, at least when they're bought through the Exchange:

"The Obama administration said Thursday it would allow some of the millions of Americans whose insurance policies had been canceled to purchase bare-bones plans next year"

Now, in and of itself, a truly catastrophic plan isn't a bad idea. In fact, it's what a health insurance policy should be: coverage for large, unexpected claims, not every sniffle or paper cut (or birth control pills convenience items). While the mandate is evil, it would at least have been more palatable if it required folks to have at least this level of coverage. And if it were deemed Health Savings Account (HSA) compatible well, then, Bob's your uncle.

Alas, that's not to be.

But there are a few problems with how this is being handled, not the least of which is that it is blatantly, spectacularly illegal.

Here's the relevant section from the ObamaTax itself (emphasis added):

 (e) CATASTROPHIC PLAN.—
(1) IN GENERAL.—A health plan not providing a bronze, silver, gold, or platinum level of coverage shall be treated as meeting the requirements of subsection (d) with respect to any plan year if—

(i) except as provided in clause (ii), the essential health benefits determined under subsection (b), except that the plan provides no benefits for any plan year until the individual has incurred cost-sharing expenses in an amount equal to the annual limitation in effect
under subsection (c)(1) for the plan year (except as provided for in section 2713);
(2) INDIVIDUALS ELIGIBLE FOR ENROLLMENT.—An individual is described in this paragraph for any plan year if the individual—
(A) has not attained the age of 30 before the beginning of the plan year; or
(B) has a certification in effect for any plan year under this title that the individual is exempt from the requirement under section 5000A of the Internal Revenue Code of 1986 by reason of—
(i) section 5000A(e)(1) of such Code (relating to individuals without affordable coverage); or
(ii) section 5000A(e)(5) of such Code (relating to individuals with hardships).

Seems pretty clear-cut to me.

But in case it's not, the helpful folks who provided training to become certified to sell on the Exchange confirm:

Eligibility for catastrophic plans is limited to:
• Individuals under age 30
• Individuals who otherwise do not have an affordable coverage option, or who otherwise qualify for a hardship exemption to the minimum essential coverage rule

So again, we just throw the actual reg's out the window because they're, well, "inconvenient."

But that's not the only problem. With roughly 84 hours left on the clock - and a weekend taking up most of that - carriers are supposed to price these plans for people aged, oh, 35 or 45 or 55. This, despite the fact that rates have already been reviewed and approved (or not) by the 58 different states' departments of insurance, which will now also have to review and approve (or not), these new rates.

Rostsa ruck with that.

It gets better, though, if by "better" we mean "worse:" what if you've already bought an ACA-compliant policy (hey, it could happen!) but would prefer the less expensive catastrophic plan? The good news is that it appears that you can make this change (or pretty much any other) during the Open Enrollment season. Of course, you'd still be stuck with the old plan for a month, and good luck getting through to 404care.gov, but at least it's an option.

Probably.

UPDATE: It's also worth noting that - as the ObamaTax legislation is written (not that this continues to have any significance) - Catastrophic plans are not eligible for premium subsidies. So folks who opt for this choice may be in for a rude surprise. And as Bob would remind us, this is another great reason to shop (and buy!) OFF the Public Exchange.

Insurance News - Saturday, December 20, 2014

Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Saturday, December 20, 2014:

• Smartphone applications and devices that record trip and vehicle data are set to infiltrate auto insurance at a rapid pace, bolstered by discounts of as much as 30 percent.
• A new Uber-like phone app lets stranded drivers summon the nearest tow truck. Is this a good or bad thing?
• It seems driverless cars do not do well in rain, snow and fog.  Just like we humans.
• Given the size of the Ontario auto insurance market, recent auto insurance reforms (Bill 15) could impact on the entire Canadian P&C market.
• Not everyone is happy about Bill 15. Tow trucks organized a protest at Queen's Park regarding provisions in Bill 15 dealing with towing regulation.
• Uber's process for vetting potential drivers is receiving a lot of scrutiny.

Trick Question below

Q: When is a subpar plan not a subpar plan?

A:  When I change my mind.

CCIR Report On Credit Scoring Is Inconclusive

The Canadian Council of Insurance Regulators (CCIR) Credit Scoring Working Group released its Findings Report: Use of Credit Scores By Insurers in late November 2012.   Unfortunately, the report has little new to offer despite spending a considerable amount of time looking at the issue.

The working was established in 2009 to gather the facts surrounding credit‐based insurance scores and how they are used in today’s regulatory environment.  Public consultation was undertaken in 2011.  That process turned out to be a disappointment as only 15 submissions were received and all from either the insurance sector or credit bureaus.

No feedback was received from consumers. That is not surprising because insurance consumers are not really organized. There are consumer groups, such as the Consumers Association of Canada, but their scope of issues are so broad and their resources so stretched that it is unlikely that you would ever get them to respond to these types of consultation.  That is why organizations tend to rely on marketing research firms to reach out to consumers.

The report itself highlights what we already know about this issue, insurers and brokers are on different sides of the debate on the use of credit scores.  The report acknowledges the IBC Code of Conduct for Insurers’ Use of Credit Information. However, it notes that not all insurers are members of IBC and not even all IBC members have “signed on” to the Code, which makes it difficult to consider this code an industry standard.

As well, since few regulators have authority (outside of automobile insurance) to reject underwriting criteria, the decisions on which, if any, actions to take on the use of credit scoring for underwriting rest with the policymakers in the various provincial and territorial governments.

So we are essentially in the same spot we were in 2009.

Exchange Nightmare

Anyone remember Phil Conners? You know the weatherman in the movie Groundhog Day. He's a guy I can relate to.

Loyal readers may remember my post about Jane. She was the lady who is a cancer survivor, exhausted her COBRA, then had to go bare for six months before PCIP would begin. However, the Government shut down the program during her six month window. This left her without coverage.

For the last month we have been trying to get her enrolled through amazon.com, I mean, healthcare.gov. Time and time again we would log in only to get kicked off. We finally made it through to where she was able to pick a plan and put it in her "shopping cart". That was two weeks ago.

Ever since then we keep getting stuck.

It's not for a lack of effort though. She has tried to log on daily. I have done the same on her behalf. We have done "chats" and gotten the same canned answers so many times that I have it memorized.

"Thank you for your interest in the Marketplace and for sharing your feedback. We apologize for any technical difficulties you may be experiencing as you use HealthCare.gov. We know this can be frustrating, and we're working around the clock to improve HealthCare.gov and to make sure your experience with it is a positive one."

Tuesday was different. We logged in, got to the same issue and instead of these great responses we were simply told: "You have to call the toll free number." So we did. It was 4:30pm Eastern time when we got Shelby on the line. Outside of being cold, monotone, and unfriendly she was a very pleasant woman to talk to. After reading her script she was able to use my clients' information to log in and see the exact same thing we were seeing! In fact she got the same spinning hourglass that went round and round. Then she told us what we figured was coming:

"I'm sorry, this is our peak time. There are too many people on the system and your going to have the same problems if you try again. You need to try again later."

With that we bid farewell to Shelby and I told my client that I would try and log in after hours. On Wednesday I logged in at 7:30am. Had the same issue and called 1-800-GOOD-LUCK again. This time it was Markeeta on the line. She read me her script (same as Tuesday) and logged in with me just like Shelby had done. This time I was told:

"I'm sorry, this is our peak time. There are too many people on the system and your going to have the same problems if you try again. You need to try again later."

Just as Phil had Ned Ryerson, I have healthcare.gov.