My contractor did poor repair work on my home, and my insurance company won’t pay for fixing the work. Doesn’t my insurance have to pay for it?
Consumers often ask us about this. Unless your insurer gave you no choice but to use its recommended contractor(s), the answer is no. If you chose the contractor, then the resolution will be between you and the contractor. If the contractor does not fix the work, then you may need to seek legal advice about your options. Generally, a contractor will try to resolve such issues, so we recommend that you first try to work it out with your contractor.
By the way, the situation is the same for auto repairs. If you chose the repair shop, then resolution needs to be between you and the shop. If you chose a shop recommended by your insurer, then we would expect your insurer to help you resolve the issue.
Learn more about understanding home insurance or auto insurance.
You can report consumer issues to our experts at 1-800-562-6900 or by viewing Talk to an Insurance Expert.
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Friday, January 23, 2015
Polar Vortex Risk Management
While much of the country continues to shiver from Polar Vortex v2.0, the biggest risk most of us are thinking about is frostbite and slipping on the driveway.
Or perhaps our pipes freezing [ed: from a strictly utilitarian viewpoint, the gentleman was successful].
But there are really a number of other severe weather risks about which we should be aware, and for which we should be prepared. Courtesy of FoIB Bill M and the fine folks at Auto Owners Insurance, here are few key Polar Vortex-related risks:
■ Ice Dams: these are "accumulation(s) of ice at the lower edge of a sloped roof ... [as] interior heat melts the snow on the roof, the water [runs] down and refreeze(s) a the roof's edge." This, of course, leads to a build-up of ice and creates major drain blockage which could end up forcing water into your walls and ceiling.
How to mitigate this risk: make sure your attic is well ventilated and keep the floor of the attic insulated.
■ Freezing pipes: as mentioned above, a blow torch (while effective) is not recommended. Water is funny: it expands when it freezes (perhaps you've noticed this phenomenon in your freezer's ice tray). When the water in a pipe freezes, it can expand so fast and so much that it breaks (bursts) the pipe.
How to mitigate this risk: insulate exposed pipes with special (and inexpensive) foam sleeves. You should also seal any cracks in outside walls, and keep cabinet doors open so warm air can circulate. Don't forget to keep a slow trickle of water going, especially on lines that pass through exterior walls.
Oh: a hair dryer beats a propane torch if you do have a frozen pipe (really!).
Be safe, and stay warm.
Or perhaps our pipes freezing [ed: from a strictly utilitarian viewpoint, the gentleman was successful].
But there are really a number of other severe weather risks about which we should be aware, and for which we should be prepared. Courtesy of FoIB Bill M and the fine folks at Auto Owners Insurance, here are few key Polar Vortex-related risks:
■ Ice Dams: these are "accumulation(s) of ice at the lower edge of a sloped roof ... [as] interior heat melts the snow on the roof, the water [runs] down and refreeze(s) a the roof's edge." This, of course, leads to a build-up of ice and creates major drain blockage which could end up forcing water into your walls and ceiling.
How to mitigate this risk: make sure your attic is well ventilated and keep the floor of the attic insulated.
■ Freezing pipes: as mentioned above, a blow torch (while effective) is not recommended. Water is funny: it expands when it freezes (perhaps you've noticed this phenomenon in your freezer's ice tray). When the water in a pipe freezes, it can expand so fast and so much that it breaks (bursts) the pipe.
How to mitigate this risk: insulate exposed pipes with special (and inexpensive) foam sleeves. You should also seal any cracks in outside walls, and keep cabinet doors open so warm air can circulate. Don't forget to keep a slow trickle of water going, especially on lines that pass through exterior walls.
Oh: a hair dryer beats a propane torch if you do have a frozen pipe (really!).
Be safe, and stay warm.
Thursday, January 22, 2015
Good News for Medicare Advantage
First, overall Medicare Advantage enrollment for 2014 rose more than anyone expected.
Next Bertolini suggested that Medicare Advantage is now “too big” for the federales to shut down. Nearly 30% of all Medicare-eligible seniors today have elected to buy a private Medicare Advantage policy rather than enroll in traditional Medicare. That’s around 14 million people. Bertolini also said that today's employees are increasingly willing to sign up for Medicare Advantage when they reach age 65, because they have had years in which to become familiar with managed care. I think that means enrollment growth in Medicare Advantage is likely to accelerate over the next few years; an accelerating trend would of course be compounded as more “boomers” retire.
CMS pays private insurers to take over the risk for each senior who enrolls for Medicare Advantage. At one time, the average CMS payment was 114% of the cost for traditional Medicare enrollees. These higher payments were partly because of risk-adjusters in the CMS payment formula – and partly because Medicare Advantage provides better coverage than traditional Medicare. However – and this is important information – Bertolini said the average government payment to Medicare Advantage insurers is now down to 106%, and is “headed to zero.”
In other words, private Medicare Advantage insurers believe they have figured out how to provide better benefits and better service than traditional Medicare, for the same cost. That's big.
It's big because it would bring good news all around: CMS will shed even more traditional Medicare risk – and cost – thus reducing its financial strain; private insurers will pick up even more Medicare Advantage enrollment on a profitable basis even when paid the same as the cost of traditional Medicare; the taxpayers will benefit if there is reduced need for higher taxes to support traditional Medicare; and seniors who prefer Medicare Advantage over traditional Medicare will still have that highly popular option available to them.
Ontario Auto Insurance Rates Fall by 1.44% in 2014
This past week FSCO released rate filings approved for fourth quarter of 2014. Sixteen insurers, representing 46.81% of the market based on premium volume, had rates approved in the fourth quarter of 2014. Approved rates decreased on average by 0.54% when applied across the total market. The total annual approved rate decreased on average 1.44% in 2014.
In the backdrop is the Ontario government's commitment to reduce rates in the province by 15% before August 15, 2015. The chart below breaks down the quarterly rate approval changes following the announcement of the rate reduction strategy in 2013. The third quarter of 2013 has been included although many of the rate approvals for that quarter may have been filed well before the strategy was announced.
In the backdrop is the Ontario government's commitment to reduce rates in the province by 15% before August 15, 2015. The chart below breaks down the quarterly rate approval changes following the announcement of the rate reduction strategy in 2013. The third quarter of 2013 has been included although many of the rate approvals for that quarter may have been filed well before the strategy was announced.
Quarter | Rate Change |
2015-3Q | -0.68% |
2015-4Q | -3.98% |
2015-1Q | -1.01% |
2015-2Q | +0.22% |
2015-3Q | -0.11% |
2015-4Q | -0.54% |
Total 2014 | -1.44% |
Total Since Aug 2013 | -6.10% |
The accumulative rate reductions approved by FSCO during this period have been 6.1%. With just 7 months remaining, the government is considerably short of its target and requires further reductions of about 9%. Likely not achievable in the remaining time despite the recent passage of Bill 15 and a number of regulatory changes. The government will not achieve sufficient savings from reduced interest payments and the licensing of service providers to bring down rates another 9%. If the creation of a new dispute resolution system at the Licence Appeal Tribunal has an impact on costs, it will not happen in 2015.
However, the government has not abandoned their rate reduction strategy. That might mean additional reforms may be on the way and that the timeframe for achieving the target will need to be extended. The report on FSCO's Three Year Review has not been released The review was initiated in 2014 and one must assume it was been completed by now. It is possible that the review could evolve into another set of reforms as was the case in 2009. The government is also committed to a minor injury treatment protocol, towing regulations and changes to the definition of catastrophic impairment.
We shall see what transpires in the months ahead.
However, the government has not abandoned their rate reduction strategy. That might mean additional reforms may be on the way and that the timeframe for achieving the target will need to be extended. The report on FSCO's Three Year Review has not been released The review was initiated in 2014 and one must assume it was been completed by now. It is possible that the review could evolve into another set of reforms as was the case in 2009. The government is also committed to a minor injury treatment protocol, towing regulations and changes to the definition of catastrophic impairment.
We shall see what transpires in the months ahead.
Healthy Food News
"Chocolate and red wine can help stave off diabetes: High levels of antioxidants can regulate blood glucose levels"
Turns out, the candy, booze and fruit diet provides a boatload of "flavenoids" - antioxidant compounds - that may help to regulate one's glucose levels.
Eat, drink and be healthy!
Another Sceptered Isle falsehood – this one from a Quango
From an article in the London Telegraph today, January 22, “ . . . patients suffering from cancer and other serious illnesses are being denied the drugs they need from the NHS, according to a Quango report." Even though the treatments have been approved by the health service rationing body [“NICE”], the Quango finds that at least 14,000 patients a year are not receiving them.
So a long-established government-run medical care service ignores its official death panel by withholding medical services from citizens who have the most serious illnesses? Alarming, is it not?
How can this happen? Locally, it seems. The Quango report continues “patients were being condemned to an early death because local NHS bodies were failing to fund drugs even though they had been proven to work.”
It's important to understand that less than one year ago, legal responsibility for managing most of the NHS budget was transferred to new local bodies, overseen by an NHS Commissioning Board ". . . charged with ensuring [the local bodies] do not overspend their budgets." To protect their budgets, it appears these local bodies decided not to spend money on expensive drugs for some of their sickest patients.
As a sad result there will likely be more local bodies than just the new NHS bodies.
By the way, exactly who or what is a “Quango”? It’s a quasi-autonomous non-governmental organization. Her Majesty’s government defines a Quango as a non-departmental public body that has a role in the processes of national government, but is not a government department or part of one. This means a Quango is meant to operate more or less at arm's length from Ministerial control. This particular Quango is the “Health and Social Care Information Centre”.
But now - let’s get real. This story – like others before itand in fact any story critical of NHS that you might read from today until the end of time - is false. How do we know these stories are false? Because Paul Krugman told us so, that’swhy.
So relax everyone. Besides, neither the U.S. government nor one of the States would ever, ever do his kind of thing.