California Personal Injury and Insurance Blog

Health insurance to be reinstated

The California Department of Managed Health Care did a good thing. It brokered a deal with Health Net and Kaiser to reinstate health insurance policies to 1,200 people whose policies were rescinded by the insurance companies. The State is trying to reach a similar deal with PacifiCare, Blue Shield, and my favorite, Anthem Blue Cross. (By the way, adding Anthem to their name does not change the humor to the YouTube video.)

In a nutshell, these people had policies cancelled when they started to run up large medical bills. The insurance companies would dig through to find some technicality to use to cancel coverage. The DMHC determined this was not proper underwriting. Health Net, in fact, agreed to a fine, but admitted no wrongdoing. (For once, wouldn't it be nice for someone to actually admit wrong doing a la Charles Barkley.)

This is good news for people who have had policies cancelled.

Keep Looking on the Bright Side of Death

I wrote previously and posted a few funny cartoons. One was a Blue Cross video on YouTube. Some poor guy was sick and Blue Cross called it a pre-existing condition and denied coverage. Here is the video, if you want to see it again. Really funny!

Well, it may be more true than funny. Blue Cross, according to the LA Times, is sending out applications for new members to the doctor who will treat the member. Blue Cross is asking the doctors to report to report pre-existing conditions. According to the letter "Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately."

Amazingly, Blue Cross wants the doctors to conduct its underwriting. And, it wants them to violate the doctor-patient relationship all in the name of PROFIT. Now, I have nothing wrong with making money, but there is a right way to do it and a wrong way. This, my friends, falls under the wrong way.

The Health Insurance Crisis

Now, it is not often that I get political. And, it is not often that I post cartoons, but today seemed like a good day. Why? Because I received two today.

The first, found here, Download new_yorker_cartoon.pdf,  is a cartoon from "The New Yorker." Pretty funny.

The second one is a YouTube video. Yes, YouTube. This is brought to you by SickofBlueCross. It is a spoof of Monty Python's "Bright Side of Life."

Enjoy!

Blue Cross At It Again

So on Tuesday, I railed about Blue Cross sending customers a bill so that they can get a bill. Sheesh. Well, it turns out Blue Cross probably was not rescinding policies correctly. Amazingly, they even rescinded at least one policy for an undisclosed prior condition that was disclosed on the application.

One might think it is amazing that this happens, but, alas, it is not. Interestingly, most insurance companies do not look at the policy or the application until a claim is filed. At that point, the application is pulled and the insurance company goes through the application to see if there is grounds to rescind the policy. Seems a bit backwards to me.

You can read more about this and some additional commentary at Injuryboard.

The BEST Insurance Company

Someone asked me who the best insurance company is. My answer is quite simple: I don't know.

Yes, I admit it. I don't know. Why? Because the best insurance company depends on a variety of factors. Here are things you should consider:

• Price
• Service
• Membership in groups
• AM Best rating
• Availability of an agent
• Claims handling
• Department of Insurance complaints

Let me explain each one. Price is pretty easy. You may want the cheapest, if price is important. But make sure you are comparing apples to apples.

Service is a bit more complex. Service includes underwriting, customer service to change your policy, etc.... The only way to find out about this is to ask around.

Membership in groups is another easy one. Are you military? USAA might be best. Are you a teacher? California Casualty takes care of teachers. If you are in a group or association, see if there might be a special insurance policy. It can make a big difference in how you are treated, even if it cost a few dollars more.

AM Best, as I have said before, rates the company's ability to pay claims. A or better is what you are looking for. Simple enough?

Agent availability is important to me. Some people do not care. However, when I have a problem, I want to be able to call someone who has a financial interest in making sure I am happy. The only way that happens is with an agent.

Claims handling is very important, but very hard to measure. I want a company that has a good reputation for resolving claims. And not just its insureds claims, but if I injure someone, I want that company to pay the claim so I don't get sued. How do you measure this? Search the internet, or better yet, call around and ask personal injury attorneys in your area. They will have the pulse on this.

Department of Insurance complaints can be checked at the website. Look at verified complaints and not just total complaints. Anyone can complain, but it is when the Department of Insurance considers it something with merit that you need to consider it.

When you have all of this information, rank it and figure out what is important to you. Then you can pick the best insurance company for you. Of course, feel free to listen to my podcast about buying insurance and ask me, if you still have questions.

Health Insurance for Twenty-Somethings

There are millions of uninsured people in this country. A large number of those people are between 19 and 39. These people go without insurance for a variety of reasons - some financial, some because they do not think they will need it, some because they dont know better.

Now, Wellpoint is offering a product called Tonik. It is health insurance aimed at these people who do not have health insurance, but are relatively healthy. The premium is very cheap and it provide coverage after a pretty high deductible.

Some people, like the Indiana State Insurance Commissioner are praising the product. Meanwhile, in California, Mr. Garamendi is calling this a "cherry picking" product designed only to profit the insurance company.

Yes, the insurance company is going to make money on this. If they were not going to make money, they would not be offering it. But, it also provides insurance to a group of people who otherwise would be without. Picture the 22 year old just out of college who is skiing and breaks a leg. If this person has insurance, great. If they dont, you and I will pay his expensive hospital bill.

I am all in favor of any product that makes health insurance more available. If you do not have insurance, you should check this out.

A Website Everyone Should Go Read

Its not often that I openly plug an organization, and I can only think of one other that I have plugged, the CPCU Society, but here is another one.

United Policyholders is a group who attempts to educate the public and legislators about insurance. It is a great group and their website has a TON of information on it. Everyone should visit the website.

3 Myths about Insurance

MSN has a great article about insurance myths. Here are their 3 top insurance myths:

• Your benefits should be equal to your premium payments
• Insurance should cover events that are likely to happen
• Insurance is a rip-off, so you should only have the minimum amount of insurance.

These myths are very prevalent. Of these three, I get the 3rd one very often. People will call me and tell me what a rip off it is, or they email me and complain about it. Insurance is designed to cover you when something happens. You need insurance for when that disaster occurs. Insurance companies make a LOT of money, and their practices, especially with claims, need to change. But, insurance is not a rip off.

20% of Health Insurance Costs is for Paperwork

I came across this twice this article weekend and thought it was something to pass on. 20% of your health insurance premium is going to billing and paperwork. So, if you spend $500 per month on health insurance for your family, $100 is just for billing and paperwork. That seems to me to be amazingly high, especially when the property and casualty insurance business does not spend anywhere near that number for paperwork.

The study concludes that public health insurance does not have the same issue with billing and paperwork. While I am not sure that public health insurance is the way to go, I think that the insurance companies needs to start using technology to trim the fat and return some of the savings to consumers.

Health Insurance for Jockeys

This is somewhat related to my blog. I came across an article today about jockeys and their health insurance. Its an interesting read, but maybe just to us insurance geeks.

Basically, the jockeys guild (the union for guys who ride racehorses) has about $700,000 in unpaid premium. The problem is that they have a self insured plan. So, the premium is used to pay expenses. If they have that much money owed, they may be nearing insolvency.

Apparently, guild management let another policy that provided $1,000,000 in coverage for on-track accidents lapse. But, they forgot to tell their members. OOPS!

If you want to understand self funded health insurance plans, this is a good article. If you like horse racing, this is a good read.