Articles Tagged with insurance

Your news feed is constantly cluttered with natural disasters – wildfires, hurricanes, and floods seem to have become part of our daily conversations. According to a recent study by the Institute for Economics and Peace, natural disasters on a global scale have increased ten times since the 1960s. We often absorb this information with sorrow for those affected by the disaster, without stopping to think what we would do if our own home were affected. If you open mail for your homeowners insurer and stuff it in a draw or throw it in the garbage, this brief post is intended to help give you some tools to be a more proactive homeowner in the event you do need to file an insurance claim.

In order to adequately protect yourself before any potential loss, you should be intimately familiar with your homeowners policy. Upon receipt, you should set aside time to thoroughly review a complete copy of your homeowners policy. Highlight sections that are concerning to you and contact your agent for answers. Ask yourself questions such as:

  • What is the current value of your home?

I highly recommend the NPR series, “Bill of the Month,” which offers an expert analysis of medical bill surprises. This month’s bill concerns jaw surgery and a hospital bill of more than $27,000. The patient, Ely Bair, had a condition requiring two jaw surgeries. The first jaw surgery went very well and Bair paid his out of pocket maximum of $3,000 and his employer’s health plan with Premera Blue Cross covered the rest.

Bair’s second jaw surgery was with the same hospital and the health insurer was also Premera. But this time, Bair received a bill of $27,119 from the hospital.

The reason is in the fine print. Although Bair was covered under Premera policies for both surgeries, he changed employers between the two surgeries. Although both employers used Premera, the insurance coverage provided by Premera was different with each employer. The second Premera plan had a lifetime maximum of $5,000 for this jaw surgery. That left Bair responsible for the rest of the hospital bill. When he appealed, Premera pointed him to the specific language in the 80-page policy that addresses the lifetime maximum for this specific surgery.

The United States Department of Education recently announced it would forgive the student debt of more than 300,000 disabled borrowers. Could this impact your long-term disability benefits?

The topic this pertains to is offsets (amounts that can be subtracted) that insurance carriers are allowed to take from their claimants’ benefits. The “Other Income” provision of your group long-term disability policy sets forth the types of “income” a claimant might receive that the carrier would be allowed to offset – subtract – from the benefit it pays.

Typically, group LTD policies list things like: Social Security Disability Income benefits, Dependent Social Security Disability Income benefits, Workers’ Compensation benefits, certain pension benefits, and income from third party settlements, among others. The claimant must notify the carrier when he or she receives these benefits and the carrier will then calculate the amount it gets to offset, as well as whether it believes it has “overpaid” the claim.

Glioblastoma, also known as glioblastoma multiforme, is an aggressive type of cancer that can occur in the brain or spinal cord. Glioblastoma can occur at any age but tends to occur more often in older adults. Many glioblastoma symptoms develop slowly and get worse over time. Common symptoms may include:

  • Headaches
  • Loss of appetite

This Kaiser Health News article highlights the challenges of women attempting to obtain coverage for appropriate birth control options recommended by their physicians.

The article shows how insurance coverage is driven by a chart developed by the FDA for consumer education, not intended to exclude insurance coverage for other types of birth control.

Insurance companies further restrict coverage by limiting options to a list of approved products and requiring patients to given reasons why they cannot use other forms of contraceptive methods before other products will be approved.

Autoimmune disease is a broad category of related diseases in which a person’s immune system mistakenly attacks the tissues and organs it was designed to protect. Normally, the body’s immune system protects it by responding to invading microorganisms, such as bacteria and viruses. The immune system produces antibodies, which are special proteins that recognize and destroy the invaders. Autoimmune diseases occur when these autoantibodies attack the body’s own cells, tissues, and organs.

Autoimmune Facts:

  • There are more than 100 autoimmune diseases.

One of the most crucial pieces of evidence in supporting a long term disability (LTD) claim is the opinion of the claimant’s treating physician that he or she is disabled.

Many physicians are more than happy to assist their patients with forms required by the LTD provider and in some cases, narrative accounts of their patient’s disabling condition. Sometimes, though, the doctor is unable or unwilling to assist. There are a variety of reasons for this: lack of time, lack of compensation, misunderstanding of the level of involvement required by the doctor, employer/hospital rules preventing them, and in some cases, a disbelief that their patient is actually disabled.

If you have a disabling condition and you are making an LTD claim, or you are receiving benefits, your doctor’s participation in the process is essential. Without a doctor’s support, in most cases, your claim is finished. If your doctor has notified you that he or she will not be able to assist you with your claim, it is important to ask him or her to tell you the reason for their decision. If it is anything other than lack of belief that you are disabled, often, further information can change their minds. The offer of additional compensation for their time is a big help. Explaining that they will not have to do anything more than the forms or a letter – that they will not have to testify in court – goes a long way in changing minds.

If you have a disability insurance policy, you probably assume that if you’re unable to perform the duties of your job because of your medical condition, you’re entitled to benefits under your policy.

Not so fast! You may be surprised to learn that most disability policies don’t insure you from being unable to perform the duties of your job – instead, they insure you from being unable to perform the duties of your occupation.

What’s the difference? Well, as insurers will tell you, they are concerned about insuring people when they don’t know what those people are doing. There are too many jobs with individual specific duties performed in a variety of idiosyncratic ways for insurers to keep track of. As a result, they only insure the “type” of job you have, i.e., the job as it is typically performed in the national economy.

Almost one year since the beginning of the COVID-19 pandemic and it is clear that the effects of COVID-19 go beyond the numbers of cases and deaths.

How many people are struggling under the stresses of the pandemic? Is mental health suffering as Americans try to manage isolation, worries about jobs, and a constant stream of anxiety-producing headlines? Are they putting their future health at risk by delaying trips to the doctor or avoiding the emergency room when needed?

The Household Pulse Survey is an experimental survey designed to help answer these questions by capturing data in new ways. This survey is a cooperative effort between the Centers for Disease Control and Prevention, the U.S. Census Bureau, and several other government agencies to provide critical, up-to date information about the impact of the COVID-19 pandemic on the U.S. population. The Household Pulse Survey is different from other surveys conducted by the Census Bureau since it was designed to be a short-turnaround instrument that provides valuable data to aid in the pandemic recovery.

Most insurance companies unveiled national advertising campaigns in March 2020, promising to “pause” all policy cancellations or expirations for at least a month due to non-payment of premiums. Many continued this policy, stating that insureds simply had to ask to have their insurance payment plan extended during COVID-19.

Insurance companies did not do this out of the goodness of their hearts. In most states, the state insurance commissioner issued directives asking or requiring insurance companies to do exactly this. The federal government similarly issued regulations for policies governed by ERISA, extending the deadlines for appeals until after the pandemic ends.

Despite the state and federal mandates, and their own advertising, insurers have not all followed these requirements.  Many insurance companies did in fact still cancel or allow policies to lapse in the first month of the pandemic.  Many more put the onus on their insureds to reach out and request help, despite promises that all such extensions would be “automatic.”  Here is a summary of the positions taken by some of the major insurance companies:

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