Florida’s Office of Insurance Regulation (OIR) gets an A+ for creativity in its effort to avoid a perfect storm insurance crisis, which I noted in Shocking! Shocking To Believe That Any Insurance Regulator Would Rely Upon Demotech, and Insurance Agent Leader Questions Motives of Demotech to Downgrade Florida Insurers. In a successful last second three-point... Continue Reading
The photo above is of a black catholic priest from Ghana leading a limbo dance. I was at a funeral today. I last saw Bernice Krueger, Donice’s mother, several weeks ago and knew her time was near. It was not easy to say goodbye then, and the last couple of days seemed strange, and it... Continue Reading
There are 10 categories of services — called essential health benefits — that all private health insurance plans offered in the Health Insurance Marketplace® must cover.
What are the 10 essential health benefits?
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (this doesn’t include adult dental or vision coverage)
What else does the Marketplace cover?
- Marketplace plans must also offer birth control and breastfeeding coverage.
- Some Marketplace plans may have dental and vision coverage too, but these benefits aren’t required.
- Call your plan to check if it covers a particular service.
A recent Duke Law Journal article argued that the current property insurance marketplace cannot properly insure disaster-prone areas, and the federal government needs to intervene. The article indicates that the situation is similar to the national health insurance dilemma and calls for a similar response. Here is the abstract of Regulating Homeowners’ Disaster Insurance Through... Continue Reading
How many readers of this blog are professional risk managers who have studied the risks we face? Few. Liberty Mutual’s new slogan seems common sense and is catchy. It is deceptive because it undermines the role of professional insurance agents and risk managers. Most of us do not fully understand the real risks we face,... Continue Reading
Appraisals are a common alternative method to litigation for resolving property insurance disputes. Still, the time to file suit varies from state to state, even when an appraisal is invoked. Policyholders should be wary that even though an appraisal is invoked, some states still allow the time to bring suit to run despite the ongoing... Continue Reading
An insurance agent leader in the Florida Association of Insurance Agents has questioned Florida’s dominant insurance rating agency’s motive to downgrade Florida-based insurers. A post to its membership suggests that Demotech made the downgrade for a self-serving financial reason as a power ploy: Are there ulterior motives for the timing of these downgrades? For years,... Continue Reading
The recent events by Demotech indicating that it may downgrade seventeen Florida insurance companies reminded me of the above scene from Casablanca. Florida’s Insurance Commissioner David Altmaier should try out for the role of the corrupt police Captain Louis Renault if the movie is ever remade. Altmaier wrote a Florida insurance industry orchestrated letter of... Continue Reading
My Property Damage Was Caused By a Third Party—Should I Wait to Notify My Own Carrier of the Loss Until I Collect From the Other Party’s Insurance?
Is it advisable to make a claim against the other person’s insurance carrier rather than your own insurance company? Maybe. But there is one big warning—you have a duty to notify your own carrier as soon as the loss happens. If you fail to promptly notify your insurance company of the loss, you may jeopardize... Continue Reading
Chip’s Note: This guest post is by Luke Irwin, a public adjuster in the Gulf Coast Region and President of Irwin & Associates. April 14, 2020, I received the shipment. And with the patience of a child looking at a Christmas gift, I ripped open the box to find eight fresh books… Pay Up! by... Continue Reading