Life insurance fraud: a tale of a falsified death for money

21/03/2009

All of us experience hard times although some people feel as though they would be better off dead rather than face debt. Many fall victims to the burden of debt and end their lives. Some, on the other hand, pretends death or pretends that they’ve already died just to claim some insurance benefits (usually pecuniary in nature) from their security plans.

A loophole, found not too long ago, in the health insurance system has given people the idea to fake their own deaths in exchange for some advantages. An example of this would be the famous John Darwin’s disappearance in 2002. John, a former British teacher and a prison officer went missing while canoeing. After the long—unsuccessful—search for John, with the help of search and rescue teams, they declared John to be dead. Since he was presumed dead since his body was never found, his wife, Anne, claimed his life insurance money.

Years went by without people knowing where John was when in reality, he was just staying next door while the couple secretly looked for estates abroad so they could make their escape. John and Anne scouted numerous residencies all over the world before settling in Panama, Central America. It was then that they made the mistake of taking a photograph with a real estate agent who suspected something fishy with the couple and did some research on them. The agent uncovered the truth and reported them to the authorities and that was when their plan got spoiled.

Another factor which led to their discovery was the frequent phone calls Anne made to her husband. She suspected that the agent was getting wary of them and wanted to do something about it. So every now and then, Anne telephoned John to find a solution. During one of their phone conversations, a co-worker overheard the couple’s discussion and reported it. This, consequently, indicted the two in the late 2007.

In later reports, John Darwin claims he had “no recollection” of the last 5 years he had been gone. However, enough evidences were accumulated to prove him wrong. These consisted of letters to his girlfriends and his wife. All in all, they were able to obtain over 150 GBP’s from his life insurance policy and another 75,000 GBP’s from his teacher’s pension. He also got 4,000 from the Department of Work and Pensions.

In the end, John and Anne were sentenced in July of 2008 for their deception and life insurance fraud. John was sentenced to 6 years and 3 months in jail while his wife, Anne, is serving 6 years and 6 months in prison. This goes to show that it never pays to deceive someone for personal gain.

Posted in Life Insurance |

Basic Information for Home Insurance Policy Owners

19/03/2009

Each security policy has its own way of gauging the premium to be given to a policyholder. This may include the number of rooms, the living space, and other add-ons like a fire place, basement, dogs, and so on, although usually the value of the lot is excluded in the decision of pricing your premium. All factors attributing to your premium are listed as the ‘actual cash value’ or ‘replacement cost’. The policy owner may expect that cost of repairs and renovation of the house is included in the plan’s coverage.

Many have experienced incremental increases in their premiums especially last year when the economic hit the market big time. Security companies are continually increasing the premium due to the increase in other expenses such as labor, materials and inflation rate. The policyholder may take different approaches to review his home security policy to evaluate the current value of your home. Questions regarding your home may be asked like the main items replaced, the appliances and furnishings bought and so on. If, after the evaluation of your home, its value has gone up then expect that there will also be changes to your premium.

When a market value drops in your area, one should not expect a lower premium as well since the payment is not gauged based on the value of your place but rather on the repairs and other house-related aspects. The premium will only decrease if prices of materials, labor and other miscellaneous expenses will experience a decline. All equipment found in your home has a contra-asset feature which is the depreciation. This makes the cost of replacing your appliances, walls, etc. less expensive than years before and so it is a must that you hire someone to reevaluate the value of your house since this can affect the amount of your premium.

Have an inventory of the things you possess. List the items inside your home that are covered by the insurance policy since this will be beneficial to you once a fire accident or any other occurs. Keep this list or give this to a friend or relative to keep it safe so when you are to file a claim, you know the items that the company needs to reimburse you with.

One may also compare insurance quotes from one firm to another and check if there are any differences regarding the rate they are to give your house. This will serve as a check and balance so you would know if there are any discrepancies on the side of your insurer. Once you ask around for quotes, you may also find other deductibles and discounts that can assist you in your desire to save more and that your company does not offer. You can then decide whether to switch to another policy or not, since other firms offer a multi-policy discount which is very advantageous for the policy owner.

Posted in Frontpage |

High Deductible Health Plans

Many might have heard of catastrophic health insurance plans or otherwise known as the high deductible health plans. This coverage is characterized by giving lower premiums by making the health security deductible higher to decrease the potential overall medical expenses. An annual deductible amount is the quantity that is not included in the insurance plan which is obtained by a taxpayer with its annual income. With this type of health insurance policy, the insured pays for most of the medical costs until the annual deductible amount is reached, as a result, traditional health coverage takes the place of the former health plan.

When availing a high deductible health plan, the insured pays personal funds to incurred medical expenses until the annual deductible amount is reached. When this happens, the health plan covers most medical expenses. For the year 2008, the IRS required tax-exempt HSAs to own a high deductible health plan with a minimum annual deductible of $1,100 for an individual and a minimum of $2,200 for a family. For more technical information, one may inquire their respective government departments regarding catastrophic health insurance policy conditions.

The purchase of catastrophic health coverage can either be an individual or group policy. Diabetes, mental incapacities and other pre-existing conditions or health problems can disqualify a person from getting an individual plan before acquiring group coverage. The latter is subject to HIPAA bylaws which regulates the purchase of this type of insurance. The plan’s coverage depends highly on the type of catastrophic policy the insured chose. Details will be provided by the provider but basically, this type of plan is inclusive of prescriptions, routine and non-catastrophic care. If the plan you chose has a vast coverage, then it will follow that the premium for such will also be higher than an ordinary security policy. Although shelling out more money to cover costs will entail a lower premium per month.

Generally, the high deductible health policy gives a lesser premium because the insurer knows that in case of medical emergencies, you will pay a higher percentage of the total cost and thus, will be given a lower premium. Personal funds will have to be given to cover medical expenses before the policyholder reaches his annual deductible. The low premium offered should not only be the basis for purchase. One should weigh the pros and cons (risks) before deciding to buy this type of coverage. If you have an annual deductible of $2,000 and medical costs totaled $2,800. You should be certain that you can shell out all $2,000 since this will be the amount you are going to pay and the balance will be the taken cared of the company. So if you think you can take the risk of paying out a bigger percentage, relative to the total cost, for a lower premium then this type of plan might just be for you.

Posted in Health Insurance |

How to Get the Best Life Insurance Policy

18/03/2009

Life insurance policy is a means of providing protection for the policyholder’s family when he passes on. The insurer finances the surviving family and also takes care of the funeral expenses and other debts left by the policyholder. The proceeds of the plan serve as the income lost to the family of the insured individual and eases their problem of where to get the money to pay everyday expenses.

How can one get the best security plan? One might ask if he should avail of a term or cash value plan. Well, it actually depends on the plan holder and his family’s needs. A term insurance plan covers a specific period of time while a whole life security plan combines both death benefits with a cash value element. A term policy offers security at the cheapest price. This type of policy is renewable but when a plan holder purchases the same plan (when his health and other conditions change), the premium would most likely increase with the repurchase. Moreover, term policies can also be converted to a permanent life security plan.

On the other hand, cash insurance policies give the advantage of providing a lifetime of protection and thus, plan owners are charged with a higher premium. The ultimate value of this type of plan lies mainly on the performance of stocks and bonds since it acts like investments. People usually utilize their cash value by lending against a policy. The amount taken from the plan does not need to be reimbursed or paid back but the particular amount taken will be deducted from the death benefits originally offered resulting in a lesser payout. The premium paid for the coverage basically depends on the amount of financing the survivors will need, the properties owned and loaned, and the security plans available.

Shop around and compare insurance quotes. Make sure that the policies put into comparison are in the same category and these provide similar coverage. Find out the rating of the company you are considering to be your security provider, and see if it is reputable and reliable. Once you are ready to buy a policy, fill up a life insurance application, which has questions regarding your health records and lifestyle. Taking a medical exam might also be required before you are granted the security policy. There are numerous life insurance companies. If you are not granted one in a certain firm, you may always go somewhere else.

One should always carefully read and understand the policy fully before pushing through with the purchase. Plan rules, benefits, the premium and other fees that you will eventually pay will be listed on the contract together with other information regarding beneficiaries and the period that the premium will be given. You also have a “trial period” (usually 10 days) wherein you can withdraw from the policy without any penalty. Always tae the time to know all there is to know about the insurance policy you are purchasing because this will be of great help to your family when you are gone.

Posted in Frontpage |

Car Insurance Companies in Danger of Losing Control

The recent inauguration of the current President Obama has caused the citizens to hope that the economic turmoil will soon recede. The speech held so much promise and President Obama actively creates solutions to confront and address the problems at bay. Insurance companies are suffering the most with the current financial maelstrom and people are beginning to lose faith in these well established institutions. With everything that is happening, can insurance companies surpass the existing dilemma?

The economic meltdown has greatly impacted each industry known to mankind. It has created havoc and certainly will continue to do so in the next two years. Government agencies are doing their best to cope with the situations and help each industrial firm get back on its track. Insurance companies, mainly, have become more and more unstable and in need for government aid.

Recently, though, there has been a proposal to eliminate age as a factor in gauging car insurance premiums. Consequently, all payments will most likely be set higher for all individuals availing a security plan. Insurers fear that with this, as a starting point, legislation might also influence them in its prerogative to charge riskier customers with a higher premium as a means to manage risk. This can result in imbalance and can further create a slack in control for insurance firms. To address this concern, insurers will then have to set higher prices for all ages disregarding their inherent characteristic of engaging in risky or adventurous activities.

ABI declared that 60-64 year old drivers have average claims of £1,170, while those aged over 80 have £1,716. With the proposed law, this factor (age) is disregarded unless a medical assessment approach is done (which is costly). Either the insurer will go ahead with the assessment plan and charge a higher premium to the policyholder as a consequence, or the insurer will directly give equal premiums to every individual disregarding age that is much higher, still, because the risks are generally assumed for all ages. Either way, the proposed bill is still disadvantageous for the policyholders and insurers alike.

Every demographic differentiation has an impact in measuring a policyholder’s premium. A woman, for example, would yield a lesser premium than a man, because of its nature to be more cautious (majority) and to drive lesser miles than a man does. A young adult would also yield a higher premium than those people in their 40s that have families since the latter are deemed to be risk-averse. All these legislations can break the insurance agencies because of the control issues within each company that arise with the given bill.

Posted in Auto Insurance |

Business Insurance Can Protect Your Business from Any Eventuality

17/03/2009

Owning a business entails a lot of risk. Some actually consider owning a business as a form of gambling because of the significant amount of risk that you face in its daily operation. But you can hedge these risks by purchasing a business insurance policy for your venture.

A business insurance policy is a major investment for any business owner. The cost associated with this type of insurance prevents some business owners to take out a policy for their enterprises.

Not getting a business insurance policy is a mistake that you should never make. You are actually exposing your business to greater risks if you will not insure it. So whether you own a small business or a relatively big company, you will still need to protect it with a business insurance policy.

Here are the basics of business insurance and the benefits that you can get from it. A wise business owner always protects his or her business from any eventuality. And a business insurance plan is probably the best protection you can get for your investment.

The Basics of Business Insurance

Like any other type of insurance, a business insurance policy is a form of financial protection. It will keep your business protected from any type of loss or liability. This is probably the simplest definition of business insurance.

However, unlike other insurance policies, a business insurance policy is more complicated. Aside from the fact that there are several types and combinations of business insurance policies, there are several exclusions that you need to study for each type of policy.

That is why it is critical to consult a legal or a financial expert if you are going to purchase a business insurance policy. This is a major investment so you need to take all the right steps so you can ensure that your business will get a proper protection.

Different Types of Business Insurance

There are several types of business insurance and all of them have their own merits. There are also business insurance policies that may not be applicable for your enterprise. Choosing what type of business insurance that would be suitable for your company is a little bit confusing at times.

So, here is a general overview of the different types of business insurance policies that you can purchase.

1. Property Insurance Cover – Property insurance covers loss or damages to existing structures of your business. Usually, a property insurance policy will also cover all the listed contents of the property such as machineries and other office equipments. It can also cover properties that you do not own but you control through a lease or rent agreement.

This is the most common type of business insurance because business properties are the most valuable investments of any enterprise. This type of business insurance can also be very specific.

For example, a fire insurance policy will cover your property in case it was destroyed by fire. If your property was damaged by flood, then a fire insurance policy cannot cover it. You need to specify the type of risk that will be covered by the policy.

2. Liability Cover – This type of insurance can cover your business from any legal action due to negligence. Litigation and liability compensation can be very expensive and could cripple your business. With a liability cover, the policy will protect your business from all the expenses related to liability lawsuit.

3. Workers/Employee Compensation Policy – This kind of business insurance covers your employees for work related injuries. In most states and in some countries, this type of policy is mandatory. Your employees cannot sue you for negligence if your business has workers compensation policy.

4. Business Interruption Insurance – This type of policy covers your cash flow. If your business suffers from interruption due to strikes, broken machineries, or any events that affected your cash flow, then this insurance will cover for such loss of profit.

5. Health / Life / Disability Insurance – You can get this type of business insurance separately or as a combo package. These policies cover your workers or the key executives of your business. You can use these policies to become more competitive in attracting the best and the brightest employees.

6. Auto / Fleet Insurance – This is a very specific policy that covers vehicles you own or rent. Motor vehicles are part of your business operations. If an accident happens, the auto insurance can cover for the loss of a vehicle and can pay any liability caused by the accident.

Getting a vehicle insurance policy is very important if your company has a fleet of vehicles. These are very valuable properties that you should protect. Auto insurance however is one of the most complicated types of business insurance. Make sure to consult your legal counsel before taking insurance for your motor vehicles.

7. Packaged BOP – BOP stands for business owner’s policy. This insurance usually includes property, liability, and business interruption coverage. This is the most convenient type of business insurance you can get.

8. Special Insurance – There are policies or plans that may not belong to any of the above business insurance policies. Such insurance would be very unique for your business and you must personally negotiate for the specific terms of a special insurance.

What to Expect from a Business Insurance Policy?

Basically, business insurance protects your business from any eventuality. The policy will cover the cost associated with unfortunate events so that the profitability of your business and its financial stability can be protected.

Probably the best thing that you can expect from business insurance is coverage from liability. Some businesses, especially small and medium enterprises, have been forced to fold up because of liability claims. To avoid this scenario, you should take a business insurance policy that can protect your company from crippling liability claims.

With a business insurance policy, your company can easily recover from damages. Your equipments and machineries are not indestructible. They can be damaged due to several reasons. You can easily recover from such loss by hedging this risk on business insurance.

Your business can also recover quite quickly if it suffers from theft, natural disasters, or human vandalism. These are real risks that you need to face. You can mitigate these business risks by taking a business insurance policy.

Business insurance also ensures that your company can comply with existing regulations and statutes. This is particularly applicable for compensation insurance policies. You can face legal problems if you do not have business insurance for your personnel.

Other Key Benefits of Business Insurance

Aside from the coverage that you can get from business insurance, it can also bring added windfall for your company.

If your business is well insured, you can easily get fresh loan, favorable line of credit, and new investors. Lenders, banks, and investors are wise enough to know which businesses can provide good profits for them. So before they stake their money, they always ensure that their own investments will be protected.

If your business has adequate coverage from business insurance, then it would not be difficult for you to negotiate favorable terms with these institutions. Your cash position therefore will always be in the black and this is very good for your business to stay afloat especially during times of recession.

Improving business image and ensuring company stability are also key benefits that you can get from business insurance. Clients, professionals, and other business owners will respect your business because it is well protected from damages, loss, and liability.

Good corporate image is essential to ensure the continuity of you business. You can achieve such good image if your business has several insurance that conveys stability.

Because your company is well protected by business insurance, clients and customers will be confident in transacting with you. This means more business opportunities, more profit, and continued robust growth. You cannot achieve such business stature if your company does not have business insurance.

Conclusion

Business insurance is a critical part of your business risk mitigation strategy. It can protect your business from any eventuality such as loss, damage, interruption, and liabilities. Such protection and coverage from business insurance can protect you from bankruptcy.

There are several types of business insurance you can avail. Getting the right insurance for your business is quite confusing so you may need the assistance of a competent attorney or financial expert.

You can take separate insurance or you can get a packaged combination insurance policy for your business. The most important thing however is to ensure that your business has adequate coverage for all types of losses.

You need to seriously consider getting business insurance for your company. This is a major investment and it is true that such policies could be very expensive. However, the benefits that you can get from business insurance can provide good returns for this investment.

You need to become a wise business owner. It does not matter whether you own a small business or a big company. In times of uncertainty and acceleration of business risks, a business insurance policy could be your reliable partner for continued business growth and profitability.

Posted in Business Insurance |

Health Insurance Fraud

“Massachusetts orthopedic surgeon Harold Goodman routinely gave patients potentially harmful X-rays and steroid injections they didn’t need so he could falsely bill Medicaid. Goodman spent as few as five minutes with each patient, giving one patient 74 X-rays and 112 steroid injections in less than three years. Goodman received six months in prison in 2000.”

This is only one of those crazy cases where people harm others just to get what they want. Physicians, doctors or surgeons cheat and provide unnecessary services to charge greater fees not taking into consideration the ethical and physical consequences of their acts. Excessive and inappropriate examinations are illegal but are difficult to detect because as professionals, people trust and entrust them with their lives without questions. Their degrees and titles demand respect and are granted such without much thought or question. People bank on them because they are, supposedly, experts on that field. But sad to say, medical professionals tend to abuse their influence and power over others especially during this trying times of economic meltdown.

Computerized Inclinometry: This procedure gauges joint flexibility and is useful to check a person with motion disability. This can be done once or twice depending on the gravity of the disability but repeated measurements “to assess the patient’s progress” might be deemed inappropriate and incur unnecessary cost.
Nerve conduction studies: This can be used to determine the status of ones nerve function when a person has experienced an accident and obtained grave physical injuries. However, this test is used inappropriately by some physicians just so they could bill more to insurance companies and thus get more.
Ultrasound: This procedure has many uses but is definitely not appropriate for “diagnosing muscle spasms or inflammation”. Also, patients with back pain do not need to undergo this type of procedure.
X-rays: This can be vital for people which have internal organ problems that are hard to diagnose. This examines the condition of the patient but is deemed inappropriate when it is done routinely.

To be able to discern whether or not you are being deceived by your medical practioner or doctor, take the time to check a doctor’s background and feedback from other patients before availing of his services. This will help you choose the right competent, medical professional who will be ethical enough to provide quality service that is attuned with the rate he charges you or your insurance company. If you think you have been cheated by either your physician or insurer, never be afraid to file a complaint so these malpractices will be put to a stop.

Posted in Health Insurance |

Life Insurance Fraud and Abuse

16/03/2009

We have to accept the truth that 1 out of 10 people today will create a plot to pull out money from another person’s pocket. This is the current reality. Scams are everywhere and are evident in fraudulent life insurance claims. This type of insurance scam is prevalent in USA and cases like this are growing in number. It affects the life of innocent people, directly—through deliberate injury or damage to the other party or to the policyholder himself—and indirectly as these crimes cause insurance premiums to be higher.

Insurance companies are susceptible to fraud because false insurance claims can be made to appear like ordinary claims. The ultimate objective for such unethical practices is financial gain. Policyholders charge bills for services and tests that weren’t even provided. Sometimes they bloat expenses incurred from medical procedures or medical diagnosis or the identity of the beneficiary. At times, to gain more money, fraudulent policy owners order unnecessary tests just to get something more out of the insurer.

Physicians also commit deception through charging higher fees to individuals with insurance policies and merely tell them that the given rate is the usual fee for all patients. This is illegal but is widespread in the USA and in third world countries. It is also illegal to exempt patients from copayments and deductibles unless they are proven to be experiencing financial hardships.

Other illegal practices that people do for money include:

Filing a claim for services not performed or charging a patient for services that weren’t provided.
Charging patients for different fees that were supposedly covered in one fee. This results in higher payment. Policy owners also do this when they file a claim and thus gain more reimbursement than the actual money that they should be receiving.
Plan holders sometimes charge fees twice for the same service given to them.
Making simple procedures complicated as well as the fees charged with these.

All these and more are schemes to get more than the actual money that the policy owner or physician has earned. Insurance companies today have come together to from a group that could protect themselves from these fraudulent individuals. They have joined forces and came up with the National Health Care Anti-Fraud Association. This corporate group has developed computer systems that can detect suspicious billing and claim patterns. The government has created departments of their own in association with the insurance companies to create legislation gearing towards the protection of these security firms.

Posted in Life Insurance |

Tackling Issues on Auto Insurance

13/03/2009

Undeniably, millions of people around the globe now own automobiles. These people either possess insurance already, they want to get one, or perhaps are hesitant to get insured. To have a security plan for your car gives the insured individual the sensation to be at peace and to feel free because whatever accident that will happen, the insurers got your back.

Insuring your car costs much and this has been one of the major reasons why people hesitate to get one. Some people file complaints because they thought the insurance company will pay for all costs incurred so they don’t have to shell out anything, but when it comes to the real thing, these insurers will pay only a rather small percentage of the entire cost and you have to pay for the bigger balance. Moreover, policyholders expect—when a part of the car is damaged and needs to be replaced—replacement parts to be of good quality and if possible, parts that are really coming from the manufacturer of the automobile. Sadly though, most of the security companies are the ones who choose where to get the replacements from to make a cheaper deal which further results in a lesser quality substitute and an unsatisfied customer.

Purchasing an insurance policy is also very complicated and takes a lot of effort to accomplish that is why people refuse to get coverage since they do not want to endure the hassle. In filing for a claim, insurers also make your life miserable by providing a lot of excuses why your reason is not valid for reimbursement. In one case, a woman complained about her car part having a vandal and asked the insurance company what they could do about it since she availed of a comprehensive coverage. The insurer told her that the company would not cover the costs since the incident is categorized as car damage and thus, would belong to another type of coverage. The woman not knowing that she was fooled accepted what the insurance company told her and learned later on (too late) that she had every right to demand reimbursement since damage was not a result of an accident or collision.

Before acquiring insurance for your car, make sure to know the terms of your contract. Many people overlook this and become very trusting to their broker or agents. All facets of the policy should be read and understood so when the time comes that you need to file a claim, you would know what to expect from the company as well as know what to do in case they do not deliver.

The main purpose of security plans is to provide services that enable the policyholder to have peace of mind. Opt for companies that are credible because they deliver as promised.

Posted in Auto Insurance |

Why People Refuse to Get a Home Insurance Policy

12/03/2009

As the current population continues to increase, people are also continually crowding over the cities. Most of them are residing in places that are hazard-prone just to get cheaper rents and housing rates. The demand for commodities has soared and their respective prices followed. Consequently, people are trying to look for a less expensive way of living.

Getting and paying for insurance premiums today are more costly than it was a year back and even lesser the year before that. People today are hesitant to get a home security plan especially with the global financial crisis. They would rather save the money than invest it on something which they believe will give something less in return. Most people, in their desire to save money, also choose to rent apartments in areas that are charged highly by security firms, due to its perilous location. These areas are known to have high risks of accidents, damages and the houses are in bad shape. Insurance companies, knowing these conditions, would charge the potential policyholder with a greater premium (the payment given to acquire a security policy) or the company might deny such purchase because of its undesirable location.

There have been reports regarding inconsistencies on how insurance firms handle policyholders. In some parts of America, homeowners are affected by a higher charge for policies and a series of plans that are not renewed. The discrepancies have been a factor that made people cautious and untrusting to insurance companies. Some security agents even go as far as misleading potential policyholders by promising things that the corporation cannot deliver. As Rebecca Bloomwood would put it, it’s like falling in line to pay for a cashmere coat only to be wooed by a sales personnel telling you and promising that the item she is offering is far better. Trusting the sales personnel, you would then buy the other one being offered, only to find out later on that you were deceived. Only when you looked closely at the item did you realize that it is only made of 2% cashmere and 98% cotton. This is basically what is happening today. Many security agents are deceiving people to meet their own quota. They tend to bloat the benefits or promise additional benefits that were originally not in the policy or omit some disadvantages like some limitations of the contract, for them to make a sale. They’re letting the customers down and are destroying the company’s brand image in the process. People have learned to distrust management and will continue to do so and most probably, will spread the firm’s unethical performance.

Government agencies are doing their best to address the needs of its people by regulating the security plans offered by different businesses. Government affiliates are also taking actions to stop these malpractices and are now more active at educating the public regarding different house insurance policies.

Posted in Home Insurance |