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Around the PIA Western Alliance States

Posted By Administration, Tuesday, August 9, 2016

California — Rate Reduction Pressure

Consumer Watchdog wants State Farm’s homeowners rate increase dropped. The group has filed a petition with the Department of Insurance and says State Farm needs to cut it by 40%.


It states 280,000 homeowners are going to be overcharged by close to $100 million.


Citing Proposition 103, the group says it does not allow “excessive” home, auto and business insurance rates. Consumer Watchdog said the 26% rate increase asked for is unwarranted and State Farm’s own figures show it is not needed.


State Farm had no comment.


Source link: Insurance Journal


California — Uber Arbitration

Uber recently said the $100 million settlement it made with the drivers is a take it or leave it scenario. That’s what it told U.S. District Judge Edward Chen and Seattle University School of Law associate professor Charlotte Garden said Uber asked him to cancel his order protecting the drivers.


Uber is almost daring Judge Chen to go against its wishes. Uber all but says that if he doesn’t treat the issue the way it wants, it will walk away from the deal,” she said.


The judge has two choices. He can approve what he already says is a flawed agreement or he can send both the drivers and Uber back to negotiations. Experts say if that happens the deal goes away and essentially leaves the 350,000 drivers in California and Massachusetts with nothing.


The company continues to maintain the drivers are independent contractors and not employees. Drivers want what is — more or less — employee status.


Source link: Insurance Journal



Idaho — Insurance Fraud

From the Idaho Department of Insurance.


Ashley Monroe, a former Idaho resident, was sentenced on July 25, 2016, on one count of insurance fraud for filing a false claim with her insurance carrier, USAA. The Idaho Department of Insurance fraud unit investigated the claim.


Monroe reported that her diamond engagement ring fell off her hand and into a storm drain while she was getting into her car. USAA paid her $2,955 for the ring. Department of Insurance investigators discovered that Monroe had pawned the ring and that it was still in the pawn shop when the claim was filed. Investigators also learned that she had pawned the same ring at least twice after receiving the claim money.


Monroe was charged with one count of insurance fraud and one count of theft by extortion. She pleaded guilty to one count of insurance fraud and was sentenced in Ada County. She was granted a withheld judgment and placed on felony supervised probation for three years, and was also ordered to pay a fine of $1,240,50 and serve 20 days in jail.


Department Director Dean Cameron says, A fraudulent claim may not seem like a big deal on the surface. But according to FBI estimates, insurance fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums.”


This case was prosecuted by Deputy Attorney General Nicole Schafer of the Idaho Attorney General’s Insurance Crimes Unit.


Washington — Insurance Commissioner Actions

The Washington Office of the Insurance Commissioner recently filed the following items with the Code Reviser’s Office.


Action 1


CR-102 for R 2016-06: Rating requirements rule to implement SSB 6536.



The OIC is writing rules to standardize rating requirements under SSB 6536, which the Legislature passed during the 2016 legislative session.



This comment period closes on September 14, 2016


Rule hearing:


Thursday, September 15th at 10:00 a.m.

5000 Capitol Blvd. SE

Tumwater, WA 98501

Driving directions

For questions or comments, please contact Bianca Stoner, Senior Health Policy Analyst, at rulescoordinator@oic.wa.gov.


Action 2


Code Reviser’s Office:


Notice to start rulemaking

CR-101 for R 2016-22: Prescription drug substitution process.



This rule ensures that the OIC’s regulations are consistent with the federal government’s HHS Notice of Benefit and Payment Parameters for 2017 (www.federalregister.gov) regarding drug substitution. The rule creates turnaround timeframes for when an enrollee requests a prescription-drug substitution and clarifies the appeals process.



The comment period for the CR-101 is open until September 15, 2016.

For questions or comments, please contact Jim Freeburg at rulesc@oic.wa.gov.


Action 3


Proposed rule

CR-102 for R 2016-08: Prescription drug substitution process.



Previous rulemaking allows certain prescriptions to be filled on a short-term basis, but the rules did not address how consumers should be notified when such emergency fills occur. Additional rulemaking, per RCW 48.43.510 (leg.wa.gov), requiring insurers to notify consumers of any covered benefits, is necessary to clarify how consumers are to be notified of the emergency fill, including any cost-sharing obligations.


Rule Hearing

September 6, 2016 1:30 p.m.

5000 Capitol Blvd. SE

Tumwater, WA

Driving Directions



The comment period for the CR-102 is open until September 6, 2016.

For questions or comments, please contact Jim Freeburg at rulesc@oic.wa.gov.


Tags:  Around the PIA Western Alliance States  Insurance Content  Insurance Industry  Insurance News  Weekly Industry News 

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