California — Electric Scooters: Cities all over the country are doing battle over the use of electric scooters on sidewalks, streets and even highways. Some cities have regulations for them. Some don’t.

The California Legislature — at least the Assembly — wants to look at scooter regulations. The bill is Assembly Bill 1286 and it has passed the Assembly and is now off to the Senate.

It is authored by Assemblyman Al Muratsuchi. He’s a Democrat and wants cities to be required to make the scooter companies get permits that make them adhere to rules on parking, maintenance and safety.

Muratsuchi thinks the scooters are fun and ecologically friendly but they are also dangerous when ridden improperly on sidewalks or when parked improperly.

Source link: Insurance Journal

Idaho — Medicare Workshop: Free Medicare Workshop for individuals turning 65 and those approaching Medicare eligibility are being held in a number of Idaho cities. Caregivers and all those interested in learning how Medicare works are encouraged to attend.

One will be held in Hailey on Wednesday, June 5 from 4:30 p.m. to 6:30 p.m. at the Hailey Public Library at 7 W. Croy Street.

They are designed to introduce the various parts of Medicare and to share some of the costs and benefits associated with the program. Sessions cover enrollment timeframes for Medigap, Medicare Advantage, prescription drug plans, and how the different parts of Medicare work together.

Staff with the state’s Senior Health Insurance Benefits Advisors (SHIBA) program, a unit of the Idaho Department of Insurance, conduct the workshops. To register for the upcoming session, please contact the SHIBA Helpline at 1-800-247-4422.

Nevada — Wildfire Settlement: The state of Nevada has been ruled negligent when a controlled burn got out of control and destroyed 24 homes just south of Reno. High winds reignited the burn while it was smoldering.

The state was sued by 60 plaintiffs. Their attorneys say the Board of Examiners is going to vote on a settlement on June 12th. It is said the settlement will be $80 million.

Source link: Insurance Journal

New Mexico — Albuquerque Looking at Billing Drivers Emergency Costs: Albuquerque Mayor Tim Keller is proposing the city begin collecting money for emergency services provided by the city when there is a car crash.

The 2020 budget says proposed cost recovery fees will range from $400 for hazard mitigation and cleanup to $1,305 for the use of heavy rescue tools and other equipment. The city will also — if this passes the city council — be allowed to bill $400 an hour for additional time spent at accident scenes.

Proponents say this will pass the cost of complex crash situations onto those directly requiring them. Opponents say these services are already funded by taxes.

Source link: Insurance Journal

Washington — Kreidler Issues Fines: Insurance Commissioner Mike Kreidler issued fines in April totaling $401,900 against insurance companies, agents and brokers who violated state insurance regulations.

Insurance companies

Premera Blue Cross, Mountlake Terrace, Wash.; two orders:

    Fined $50,000, order 19-0079: Premera underpaid dental providers for certain anesthesia services by $182,766 on 1,008 claims from January through June 2018. The company will reprocess all of the underpaid claims within 90 days.

    Fined $50,000, order 19-0138: A consumer complained to Kreidler when Premera denied a lifesaving specialty formula for a child. Kreidler’s investigation found that Premera improperly handled the appeal, which should have included a review by an independent review organization (IRO). Premera subsequently reported that it improperly handled 59 appeals from June 2016 until July 2018.

Lifewise Health Plan of Washington, Mountlake Terrace, Wash.; fined $25,000, order 19-0139

A consumer complained to Kreidler about a claim appeal that was mishandled by Lifewise, a sister company to Premera Blue Cross. Lifewise reported that it delayed 31 appeals to be reviewed by independent review organizations (IRO) from June 2016 until July 2018. 

Delta Dental of Washington, Seattle; three orders:

    Fined $15,000, order 19-0071: The company did not maintain dental provider directories in accordance with state law. Violations included obscuring specialty providers, accuracy of the directories, and reporting providers to Kreidler’s office. 

    Fined $15,000, order 19-0072: The company overcharged and undercharged a total of 3,370 Washington consumers, affecting 4,624 claims. Overcharges totaled more than $13,000, which it refunded to customers.

    Fined $50,000, order 19-0073: The company sold unapproved policies to 6,140 Washington consumers. These policies contained language that was specifically disapproved by Kreidler’s office.  The company also misrepresented the terms of its contracts in its confirmations of treatment and cost in 6,456 instances.

Kaiser Foundation Health Plan of Washington Options, Inc., Seattle; fined $50,000, order 19-0075

The company improperly processed claims totaling nearly $213,000 for 42,036 consumers in 2017. The company’s plan stated that each policyholder’s first four visits of the year were not subject to the annual deductible. The company processed claims in the order they were received, rather than in chronological order. The result was that policyholders could be subject to higher out-of-pocket charges depending on how fast medical providers submitted claims.

Ameritas Life Insurance Corp., Lincoln, Neb.; fined $50,000, order 19-0107

In 2015, Kreidler denied a standalone combined vision and dental policy that the company wanted to sell. In 2017, it sold 1,552 of these plans to Washington consumers, generating $95,997 in premiums. Additionally, from January through July 2017 the company allowed insurance producers to sell the policies without being properly affiliated or appointed. Kreidler suspended $30,000 of the fine under the conditions that the company certify that all of its producers are appointed and affiliated every six months and commits no further law violations for two years.

Kreidler disciplined the following companies for violating state insurance laws:

    Bankers Life & Casualty Co., Chicago; fined $30,000, order 19-0074

    Omni Insurance Co., Springfield, Ill.; fined $20,000, order 18-0079

    Principal Life Insurance Co., Des Moines, Iowa; fined $16,150, order 19-0040

    Banner Life Insurance Co., Frederick, Md.; fined $10,000, rescinding cease and desist, order 19-0172

    Seneca Insurance Co., New York City; fined $3,000, order 19-0175

    Mutual of Omaha Insurance Co., Omaha, Neb., fined $3,000, order 19-0101

Agents and brokers

Kreidler fined the following insurance producers for violating state laws:

    Trever Marshall Maestas, Kennewick, Wash.; fined $250, order 19-0173

    Barbara Jean Otiker, Bremerton, Wash.; fined $250, order 19-0202

    Aliyah Hunt, Middleton, Wisc.; fined $250, order 19-0008

    Southwest Risk LP, Dallas; fined $250, order 19-0103

    Brandon Lewandowski, Garfield Heights, Ohio; rescinded revocation and fined $500, order 19-0104

    Sarah Miller, Denver; rescinded revocation and fined $500, order 19-0105

    National Rural Letter Carriers Association, fined $8,500, order 19-0099

    Landcar Agency, Sandy, Utah; fined $4,000, order 19-0053

    Alison Page Newman, El Cajon, Calif., fined $250, order 19-0080

Kreidler revoked the licenses of the following insurance producers:

    Ruth Lynn Elder, Melbourne, Fla., order 19-0102

    Victor Inman, Henderson, Nev., order 19-0109

Source link: Washington Department of Insurance

Washington — Surprise Billing Legislation: Gov. Jay Inslee has signed Insurance Commissioner Mike Kreidler’s request legislation to end surprise medical billing, enacting arguably the strongest law in the country to protect consumers from this unfair practice.

The new law (www.leg.wa.gov) protects consumers from getting a surprise bill when they get either emergency services at an out-of-network emergency room or medical treatment at an in-network hospital or facility but are seen by an out-of-network provider.

“For more than a decade, we’ve heard from people hit with a balance or surprise bill,” said Kreidler. “They’ve shared their stories of receiving a bill on top of what they expected to pay, despite going to the hospital or facility their health plan covers. Many wanted to know how this could be legal. This year, we learned of two consumers who received surprise bills of over $100,000 and who both faced losing their homes and medical bankruptcy.”

Kreidler added, “I think the breadth of these stories – and that no one was immune – finally provided the motivation needed for the sides to come together and find a solution. I’m grateful to Rep. Eileen Cody, D-West Seattle, and Sens. Christine Rolfes, D-Kitsap County, and Annette Cleveland, D-Vancouver, for their critical work on this legislation and to the other legislators who supported this important consumer protection."

The new law takes effect starting Jan. 1, 2020. Key protections include:

    A consumer who receives emergency care in an out-of-network emergency room or who has a non-emergency medical procedure in an in-network hospital or facility cannot be balanced billed.

    An insurer cannot balance bill a patient if they seek emergency care at an out-of-network facility in a state that borders Washington.

    Insurers must pay the out-of-network provider or facility directly for care their enrollee receives.

    If the insurer and provider or facility do not agree on a commercially reasonable payment for out-of-network services within 30 days, their dispute goes to binding arbitration.

    A disclosure template will be developed and must be given to patients describing when they can and cannot receive a balance bill.

    Insurers, providers, and facilities must include up-to-date network information on their websites.

    Any provider who continues to illegally balance bill may be referred to the state Department of Health for enforcement.

Kreidler’s office will develop rules this summer for the new law. Sign up to get updates.

“There is much more that we need to do to address the challenges facing our health care system,” said Kreidler. “But to finally put this issue to rest lifts a weight for many and should give thousands of consumers more piece of mind. For now, we’ll settle for that victory.”

Source link: Washington Department of Insurance

Marsh — like many insurers, ratings agencies and others — tracks commercial insurance prices. The company’s Global Market Index for the first quarter of 2019 has good news for commercial insurers. Prices rose by 3% overall.

Dean Klisura is Marsh’s president of global placement. He said, “While 3% is the largest average increase in insurance pricing we have seen since the index began in 2012, market capacity remains strong in most products and geographies.”

Going back to 2013, Klisura said prices have fallen 0.7% worldwide. That seems to have turned around.

In the U.S. — where most of us are concerned — first quarter rates leaped 1.1%. That’s good news. The news on another front is not so good. Casualty pricing — which has fallen in all but one quarter since 2014 — fell again and dropped another 1.7%.

Here’s the rest of the report’s highlights:

•  All regions experienced increases and they’re driven mostly by changes in D&O rates

•  The Pacific region saw the most increases at greater than 10%. That has been a trend for the last eight quarters

•  Europe and the United Kingdom saw jumps of 2% or higher

•  Property risk prices around the globe jumped an average of almost 5%

•  Casualty prices fell an average of 1%

•  Pricing for financial and professional lines rose close to 6%

As for the U.S. Marsh said the increases are at the highest rate since 2013. Here’s more:

•  Property saw a 4% increase and has now gone up each quarter since 2017

•  Multilayered property programs led the way with increases of close to 7%

•  Financial and professional liability rose 2.8% and — again — is driven by D&O liability jumps

•  D&O pricing for public companies rose about 6% and 77% of clients saw an increase

•  That is the largest number in several years

Source link: Insurance Journal

Three bills passed out of the House Energy and Commerce Committee aimed at helping reduce the price of drugs. They will remove the barriers pharmaceutical companies have to keep generic drugs from entering the market. The bills also address tactics used by pharmaceutical firms to keep competition at bay and prices high.

They passed on a bipartisan effort with both parties in support. Then the Democrats added some rollbacks to Trump administration’s decisions on ObamaCare. It forced the Republicans to vote no on the bills when they came before the full House.

It passed the package 234 to 183.

Added to the final bill are bans on short-term insurance plans that don’t meet ObamaCare requirements and some marketing and outreach funding designed to help people navigate insurance needs in the ObamaCare exchanges.

Energy and Commerce Committee ranking member Rep. Greg Walden of Oregon said the Democrats have put politics in front of what was — in effect — a bipartisan effort to help the people. “I have to express my regret that the bipartisan work we did … gets paired up with a purely partisan bill they know we had problems with,” Walden said. “That’s disappointing at best and discouraging and unfortunate, because there’s an opportunity to legislate here.”

Walden and other Republicans pushed Democrats hard and asked them to — for the sake of getting real reform done — remove the ObamaCare parts from the legislation and let these bills stand alone.

House Republican Leader Kevin McCarthy of California called the decision “partisan poison pills. They took a situation where we found common ground on drug pricing and transparency … but before they came to the floor, they put poison pills in it dealing with the Affordable Care Act.”

Walden said putting ObamaCare onto the bill means it is less likely the Republican-controlled Senate will even look at it.

The president has been up front about the issue. He supports the bipartisan effort and the decisions to get drug pricing under control but says if this somehow manages to reach his desk intact, he’ll veto.

House Majority Leader Steny Hoyer said Democrats forced the tough decision upon Republicans because they have continued to support attempts to undermine ObamaCare.

“I think, frankly, we have packaged these bills because we think they are all part and parcel of what we pledged to the American people; that is, bringing down prices and making healthcare available at a level that they need to protect themselves and their families,” Hoyer said. “I regret that the administration continues to try to undermine the ACA.”

Source link: The Hill

The World Health Organization (WHO) believes 50 million people on the planet have dementia. Each year 10 million cases are added to that number. Alzheimers is the most common type of dementia.

Aging — the report says and as most of us already know — is not the reason for dementia. It is a combination of factors including health conditions and behaviors. A new report from the WHO released some new guidelines on how to avoid having it happen to you.

The best thing you can do — the report notes — is exercise. Maria Carrillo is the chief science officer of the Alzheimer’s Association. She agrees and says the bottom brain-saving line is keeping yourself in good shape.

She said exercise — not vitamins or medications — is the key to dementia prevention. Since dementia is incurable and different kinds of experimental therapies have failed, Carrillo says exercise is one of the better choices to keep dementia from attacking you.

Plus — as you know — there are lots of other benefits that come from exercise. The National Institute on Aging agrees with WHO and says this is common sense and echoes what it has been saying for years.

Here are some of the benefits WHO and the institute say exercise provides. It helps with:

•  Diabetes

•  High blood pressure

•  High cholesterol

It also helps with an active social life and assists in helping to avoid:

•  Smoking

•  Overeating

•  Alcohol abuse

But does doing those things increase the thinking skills and help with the avoidance of dementia? Probably not. They will — however — aid your general health. That said, the WHO notes eating well does help. This is especially true — says WHO Dr. Neerja Chowdhary — if you eat a Mediterranean-like diet.

Vitamins — like some providers insist — will not help battle dementia. These would be vitamins B and E, fish oil or multi-complex supplements. Chowdhary says they just don’t work.

“There is currently no evidence to show that taking these supplements actually reduces the risk of cognitive decline and dementia, and in fact, we know that in high doses these can be harmful,” Chowdhary said.

Carrillo agrees, “People should be looking for these nutrients through food ... not through supplements.”

The WHO also points to the theory that playing games and other activities will slow down the onset of dementia. For people mildly affected by dementia they might work but not for those at higher risk.

Antidepressants are also not recommended to reduce dementia and its risk.

Source link: Associated Press

Cyber risk is soon going to be the biggest insurance risk of them all.

At least that’s the opinion of the P&C reinsurance firm Scor. Company chairman and CEO Denis Kessler said cyber is going to replace natural disasters for the highest payouts. He suggests developing a comprehensive and common global scale to define the damages from a cyber attack. 

Kessler made the comments at a conference on cybersecurity held by the Bank of France.

“I dream of a kind of Richter scale for cyber security,” he said. “It would be very helpful to have measurement and modeling tools. Unless we can model, it’s very difficult for us to provide coverage. We have scenarios but not modeling tools.”

Kessler said the cost of cyber risks — to date — has been relatively small but it will grow in the future. And grow a lot. The attendees members of the U.S. Federal Reserve and representatives of banks in Europe, Canada and Japan. They all agreed and also agreed that the losses in the future could top $600 billion a year.

That compares to $250 billion presently spent on natural disaster claims.

“The demand for cyber risk coverage well exceeds the supply and this is an issue,” Kessler said and he called for a rebalance, and for more coordination and partnering with authorities “to build databases and a taxonomy to share information.”

During the conference it was determined that the Group of Seven will simulate a border-wide crisis net month. The point is to learn as much as can be learned from the crisis and how to react.

ECB Executive Board Member Sabine Lautenschlaeger asked the financial institutions attending to review their information infrastructures and conduct stress tests and joint exercises.

The point is to improve resilience.

Source link: Insurance Journal