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California’s Painful but Expensive Power Blackouts

Posted By Administration, Tuesday, October 15, 2019

By now, Pacific Gas and Electric’s rolling blackout in Northern California has ended or is close to being done. It caused huge problems for families, individuals and businesses throughout the regions 34 counties that were affected.

The blackout ultimately affected almost 800,000 people.

The reason for the blackout has to do with the state’s annual high winds. They have caused power towers to malfunction and cause the fires that have caused billions in damages and loss of life. During the blackout winds peaked at about 45mph and at the height of the state’s fire season, PG&E felt the blackouts were important.

Important — yes — but ultimately more of a failure than a savior.

PG&E CEO Bill Johnson admitted the company blackout scheme dropped the ball in bunches. The areas he pointed out ranged from poor planning to a website that failed spectacularly to maps that weren’t correct to call centers that were overwhelmed to — worst of all — a failure to provide its customers with resources to help them do without essential services.

“We were not adequately prepared to support the operational event,” Johnson said. “This will improve.”

His comments came after California Governor Gavin Newsom gave Johnson and his company scathing criticism over the poor planning of the blackouts. His criticism started with PG&E putting profits ahead of maintenance of its infrastructure — maintenance that would have made the firm’s towers more resistant to buffeting by high winds.

“This is not, from my perspective, a climate change story as much as a story about greed and mismanagement over the course of decades, neglect, a desire to advance not public safety, but profits,” the governor. “Over the course of years and years and years, the kind of hardening of the grid was not done. Those were decisions.”

From an insurance perspective and a business-loss perspective, the blackouts are costly. The economic impact could hit $2.6 billion. At least that’s the opinion of Michael Wara of the Stanford Woods Institute for the Environment. He said, “If one sums residential and small C&I [commercial and industrial] losses, the total is $2.5 billion in outage costs.”

Wara thinks the residential costs will be about $65 million.

He added that local, smaller businesses are often harder hit than bigger businesses. Larger companies have power generators and other resources that small businesses do not possess or can access.

Though the governor was highly critical of the PG&E blackouts, he did — ultimately — say they are necessary. “The reality is that we want to protect people. We want to make sure people are safe. This is what PG&E thinks is in the best interest of their customers and ultimately for this region and the state,” Newsom said.

Source links: Carrier Management, The Press Democrat, CNBC

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Update — California Department of Insurance & the Los Angeles’ Saddleridge Fire

Posted By Administration, Tuesday, October 15, 2019

This story is fluid. It is being written on Monday afternoon, October 14. At that time the Saddleridge Fire near Los Angeles is about 43% contained. By the time you read this things will have changed. Our hope is that it will have changed for the better.

However, with California’s annual — and very predictable high winds — the picture could have changed for the worst. But at press time, the fire is 43% contained and firefighters are optimistic things will improve in the next few days.

At this point 7,965 acres have burned but all that remains that could cause it to grow is some dry brush. No more homes or other structures are in danger. All evacuations have been lifted.

Officials say 17 structures were destroyed and 58 have been damaged.

California Insurance Commissioner Ricardo Lara worried about how all of this is going to impact consumers. He says even if a home or other structures are not damaged they need to log the costs incurred if they are impacted by the fire. Homeowners — or renters — insurance will help with costs and those costs will not carry a deductible.

“Additional living expense coverage can help ease the financial and emotional toll an evacuation has on affected residents,” Lara said. “It is crucial that residents are aware of all the resources available to them. I encourage evacuees to contact their insurance agent or the Department of Insurance for assistance.”

He said ALE coverage typically includes food and housing costs, furniture rental, relocation and storage, and extra transportation expenses. These are his suggestions and — if you are a California agent — suggestions you may want to save for your clients:

  Keep all receipts accrued during the evacuation.

  Policy provisions, including deductibles, vary by company, residents should check with their insurer or agent as soon as possible to confirm coverage, limits, and any other limitations and documentation requirements. Most renters' policies also typically include ALE coverage.

  Consumer should make sure any insurance agent or public adjuster offering their services has a valid license by checking online with the Department of Insurance.

  Public adjusters cannot solicit business for seven calendar days after the disaster.

  Don't forget copies of insurance policies, important papers and a photo or video inventory of your possessions. An inventory can be completed quickly and easily on your smart phone and safely stored in the Cloud.

Source link: California Department of Insurance

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Stress at Work — 40% Close to the Breaking Point

Posted By Administration, Tuesday, October 15, 2019

Some call it perpetual stress. Or as a study commissioned by Britain’s account support charity CABA calls it — burnout. We’re all familiar with both terms.

This particular study was done on 2,000 working adults in Britain but the results are applicable to just about any industrialized country these days, and is very, very applicable to the U.S.

The study started with the occasional stressful day at work, or more hectic work schedule than usual. It found things have evolved from that to absolutely unbearable. The British study says a huge percentage of workers are at the point where they just can’t take it anymore.

The number — according to the study — is 40% and by the third work day of the week they reach the breaking point. In addition, the average employee will lose five-hours of sleep each week because of job pressure. The study outlines the triggers of that stress:

  The boss — 31 minutes of complaints about them per week

  Overly demanding superiors

  The job — complaints about it for two-hours and 45 minutes per week

  Checking emails from work at all hours of the day and night

  Giving a presentation or a speech

Or to put it another way, 70% of us are so upset that we vent about our work to:


  Romantic partners


  Family members

The study says it helps:

  60% of us report to feeling better after venting

Or to put it yet one more way, here are the top job stressors:

  An excessive work load

  Lack of recognition for work done or accomplishments

  Rate of pay

  The people we work with

  The kind of work we do

  The culture of the company we work for

  Long hours worked

  The excessive amount of work we do compared to other employees

  Difficult clients

  Career path dissatisfaction

You get the picture.

Psychologist Richard Jenkins is one of the authors of the study. “Everyone will experience pressure day-to-day. A level of pressure can actually make us work better, however too much pressure that rises to an unmanageable level leads to stress,” he said. “The working public needs to know how to manage their pressure to avoid reaching boiling point. Some people cope by blowing off steam through physical activity like the gym or going for a run, while for some things like breathing exercises can help. Unfortunately, in many cases we don’t introduce these decompressing moments in our lives which can help release the pressure and reduce stress.”

Here’s the sad part of the study. Almost half of us say we’re stressed at work but we don’t do anything about that stress, or to fix the cause. Of those who did:

  38% say they go to their manager

  51% go for a walk to calm down

Instead of calming down:

  30% of us say we have been pushed to the brink of tears at work

  20% of us turn to alcohol for relief

  31% of us call in sick to avoid stressful situations at work

  14% use their kids as an excuse to stay home

As for the work days:

  Monday is listed as the most stressful

  Thursday is the least stressful

The study also had some comments about vacation. We all know that vacation is the one way we can get away from all those job stresses. Or can we?

  60% of us are even stressed out about taking vacations

  All the work that gets undone and we have to face when we return is the reason

Source link: Study Finds

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Commercial Rates — Continuing to Rise

Posted By Administration, Tuesday, October 15, 2019

Ivans Insurance Solutions tracks insurance rates. The insurance exchange said its third quarter analysis says four of six P&C lines saw higher premium renewal rates when compared to the second quarter.

Looking at the entire year, Ivans said all lines of commercial insurance — except for workers’ compensation — saw price increases. “Quarter over quarter, there was greater variability in average premium renewal rate change,” the report said.

  Commercial rates rose 4.2% in the third quarter

  That’s up from 3.92% average hikes in the second quarter

  Umbrella liability averaged 2.66% compared to 2.59% in the second quarter

  General liability rose 2.51% up from 2.29% in the second quarter

  BOP hikes averaged 4.17% but that’s flat when compared to the second quarter

  Commercial auto rates rose 4.32% just down a bit from the 4.33% of the second quarter

  Work comp fell 2.92%

  The good news is that it’s below the 3.56% drop in the second quarter

MarketScout’s third quarter results were also released last week. Overall, commercial property/casualty rates are up an average of 3% from the second quarter.

  Habitational rose 6%

  Transportation jumped 7.5%

  Commercial auto had a 6.5% hike

  Commercial property is up 4.5%

  Umbrella excess rose 4.5%

  Directors and officers saw a hike of 4.5%

  Business interruption rose 4%

  Professional liability is up 4%

  Workers’ compensation rates fell 1.5%

MarketScout CEO Richard Kerr said, “Liability and other lines also continue the upward trend. Workers compensation rates are still down, but we do see signs indicating workers compensation rates may move up in the fourth quarter of 2019,” he said.

As for accounts:

  Small accounts — up to $25,000 — saw rate hikes averaging 4.5%

  Medium accounts — $25,001 to $250,000 — had hikes averaging 4.5%

  Large accounts — $250,001 to $1 million — saw a jump of 3.5%

  Jumbo accounts — $1 million and up — saw a rise of 3.5%

Source links: Business Insurance — link 1, link 2

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Flood Reforms & Flood-Prone Homes

Posted By Administration, Tuesday, October 15, 2019

As you know, the Federal Emergency Management Agency (FEMA) manages the National Flood Insurance Program (NFIP). It recently released data on the cost of the climate crisis on flood insurance. FEMA thinks as things warm up more and more people will be forced to move away from flood-prone areas.

That could lead to another crisis and that is one the government that cannot afford. It is  — via the NFIP — buying these people out. The fear of some is that the poorest among us will be impacted the most and will end up left behind.

That same data says since 1989 over 43,000 properties in high risk areas have been purchased by the NFIP through FEMA’s Hazard Mitigation Grant Program. Once the homes or other properties are purchased, the structures are torn down. The land is then left open to absorb any waters coming from floods.

A.R. Siders is an assistant professor at University of Delaware’s Disaster Research Center and a co-author of the FEMA study. She said the 43,000 homes purchased since 1989 is nothing compared to problems to come. The potential number of homes that will have to be purchased in the future is daunting.

“There are 49 million housing units in at-risk areas on the U.S. coast, and over $1 trillion worth of infrastructure within 700 feet of the coast,” she said and pointed out that FEMA and the NFIP or the federal government — or whoever — will not be able to handle even one-tenth of that number.

The study also said the nation’s lower income and rural areas have seen fewer buyouts than in areas with higher incomes, higher education, higher populations and population density. These are areas where homeowners can afford to take evasive flood measures like elevating homes and other structures above an anticipated flood level.

An analysis of the FEMA data by National Public Radio (NPR) found a disproportionate amount of money and aid go to white communities. It also found the states with the most flood damage are in Florida, Mississippi and Louisiana. Yet they are in the middle of the pack when it comes to actual buyouts.

The FEMA study also says the size of buyouts has gone down over the years as well and a report from the Natural Resources Defense Council (NRDC) finds that it takes almost six-years for a buyout deal to be completed. That puts many homeowners — especially the poor — into a huge financial bind.

Anna Weber of the NRDC said, “The way that we’re currently dealing with these issues is a sort of unmanaged retreat in a lot of places. That’s just not working for people right now.”

The FEMA study’s lead author, Katharine Mach said most of us aren’t going to just sit by and watch our homes be flooded out. Some take buyouts — she said — and some build levees. Her worry? Parts of the U.S. “might look more like Venice in the future.”

Source link: Insurance Journal, Carrier Management

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A Concern — Drug Prices & Drug Price Profits

Posted By Administration, Tuesday, October 15, 2019

The high cost of pharmaceuticals is big in the news these days. As many of you know, drug costs are high on the minds of the leaders of both parties and as we move toward the general election in November of next year, both parties are ramping up the rhetoric on the issue.

The next election aside, President Trump has made efforts to enact new rules on product advertising and has talked about reducing prices. House Speaker Nancy Pelosi has introduced a new plan to reduce prices. It is a much more aggressive idea than the bipartisan deal being kicked around in the Senate.

Another plan is being pushed by the Blue Dog Democrats. They’re more conservative members of the party serving in the U.S. House. The Blue Dog members want more votes on single drugs rather than on drug prices as a whole.

They also want votes on bills to encourage more cheaper, generic drugs. The plan is called the Creates Act and it aims to keep brand-name drug companies from blocking the much less expensive generics from getting onto the market.

Meanwhile, a report from the Institute for Clinical and Economic Review (ICER) took a look at the rise of the cost of seven very popular drugs in 2017 and 2018. The report found there was no clinic proof that the drugs had been improved at all in terms of effectiveness or safety and did not “provide information different from what was previously believed in order to support a price increase.”

However, those increases — more than two-times the rate of inflation — cost consumers, patients and insurers over $5 billion.

ICER contacted drug companies and the manufacturers gave a rebuttal. They took exception with the methodology used and said the price list does not reflect discounts negotiated with insurers and patient assistance programs. Those prices are often much higher than what is actually paid by patients.

The report, the manufacturers say, also does not pay much attention to the value and benefit the drugs have for those using them.

The ICER looked at the manufacturer argument and disagrees. It said the report is only focused on a per-unit cost. These are the drugs and how much they added to drug spending over two years:

  Humira: $1.9 billion

  Rituxan: $806 million

  Lyrica: $688 million

  Truvada: $550 million

  Neulasta: $489 million

  Cialis: $403 million

  Tecfidera: $313 million

Source link: The Hill

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Around the PIA Western Alliance States

Posted By Administration, Tuesday, October 15, 2019

California — Work Comp Savings: The California Workers Compensation Insurance Research Bureau (WCIRB) took a look at what the Legislature enacted in 2012 to reform the state’s workers’ compensation system. The bill — SB 863 — passed in 2012 and took effect in 2013 and 2014.

A report issued last week said since then it has saved the system $2.3 billion annually. That’s 12% of the total loss and loss adjustment expense cost. Reforms in how medical providers and the work comp system interact has caused pure premium rates to drop over 40% and today the average premium rates are the lowest in 40 years.

Source link: Business Insurance

California — Texting While Driving: Governor Gavin Newsom has signed Assembly Bill 47 into law. It passed both houses of the Legislature last summer by a unanimous vote. The new law says drivers caught texting or holding a cell phone while driving will — if they have had a similar conviction in the last 36 months — get a point added to their driving record.

Statistics say 10% of all traffic deaths in California are due to distracted driving. The law goes into effect on July 1, 2021.

Source link: Sacramento CBS 13

Washington — The Individual Health Market: Washington Insurance Commissioner Mike Kreidler has approved a record low average rate decrease of -3.25% for Washington’s 2020 individual health insurance market. Two new health insurers —  PacificSource Health Plans and Providence Health Plan — are also entering the market.

“Despite the Trump administration’s effort over the last two years to sabotage the Affordable Care Act, the record average rate decrease and interest by insurers is evidence that our market is stabilizing,” said Kreidler. “We have more work to do to lower the cost of health care and to help lower out-of-pocket costs, but more choice and lower premiums are welcome news.”

Open enrollment for the individual market runs Nov. 1 - Dec. 15. Consumers can shop for plans in Washington's Exchange (www.wahealthplanfinder.org).

Approximately 248,000 people who don’t get coverage from their employer must buy their own health insurance through the individual market, with most shopping on the Exchange. In Washington, 65% of people who buy plans on the Exchange qualify for subsidies that help lower their monthly premiums.

You can find a table of the insurers working in Washington and their rates and the rate changes by clicking the link below.

Source link: Washington Department of Insurance

Washington — From the Department of Insurance: CR-102 Title insurance agent escrow practices proposed rule posted.

We have released the proposed rule language on R 2016-05. The rule is to adopt rules similar to the Department of Financial Institutions, regulating the escrow practices of title insurance agents.

We scheduled a public hearing on the rule:

When: Nov. 15, 2019 at 9:00 a.m.

Where: Office of the Insurance Commissioner: 5000 Capitol Blvd SE, Tumwater, WA 98501

Comments on the proposed rule language are due Nov. 15, 2019; please send them to rulescoordinator@oic.wa.gov.

For more information, including the proposed rule language (CR-102), please visit the rule's webpage — https://www.insurance.wa.gov/title-insurance-agent-escrow-practices-r-2016-05?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

Notice of rulemaking on prescription drug utilization management (R 2019-11)

We are starting rulemaking on (R 2019-11). The Legislature passed ESHB 1879 during the 2019 session. It requires health carriers and prescription drug utilization management companies, which restrict prescription drug coverage through utilization management protocols, to provide the patient and prescribing practitioner access to a clear, readily accessible and timely exception process. It also requires utilization management protocols to be evidence based and creates requirements and timelines for step therapy exception requests. The Office of the Insurance Commissioner will develop rules to establish how the notice to participating providers would be given the standard process requirements and external review options.

Comments are due December 31, 2019; please send them to rulescoordinator@oic.wa.gov.

For more information, including the notice to start rulemaking (CR-101), please visit the rule's webpage — https://www.insurance.wa.gov/prescription-drug-utilization-management-r-2019-11?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

General Filing Instructions R 2019-06 proposed rule posted

We have released the proposed rule language on (R 2019-06). The rule is to revise WAC 284-38, WAC 284-44A, WAC 284-46A, and WAC 284-58 concerning the electronic filing of forms and rates. The intent is to harmonize the structure and wording of these WACs and incorporate requirements for plan management documents (binders) for health care service contractors, health maintenance organizations, life and disability carriers and charitable gift annuity filers.

We scheduled a public hearing on the rule:

When: November 6, 2019 at 01:30 pm

Where: Tumwater Office: 5000 Capitol Blvd SE, Tumwater, WA 98501

Comments on the proposed rule language are due Nov; please send them to rulescoordinator@oic.wa.gov.

For more information, including the proposed rule language (CR-102), please visit the rule's webpage — https://www.insurance.wa.gov/revise-wacs-concerning-serff-general-filing-instructions-r2019-06?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=


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A Special Story — Washington’s CSR of the Year

Posted By Administration, Tuesday, October 15, 2019

Neely Lorimer, CISR Elite

Neely Lorimer, CISR Elite, is Washington’s CSR of the Year. Do read on. And do, if you feel so moved, reach out to Neely and congratulate her. Why? Because Neely’s is a very, very special story.

To start with, her job title is Client Executive for NFP Property & Casualty in Longview, Washington. As you know, titles don’t mean much to clients. What clients want is someone to give them the best possible advice and to take care of them when a crisis happens.

You already know that.

Here’s what makes Neely so special. In her essay for the award, she said, “I approach every transaction with one thought, ‘Is this how I want my mom to be treated?’”

Things go forward quite positively from there.

Deanna Snow, CISR, works with Neely and nominated her for the award. She is one of 11 people who sent letters along with her nomination form. Eleven letters of recommendation! As anyone who knows the nomination process for CSR of the Year awards or any other award, 11 is an almost impossibly high number.

That, however, doesn’t surprise anyone who knows Neely.

In her letter Deanna Snow said, “Her dedication and her passion for insurance baffles a lot of people (even those she words with, or around). She feels she has been called to serve others — and she uses insurance as a tool to fulfill her calling.”

Insurance as a calling? Insurance as a life philosophy? Deanna Snow clarifies.

“Insurance is never ‘just a job’ for her. She wants to continue to grow while selling insurance. She wants to educate and encourage those who she comes in contact with, while doing her job. She treats all people the same — no matter what station of life they are in. Her ability to connect with others crosses all generational lines. When a person is sitting at her desk, they are the most important person to her, and she wants to bring some light and happiness to them — along with an insurance policy.”

A lot of you have that same philosophy. And that’s a good thing. That praise also brings us back to Neely’s mother.

“This may sound odd; however, it really works for me,” she said. “I want my mom treated with respect, dignity and care. I want her to be given a little extra attention when she is with any professional. I want someone to recognize she can’t reach to the top shelf (she is only 5’ 4”) and extend a helping hand. I want her to know that there is care and concern in the world — for her specifically.”

That means Neely’s customers — and mother — get a lot of extra, and much needed attention. “Do I want her to be surprised that she purchased a policy with a $1,000 deductible? Do I want her to find out she could have had roadside or rental reimbursement coverage for just a few more dollars a month? Do I want her to find out the hard way that uninsured motorist coverage is not really considered ‘full coverage?’  Of course not. So, I don’t want any of my clients to go through that either,” she said.


NFP Staff honoring Neely

This is where this story goes from, I’ve seen and read stories like this before to something very, very special. And it starts with Neely’s supervisor, Lesa Givens, CIC.

“She believes that she was put on this earth to make a difference in the lives of people, and she has committed to doing so through the world of insurance,” she said. “I have had the privilege to manage many top professionals in this business, but in all of my years, I have never seen a person go quit as far above and beyond as what Neely does. Every. Single. Day. In good days and bad, she ALWAYS puts others before herself, keeps a positive attitude and never quits on a situation until she finds a resolution.”

That takes us from Neely’s mother to Neely’s clients and the importance of her calling to serve.

“We can provide insurance for many different areas in their lives, but we can’t insure against heartache, bad health, loss of loved ones, etc. We can provide a moment of our time to listen, share their current emotion (sadness, sorrow, anger, joy, delight, enthusiasm, etc.) with them,” Neely wrote in her essay. “Insurance products are all basically the same with every company (some exceptions apply); our clients build a relationship based on trust and care. I hesitate to call this a technique or tool.  I feel that takes away from the truth of the caring. I genuinely care.”

That generates trust and that trust leads them to share their life concerns and their life cares with Neely. 

“I help them to talk through these. Many times, it leads to a new policy or policy upgrade/change. We can’t insure all of life’s situations, I know that and so do they, but we can talk about what can be and what won’t be covered,” she wrote. “We can talk about what is new and exciting for them. Mostly we can walk together in this life to make them feel more secure. It is my intention to make a difference each and every day.”

Beautiful words which leads us to Pam Busch. She is the Director of Education for the PIA. Pam attended a luncheon in Neely’s honor in September where she was surrounded by her peers.

“When Neely received the CSR of the Year award in 2010. I remember being the one to call her and congratulate her,” she said. “I wasn’t sure what to expect when she submitted her application and essay for this year’s competition. Surely, she wouldn’t win again!!!  But, not only did she win, she was a top five national finalist. Neely emailed me to tell me the good news and my response was a very professional, ‘What? Shut up!’”

In other words, “In reading through her essay, and reading her letters of recommendation, it is clear to me why she was selected as the winner for our state and became a finalist.”

It is also clear to me, Gary Wolcott, the editor of Weekly Industry News and the author of this story. Neely Lorimer — like you — I believe we were put on this planet to serve one another. It is that love of service that leads many of us into the industry of insurance.

Though I only write about insurance, service like yours — and people like you — are also why I have fallen in love with this business. I have met so many people like you in insurance; people who are in the industry to help make people whole at some of the darkest times of their lives.

However, Neely, you on this day are the best of them all. I — and this publication and the PIA Washington/Alaska — congratulate you on this much deserved award.

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PIA Montana & IIAM Annual Conference

Posted By Administration, Tuesday, October 8, 2019

The fourth annual Montana Joint Conference is here!

Montana agents and company personnel are headed to Bozeman on on Thursday October 10th for two days of all things insurance. The conference is at Bozeman’s Best Western Plus.

This is a joint effort hosted by PIA of Montana and Independent Agents of Montana (IIAM). 

Like year’s past — and all agent conferences sponsored by the two associations — the joint conference is for agency principals, producers, support staff and carrier representatives. The two-day affair has workshops, motivational speakers, continuing education and discussions designed to engage and inspire all that attend.

Plus it is the largest insurance gathering and trade show in Montana.

Click here to open the agenda.

One of the highlights of the conference is the annual awards luncheon:                

Former National Football League player Beasley Reece is our speaker. He spent nine years in the National Football League, is currently the CEO of the NFL Alumni Association and has been honored with five Emmys for sports broadcasting.

In addition, Reece has also been inducted into the Broadcast Pioneers Hall of Fame.

He brings with him — in his presentation — a unique form of expertise in the setting and achieving goals.

On any personal or professional path, life can change in an instant. In Beasley Reece's case, that change was inspired by Old Jim who worked on his family's farm. Their connection set Reece's career, and life, in motion.

Old Jim might change your life, too. Join us for Lunch on Thursday and find out how:

  To nurture laser-focused motivation to achieve goals

  To use that motivation to work toward success every day

  To find success in highly competitive environments

  To react to failure

Check the agenda for the luncheon schedule and for the CE class schedule.

Click here to open the agenda.                

Click here to register.

Click here for more information on the entire conference.

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Finally — California’s Mercury Insurance Settlement

Posted By Administration, Tuesday, October 8, 2019

California Insurance Commissioner Ricardo Lara said the California Department of Insurance and Mercury Insurance have settled their long-time dispute and feud. It took two decades and ends up as the largest P&C insurance settlement and payment in the state’s history.

The settlement total is $41 million.

It took close to 20-years and the dispute between the department and Mercury ended up before the California Supreme Court. The insurer says early decisions on the case ruled in its favor and wanted the court to look at those reversals.

The judges refused.

Originally the penalty was $27.6 million. Interest racked up another $8.1 million. And then there was a second issue of $5.4 million that hasn’t gotten to court yet. It involved false advertising claims and Lara said the department was considering prosecuting under the Unfair Insurance Practices Act.

“Today is a testament to the tenacity of the Department of Insurance team who won this in court and kept the pressure on Mercury, which profited by skirting the law and taking advantage of consumers,” Lara said. “This was a hard fought legal battle to protect consumers, defend Proposition 103 and make sure all insurers play by the rules in California. No insurance company is above the law.”

The Mercury issue started in 1998. The California Department of Insurance accused Mercury of telling its agents to represent themselves as brokers to their clients. That — Lara said — implies that the agents work for consumers and not for Mercury. It also allows the agents to collect fees from their insureds for the services a broker would provide.

This happened — the department notes — on 180,000 transactions that took place between 1999 and 2004. The commissioner said Mercury also — during that time — advertised that it offered lower rates than the competition but failed to disclose those illegal broker fees.

The department said those fees and the profits from them encouraged — even pushed — agents into placing more policies with Mercury. Not knowing about the extra fees, the consumers that picked up Mercury policies might have saved money if they purchased insurance from other insurers.

Mercury is also accused of using unapproved fees to unfairly push competitors out of the auto insurance market. “Mercury’s illegal actions misled consumers and undercut competitors, which gave them an unfair advantage in the insurance marketplace,” Lara said.

As for the false advertising. Lara said in its marketing efforts Mercury advertised that its premiums were lower than the competition when their premium rates were actually higher than they advertised. That’s — again — because of the illegal fees charged by the agents placing the business.

Mercury disagrees with the department’s accusations and issued its own statement.

“The Superior Court of California resoundingly ruled in Mercury’s favor on three different grounds,” the statement said. “This ruling was later inappropriately reversed by the appellate court, but we have decided to settle this case so that we can move forward to focus on providing California consumers the tremendous value they’ve come to expect for the past 58-plus years from Mercury.”

The Mercury’s statement also defended itself against the department’s accusations:

  The Court of Appeal, in an unprecedented and poorly-reasoned opinion, reversed the Superior Court’s decision, allegedly because the Superior Court did not give proper deference to the Commissioner, even though the Superior Court expressly acknowledged its requirement to give a “strong presumption of correctness” to the Commissioner’s findings.

  In spite of that presumption, the Superior Court found that the Commissioner’s allegations were not supported by the evidence and ruled in Mercury’s favor.

  Without justification, the Court of Appeal disregarded the trial court’s findings and reversed the judgment.

  Although appellate courts are required to uphold a trial court’s factual determinations if they are supported by substantial evidence, the Court of Appeal here ignored that standard of review: Instead of remanding the case back to the Superior Court to confirm that proper deference was given to the Commissioner, the Court of Appeal simply stepped into the trial judge’s shoes and substituted its own factual conclusions.

  Although Mercury and the California Superior Court agree that Mercury did nothing wrong, Mercury has decided to put an end to this 20-year-old plus dispute in the best interests of its customers, employees and other stakeholders.

  It’s also important to note that the fees at the heart of this dispute were charged and collected by independent brokers for the services they provided to their customers. The fees were disclosed upfront and customers agreed to pay those fees, and no portion of these fees was ever collected by Mercury.

Of the $41 million paid by Mercury, $36,227,000 of the penalties and interest will go into the California General Fund. The $5.4 million from the advertising issue will go to the Proposition 103 Fund.

Lara said the return of the $5.4 million to the Proposition 103 Fund means that Mercury Insurance — and not ratepayers — paid for the prosecution of the case.

“This historic settlement shows the Department of Insurance is steadfast in its fight to protect consumers, defend Proposition 103 and make sure insurers play by the rules,” Lara said. “When something sounds too good to be true, it usually is. Mercury made profits by ignoring the rules, and in California no insurance company gets a free pass.”

Source links: California Department of Insurance, Insurance Journal

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