Monthly Archives: October 2017

Benefits of Health Insurance to Individual and Families

Health insurance provides compensation to the insurers when they unexpectedly face health problems and urgently need financial assistance. Health insurance covers most of the medical expenses that are required at the time of hospitalization, follow-up, diagnosis, consultation and different medical exams. Health insurance agencies may be publicly owned privately owned or may be owned by non-profit institutions but all these organizations provide insurance policies for individuals or groups. Health insurance may be a program sponsored by a company to the employees or even an individual may create an health insurance policy for him and his dependents. Many developed countries provide health insurance assistance to the public through their programs sponsored by the government such as United States Mediaid program. The insured should pay some expenses to get the coverage and benefits such as fee, deductibles, premium and some out-of-pocket expenses.

The concept of health insurance was founded by Hugh the Elder Chamberlin in 1694 due to the frequency of accidents that took place. He observed that how people turned physically disabled due to the accidents they came across. Initially health insurance was the claim paid when the accidents took place and coverage for medical treatment was required. Health insurance earlier was known as accident insurance. Some companies such as Franklin Health Assurance Company operated at that time to provide claims to the insured against the rail or road accidents or steamboat accidents. Gradually health insurance companies introduced policies that covered the costs for sick patients, follow-up, diagnosis, and other medical examination. During the 1920’2 many such insurance companies began to operate.

There are many concepts of health insurance that a person should know before creating an insurance policy. Everybody knows that health insurance is a contract between an insured and an insurer. The insurance policies that are created may be for long-term or short-term.

An insured should pay a certain amount of fee to claim in the future which may be monthly, quarterly or yearly to receive the benefits in the future known as ‘premium’. The insured should also pay certain amount form his own pocket up to a certain limit when he attends the clinic, undergoes examination, treatment or diagnosis before receiving the benefits of his policy which is known as ‘deductible’. The amount that should be paid as deductible is decided by the company at the time of signing the contract. The insured should also pay a certain amount every time he follows to clinic which is known as ‘co payment’ before receiving the insurance benefits. In order to treat the dependents of the insured the insured pays to the insurer a certain fee known as ‘capitation’. Some companies provide a document to the hospitals that they shall pay a certain amount as compensation to the insured and hence the hospitals should treat the patient considering the payment made from the insurance company which is known as ‘prior authorization ‘.

Insurance plans may be comprehensive or scheduled. Comprehensive plans are fixed proportion of fees that are paid to the hospitals after the patient pays the deductibles. The comprehensive plans are paid in lump sum amount. The scheduled plans are the plans that are paid by the insurance companies to the insured for meeting the routine expenses related to hospital care such as money for prescription etc.

Mainly there are two types of health insurance. One of them is Fee for service and the other one is Managed care. The two policies are different from each other and also similar from each other. Under ‘Service for Fee’ plan, the patient visits the doctor for check-up or other routine follow-up and files the fees to be paid to the clinic. The medical service organization may also file the fees that are to be paid for providing service to the patient. Under Managed Health care there are mainly three types of plans HMO, PPO, POS. Many schemes are available for the three type of plans. These plans may be comprehensive or scheduled.

Under HMO plan the insured has a wide choice to choose his own physician or a medical organization. In most of the HMO plans the insured should pay a certain amount of fee before availing service from the medical professional per visit known as ‘co payment’. Most of the expenses are incurred by the patient before receiving the coverage and the patient should pay for lab tests also. Under the PPO plan the doctor is not preplanned, the patient signs a contract with the hospitals and the hospitals charge less fee from the insurance providers. Certain points should be considered before choosing for PPO network such as the doctors who are covered under PPO, hospitals which have introduced PPO plan, etc. Under the POS plan the doctor is chosen from a network of service providers who are covered under POS plan. Your doctor is referred by the insurance company and you should avail services from their company only.

Many residents in U.S. today have chosen the short-term insurance policy. Nearly $1-2 million dollars is spent for short-term policies. The short -term policies are renewable and are more flexible. The tenure of the policy ranges from one month to twelve months. Long-term policies also provide many benefits and cover many costs but they are costly. Hence many people prefer to buy short -term policy.

Tips Starting a Small Business Insurance

Your Company and those like it is the anchor of this country. Almost all people assume large companies create most of the revenue the United States produces, although they just don’t understand in total Small Businesses hire a lot more people and produce even more income compared to those large companies. When you start your own business there are lots of elements you’ll want to consider within your business strategy plan. An Insurance policy mitigates your risk, small business insurance is just about the most important factors within your strategic business plan. When looking in to Business insurance packages, there are many kinds of insurance you’ll want to check into and now we can look at the various insurance policies. While we will look at insurance coverage’s that are based upon many types of businesses, you might want to speak with an experienced insurance agent with regards to your businesses requirements.

Commercial General Liability

This is the first protection you will want to take into consideration because it is on the list of needed insurance policies it is possible to acquire. The following insurance policy coverage that defends your company for both bodily injury and property damage claims. This means that this protects your company for accidents that your fault, and insures your company for scenarios when an individual or property is broken and / or wounded. Every business enterprise will need to have this particular coverage because this will handle many types of claim instances. This particular policy defends your business for libel and slander as well as slip and fall incidents. This type of coverage does insure you for several claim circumstances, it doesn’t cover them all. The types of insurance not covered under your standard liability policy are; Liquor Liability, Assault & Battery, Commercial Property, Workers Compensation, Professional Liability or Business Auto. The coverage limits for this type of insurance policy goes up to one certain limit and for a limit on top of it, you will need an Excess Insurance Policy. An Umbrella Policy may also go over your Auto Liability as well as your Workers Comp coverage increasing those limits of liability. When deciding just how much Liability Insurance you must consider what amount you have to lose.

Small Business Property Insurance

Now you have a policy coverage which can protect you for both the building you own as well as the property inside of it. Generally, the following coverage plan covers the Building and/or contents for many kinds of incidents such as fire. This coverage doesn’t insure property that leaves the premises, for that you’d need an Inland Marine insurance. An Inland Marine policy can cover small equipment to large construction tools or all kinds of other kinds of Property that would be removed from the businesses premises.

Small Business Auto Insurance

This coverage is auto insurance for your business autos. Typically a small business requires increased coverage limits of auto insurance compared to your own personal auto policy. Your small business auto policy would have increased limits of liability coverage, but the insurance coverage’s are relative. Your typically looking at liability insurance coverage along with the following; Medical Payments, Uninsured Motorists coverage, Comprehensive, Collision, Towing & Rental Coverage. If you ever rent an auto or your have a staff member drive their own personal automotive on an errand, you need to have Hired & Non Owned Auto Liability. Whenever your LLC or Corporation owns the vehicle, then you should make sure the autos are insured on a Commercial Auto Insurance policy.

Workers Compensation

This particular insurance coverage, also known as Employers Liability, would be the coverage which protects the employees and can pay for claims in which any employee was hurt on the job. Yet again, yet another critical coverage considering that Medical Treatment is incredibly costly. Without having insurance you’re self insuring and you will be liable for just about any healthcare expenses or law suit. This coverage does not cover discrimination or sexual harassment claims for that you’d will need an Employment Practices Liability Insurance.

Insurance is an important part of any Organization. It protects your business for various kinds of claims. It’s important for you to understand just what you are getting, in which area’s this insurance will cover you, and just what is not insured within an insurance policy. Make sure to always understand your policy. Insurance are generally complicated knowing that is the reason you really need to buy from an insurance broker that’s versed in Small Business Insurance. Having been providing business owners like you insurance for more than 35 years, we have the experience to help you with all of your Small Business Insurance needs. Contact us for an insurance quote. We write insurance in several states and we can easily help you get the insurance coverage you may need.

The Value of a Great Insurance Agent

For many people, finding a good insurance agent is just as cumbersome as finding good insurance: if you try to handle it yourself, you struggle in an effort to find a diamond in the rough and you end up with buyer’s remorse. But there are no agents for finding insurance agents: finding the right one is up to you. Whether you’ve recently moved, recently bought a car, or simply need someone fresh, if you’re reading this it means that you’ll have to acquire some insurance in the near future. And you need to know that you’re working with someone you can trust.

So what’s someone who doesn’t have a lot of experience in buying insurance going to do? Well, there’s the typical, easy route of looking up insurance agents on Google and placing a phone call to the person who ends up at he top of the list. But Internet rankings aren’t enough to guarantee you both the best price and the best quality of coverage: if you want to find an insurance who can really help you out, ten it’s time to put a little effort into it.

But you won’t by shooting darts in the dark. In this guide, we’ll tell you all about finding insurance agents – what to look for in an in-person meeting, how to find ones with less traditional means, etc. – and you’re going to find the best quotes whether you’re looking for health insurance, car insurance, life insurance, or something else.

Of course, while you can’t do this sitting on your butt, we hope you’ll take the time to check out this buyer’s guide to insurance agents. The best way to read it is to keep a pen and paper handy so that you can write down the key points you hear and anything else that strikes you as something you’ll want to keep in mind. Keep reading and in no time you’ll be ready to find a few insurance agents that are looking to provide you with a deal – not just add to their bottom line.

What makes a good insurance agent?

Being an insurance salesman doesn’t always have a great connotation. It can be like a career in law: even though you might have a noble profession, you can find yourself to be the butt of a lot of jokes. But insurance salesman don’t have to resemble used car salesman: many are looking out for their customers and use their people skills to find deals that benefit both parties. This is what you want to find.

If you want to find it, of course, you’ll have to know how to recognize it. So here are a few tips for finding an insurance agent that is actually looking out for you.

    • The aforementioned “good deal” test. Come to your insurance agent well-prepared and ask them what they can do for you considering the deals you were able to find on your own. A good, creative insurance agent looks at this as a challenge rather than an insult and will be willing to work with you to find something from their insurance provider that works for you. You’d be surprised how many insurance agents will actually pass this test – after all, insurance salesman are looking to make a sale. It doesn’t really matter to them what kind of insurance you get as long as you make a purchase. Some insurance salesman might be a little pushier and try to get you to commit to more than you wanted, but don’t be surprised to see that many insurance salesman know that a small sale is better than no sale at all.
    • Word-of-mouth reviews. Google reviews are too up-and-down to take too seriously; instead, worry about the word-of-mouth reviews that you can find from people you know. Ask around the community you live in. Ask people you know. Find the best insurance agent through the best marketing method known out there: word-of-mouth marketing. Try to get a review or two rather than simply rely on one person’s views – then act upon what you keep hearing from other people. If you find a really good insurance agent with this method, you’ll find that it’s almost impossible for them not to deliver the goods.
    • Find quotes first. Sometimes, an insurance salesman won’t exactly wow you, but they’ll be the ones to make your signup to an insurance policy as smooth as possible. When you find the good quotes first, this is all you really need from an insurance agent. That’s the kind of forward-thinking you’ll want in your quest to find the right policy for you, but remember: an insurance agent still can help you out. Don’t assume that you’ll have to get with their program before you sign anything. Make sure they get with your program. Tell them what you need and what it would take for you to consider leaving another quote behind and signing up with their policy.
  • Pay attention to how the insurance agent interacts with you. When an insurance agent seems too eager to sign you up without asking the types of questions that would need to be answered to find your ideal policy, then you know that your insurance agent is in too big of a hurry to make the sale. This isn’t necessarily the worst thing in the world, and many good insurance agents can make this mistake, but you’ll have to be the one to correct it. Don’t let an insurance agent talk you into a policy simply because they act like they expect you to sign. A good insurance agent will be able to close the deal without being pushy; they’ll be action-oriented while taking your individual considerations to heart. Pay close attention to how an insurance agent deals with you and you’ll get an idea of how they’ll treat you down the line, too.

Obviously that’s a lot of information to absorb. But if you remember the key points about being able to find a good insurance agent you should have no problem sticking to a few of the strategies listed above. Remember that action is just as important as knowledge: unless you act on these tips, you can’t really be sure they’ll work or not!

With over 25 years of experience in the financial services industry, Vicki truly enjoys helping people. She started in the banking industry, working her way through the ranks for eighteen years. As she became more interested in planning and saving for retirement, she worked at a financial brokerage company for ten years. Vicki works independently where she focuses most of her time creating, protecting and enhancing wealth for individuals and families. She continues to keep up with tax laws and training, in annuities, life, and long term care insurance. She is especially passionate about helping families with asset protection, as she feels that many people do not always know all of the options available to them. Vicki also helps seniors navigate through their many healthcare options; she works with various private Insurance companies who offer Medicare Supplements and/or Advantage Plans.

Vicki and her husband love working and playing outdoors and especially enjoy traveling. If you are in need of some sound financial planning, with a friendly, personal touch, give Vicki a call. Integrity is of foremost importance. You can be certain that she will listen to your concerns, and provide a plan, so you can rest easy knowing your financial future is being taken care of.

nsurance Claims in North Carolina

Most people in North Carolina have some sort of insurance. By law, persons operating vehicles are required to have liability coverage. The owners of the cars might also have collision coverage. Most homeowners have homeowner’s insurance, and many renters have renter’s insurance. Many people also have health coverage, whether provided by their employer or purchased directly by the individual. Businesses often have a general liability policy. These and other policies give rise to numerous claims and numerous insurance disputes every year in North Carolina.

Governmental supervision: Insurers are subject to oversight by the North Carolina Department of Insurance (“DOI”). A consumer (or “inured”) can file a complaint against an insurer with the DOI. The DOI is not likely, however, to become heavily involved in a routine dispute between an insured and the insurer. Many statutes (within Chapter 58) regulate the insurance companies, as well as regulations promulgated by the N.C. DOI.

Terms of coverage: The scope of coverage afforded under an insurance policy is determined primarily by the terms of the policy, and also by the applicable North Carolina General Statutes and any regulations by the DOI. When disputes are litigated in the courts, any precedential cases will also affect the interpretation of the policy. Health (and other) policies subject to ERISA may be subject to federal law, which preempts state law.

Duties during claims handling process: Policies typically have provisions that give various rights to the insurer in the claims-handling process. The insured often must submit a “proof of loss” form, in which the loss is described to the insurer. The insured often must produce documents, and must submit to an “examination under oath,” at which the insurer’s lawyer can ask questions of the insured to investigate the claim. If the insured fails to comply with these provisions, then he can lose coverage. (Duties of the insurer are addressed below, in connection with the insurer’s potential liability for bad faith and treble damages.)

Resolution of the claim outside court proceedings: Some aspects of the insurance claim might be subject to arbitration or appraisal (rather than court action). For example, the standard fire insurance policy in North Carolina, governed by statute, provides that the parties can use an appraisal process to value property (N.C. General Statute 58-44-16). A standard underinsured motorist policy in North Carolina contains a provision which allows the insured to demand arbitration.

Resolution of the claim in a court proceeding: Where, however, the insurer and the insured cannot agree on coverage, and the dispute is not subject to arbitration or appraisal, they might have to take their dispute to court. The insured can file a lawsuit for breach of contract, and the insurer can file a suit for declaratory relief. In North Carolina, such suits are often filed in Superior Court in state court. They can also be filed in (or removed to) federal court if diversity jurisdiction is met. (There have, however, been a couple of decisions in our Circuit rejecting such disputes on the abstention doctrine.)

Punitive Damages: In addition to seeking to recover the amount due under the insurance policy, the insured can also pursue a claim for “punitive” damages if the insurer denied the claim in “bad faith.” Punitive damages in this state are governed by statute, and also by case law addressing this claim. According to one case, the insurer is not liable for punitive damages if its position is “neither strained nor fanciful.” Punitive damages are capped by statute in North Carolina, to the greater of $250,000 or three times the actual damages (whichever is greater).

Treble damages for Unfair Conduct: The policyholder can also assert a claim to recover “treble” (i.e. tripled) damages where the carrier’s conduct is unfair or deceptive. Such a claim is often based on the insurer’s violation of a provision in the statutes mandating that insurers handle a claim in various ways, including that they conduct a reasonable investigation, promptly investigate the claim, and provide an explanation of the denial to the policyholder. (N.C. Gen. Stat. 58 63 15.)

Coverage disputes in North Carolina can quickly become very complicated, and the policyholder and often the insurer may need the services of an attorney experienced in insurance matters.

Attorney John Kirby has represented many persons insured and many insurance companies in insurance disputes in North Carolina, both in federal and state court, and before the North Carolina Court of Appeals and the North Carolina Supreme Court. He has also taught continuing education seminars, to attorneys and to insurance professionals, on the topics of insurance coverage and litigating bad faith suits against insurers.