Monday, October 19, 2009
Written by: Lisa Matthys
Senator Dick Durbin of Illinois is pushing Congress for an extension of unemployment insurance benefits. With more than 1.3 million Americans, 50,000 in Illinois, set to lose their benefits by the end of the year if the extension is not approved, this matter should not be taken lackadaisically. The proposed extension will provide benefits for an additional 14 weeks for jobless workers in all 50 states, and would add 6 weeks of insurance for jobless workers in states with an unemployment rate above 8.5%.
However, recent efforts to extend the unemployment insurance have been blocked by the Republican Party because of how the proposed bill is to be funded. The Democrats’ plan would use an expiring surtax on businesses, whereas the Republicans want to use unspent money from the stimulus bill.
With an ever increasing rate of unemployment in the United States, something needs to be done fast as many Americans are already without unemployment insurance benefits mostly because they have termed. With jobs at a scarcity, the Senate needs to quickly determine an appropriate extension for unemployment insurance that is not only effective in helping citizens but also agreeable by both parties.
Sunday, October 18, 2009
By Michael Rivezzo
Investigators say criminals, prominently mafia members, are becoming attracted to Medicare fraud.Unlike the traditional con, the money is good and prison sentences normally run shorter than other traditional crimes like robbery and dealing drugs.
Criminals are scamming the Medicare system by typically billing Medicare for medical equipment and drugs that patients never receive and do not need. They also are involving some of the homeless in L.A; by paying homeless people for social security numbers and also using them to file fake reports for Medicare expenses.
Mafioso's across the country are committing dangerous acts to cover their tracks. Federal investigators are being threatened, in once case, a informant's body was found punctured with bullets. No one has been able to say how many violent crimes are tied to Medicare fraud because most of the crimes are usually carried out by someone within the hoax who attacks another person also taking part in the crime.
By: Jim Bassett
Posted by: Michael Rivezzo
The first thing you do when you purchase your first car is to look for the best insurance quote. Car insurance quotations will be needed, even when you are buying your second car, you will look for an insurance quote that is better than the previous one. Looking for an insurance quote and finding one is not a hard task. You can just enter the keyword "car insurance quotes "and the search engines will come up with a list of insurance quotes from many companies. The hard task is finding the best quote or the cheapest quote.
We live in a fast world and we rarely have time to research and go through the loads of websites. Most people will usually choose the first insurance company they find on the internet or which somebody refers to them. Sure, if your friend or work colleague is using an insurance policy from a certain company, we would ask them and opt for it as soon as possible.
We do not want to waste time. We just want to get what we are looking for at once. Some insurance companies may be popular than others, but we do not take the time to analyze the pros and cons of the companies. We just go with the crowd. The philosophy is "if everybody likes it, then it's good for me".
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Posted by: Lisa Matthys
Written by: Shamara Riley
One of the arguments that has been made by supporters of President Obama's health care reform plan is that a government requirement for individuals to have health care coverage is comparable to state requirements that drivers have car insurance. One must possess insurance to drive on the nation's roads, they say, so should it be for health insurance.
However, the analogy does not quite work. Nowhere in the Constitution does the federal government have an enumerated power or responsibility to mandate health care insurance. It's not outlined in Article I, Section VIII of the Constitution, nor in any subsequent amendments. Thus, the health care coverage issue belongs to the states and the people, as per our 10th Amendment, which states: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."
Aside from the potential unconstitutionality of a health care mandate on individual liberty, an individual can opt out of paying for car insurance by not driving a vehicle. Living in a big city like Chicago, I find that public transportation pretty much handles my daily travel needs. I prefer to spend my money on other priorities. In addition, the priorities of health insurance and car insurance are different. Unlike health insurance, the often-standard liability insurance is designed to protect other people from negative results of your driving actions.
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By Adam Lindheim
John Reid who is a retired businessman had just returned from a cruise to the Caribbean with an infected toe. As a diabetic he knew it was something he needed to have checked out immediately. The first doctor he saw in the emergency room told him he had to have the toe amputated right then, and scheduled him for surgery instantly. Reid was not content with the doctors recommendation and demanded he see a more senior doctor for a second opinion. The head doctor recommended a treatment plan of intravenous antibiotics and physical therapy. This treatment plan was more expensive and time consuming than the amputation, but Reid firmly believes because he is an African American the junior doctor was quicker to recommend a cheaper and more drastic treatment. Dr. Norm Oliver, director or the University of Virginia Center on Health Disparities as well as numerous studies have proven that white physicians carry unconscious biases against Latinos and African Americans. This is issue have proven even more controversial with child care.
Cincinnati Children’s Hospital Medical Center, researchers analyzed data on 818 chest-pain related emergency department visits made by children and teens included in the National Hospital Ambulatory Medical Care survey between 2002 and 2006. They found that 71 percent of white children were given either an EKG, chest x-ray, or a complete blood count, compared with 59 percent of black children. This translated into white children being 1.6 times more likely than black children to recieve testing for chest pain. This not the first time studies about this kid of behavior has been done.
In a landmark study by Schulman et al, African American patietns are less likely than white patietns to recieve life-saving therapy for a heart attack, even if the presentation of the African American patient is the same as a caucasion patient expect for the skin color. Schulman et al study has been replicated numerous times of the past 10 years, and most recently by Green et al. Green et al supported Schulman's findings, and did by using the Implicit Association Test (IAT) to measure the unconscious biases of dcotors. This test is a well validated instrument which has beeb used in more than 400 studies and on more than 10 million subjects.
These studies open a very important question when it comes to new healthcare reform. As the government continues to attempt to create a comprehnsive plan that covers every U.S. citizen, the question remains will patient care for all races be the same. If citizens are going to pay some sort of fee to the government for healthcare, the government needs to make sure they regulate the type of care given to patients and insure that it is equal no more what race the patient is.
The average cost of a family policy offered by employers was $13,375 this year, up 5% from 2008, the Kaiser Family Foundation and the Health Research & Educational Trust survey found. By comparison, wages rose 3% over that period, the study said.
The new numbers underscore warnings by President Obama about the growing cost of health insurance and were embraced by Democratic lawmakers who are pushing for legislation to change the nation's health care system. "The trends are crushing millions of businesses and American families," Senate Majority Leader Harry Reid of Nevada said.
In recent years health insurance premiums have raised rapidly what eat up a big part of the middle class’s income. In 2008, the average premium for family coverage was $12,298 and if premiums for employer-sponsored insurance increase in each state at the projected national rate this premium for family coverage would raise to $23,842 by 2020. This equals a 94 percent increase in 12 years. Looking in the short-term according to the Office of Personnel Management, federal employees’ health insurance premiums will raise 8.8 percent on average in January of 2010. This represents the largest increase since 2004.
You might ask yourself why the health insurance premiums are increasing that fast. One reason is the increase of medical costs. For every year the insurer estimates its costs by developing profiles of its patients and calculates the cost of that profiled patient. There are many different profiles, e.g. kids, teenagers or seniors, each with different medical needs and thus different costs. The insurer will find the average cost per patient or family, a figure that represents the premium paid the insured. Regardless of the medical condition, each individual or family will pay the same premium amount. This might seem unfair to healthy people, who pay much more in premium than they would pay in actual medical expenses. On the other hand, people who are sick or injured quite often or people who are older pay less in premium than their actual health cost would be. All these people are paying insurance premiums to not bear any risk in case of any incident.
Our population is aging what is equivalent with the fact that the whole population needs more health care. Thus the premiums increase and fewer people can’t afford this cost for health insurance. Now less people purchase insurance and the cost of health insurance is spread across the whole population what in turn leads to higher premiums again.Source 1
By Minjune Kim
Are you making travel plans for the holidays? Or are you planning a winter ski trip or a cruise? Have you had your swine flu shot? If not, you’d better check out the fine print on your travel insurance to see if you will be covered if you get sick.
Sir Liam Donaldson, chief medical officer of the NHS, said: "Everything suggests that we're starting to see a second wave [of swine flu] to follow on from the July peak.
"We don't know how big that wave is going to be but we're reaching the starting line."
The ABI advises swine flu victims that all they require in order to claim on their travel insurance policy is written confirmation from a doctor or, if this is not available, a certification of swine flu diagnosis from the National Pandemic Flu service.
Did you know that the UIA offers competitive rates on home insurance? Great deals also available on car insurance, travel insurance and pet insurance too. Up to 15% discount when you apply online.
You can hedge your bet by purchasing travel insurance. But experts warn that you need to know what different policies do and don't cover.
First, a little background. Travel insurance packages cost 4 to 10 percent of a trip's total price. At SquareMouth.com, a Web site based in St. Pete Beach that lets you compare travel insurance, the typical policy runs around $200 for a $3,000 trip, CEO Chris Harvey says.
That should cover nonrefundable travel expenses if you cancel a trip or need to leave early, plus emergency medical costs and reimbursement for lost baggage.
The swine flu throws a few wrinkles into the deal. A handful of companies have pandemic exemptions that won't let you collect if you catch H1N1 before you leave or during your trip. Ask before buying and stay away from those policies, Harvey says.
None of the regular package policies will cover financial losses for hotels, airlines or cruises for canceling a trip because you're worried about catching swine flu at your destination. For that, travelers must upgrade to "cancel for any reason" coverage.
Posted By Rico K Setyo
By Bill Weir and Jake Whitman
Fresh off the meltdown of the mortgage business last year, Wall Street's bankers have found a new way to make money: the buying and selling of life insurance policies belonging to the sick and elderly.
Financial investors take a gamble trading people's life insurance policies.
Advocates of these "life settlements" call them a valuable option for people who want or need money before they die. Critics call it a morbid and risky business that proves Wall Street hasn't learned from the mistakes of the past.
After Dr. Eddie Powell lost both his legs to a hospital infection, he desperately needed financial help to support his practice and two children in medical school.
"I had to get the money, you know, for my family to survive," Powell said.
Powell says he sold three life insurance policies valued at nearly $1 million for $150,000.
Written by Hibah Yousuf
Posted by Minjune Kim
NEW YORK (CNNMoney.com) -- The nation's tally of 2009 bank casualties hit 99 Friday night when state regulators closed San Joaquin Bank, based in Bakersfield, Calif. This was the tenth bank to fail in that state.
Customers of San Joaquin Bank are protected, however. The Federal Deposit Insurance Corp., which has insured bank deposits since the Great Depression, currently covers customer accounts up to $250,000.
The Citizens Business Bank in Ontario, Calif. will assume all of San Joaquin Bank's $631 million deposits, according to the FDIC. Citizens also entered into a loss-share agreement with the FDIC on $683 million of San Joaquin Bank's $775 million in assets.
The five branches of San Joaquin Bank will reopen on Monday as branches of Citizens Business Bank.
Customers of the failed bank can access their money over the weekend by writing checks or using ATMs or debit cards. Checks will continue to be processed, and borrowers should make mortgage and loan payments as usual.
The FDIC also said customers should continue to use their existing branch until they receive notice from San Joaquin Bank that the takeover has been completed.
There are about 8,000 banks in the nation, and an average of 10 banks have failed per month this year, nearly four times the number that failed in 2008. This is the highest tally since 1992, when 181 banks failed.
Though 2009's count is still far from 1989's record high of 534 bank closures which took place during the savings and loan crisis, the FDIC revealed there are now 416 banks at risk of failing -- the highest level in 15 years.
This year's failures have reduced the FDIC's insurance fund to $10.4 billion from $45 billion a year ago.
Faced with dwindling funds, the FDIC discussed how to raise money to restock the fund last month. The agency proposed that banks prepay their deposit insurance premiums for the next three years.
Friday's closure will cost the FDIC an estimated $103 million.
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By Rico K. Setyo
The Federal Deposit Insurance Corporation (FDIC) was created by Congress to maintain stability and public confidence in the nation's financial system by: insuring deposits,examining and supervising financial institutions for safety and soundness and consumer protection, and managing receiverships (FDIC.gov). However, in these recent tough economic times where financial institutions are failing at a rapid rate, the FDIC is having trouble managing their organization to assist such issues. Sheila C. Bair, the FDIC chairman, states that despite the economic recovery, many banks are still expected to fail. As of this year, about 100 banks have failed and the FDIC has estimated the cost of failures to be $100 Billion for the next few years. FDIC uses their deposit insurance fund to bail out all these financial institutions. However, recently, the FDIC has claimed that the funds are decreasing at such a rapid rate that the net worth has become negative. Blair, has some recommendations to solve such issues but the causes have been analyzed by other experts.
One of the causes that many experts say is that the FDIC has been poorly managed because it was not able to generate enough revenue to cover such emergencies. Another issue might have been Congress because of a limitation to how the FDIC can raise funds but in 2006 Congress has changed the law. However, FDIC did not act quickly by charging banks premiums for the insurance fund. Now that the fund is at a negative net worth, Blair mentions that she will charge banks higher premiums to replenish the funds. Another way to solve the negative net worth might be to borrow from the Department of Treasury but many people are not in support of such drastic actions.
Our elected do not have a clue as to how to fix health insurance. They are doing all the wrong things. Ask any doctor or anyone who really understands the problem and they will all tell you that the biggest problem by far with health insurance is malpractice and lawyers. There are many places in the country where Obstetricians cannot even practice because doctors insurance is so high. Statistics have shown that if we fixed the malpractice problem costs for insurance and fees for doctors would go down by more than half. However, almost every politician is a lawyer and sharks will not harm each other.
Thursday, October 15, 2009
Posted by: Scott Graulich
On the eve of the vote on the Senate Finance Committee's health care reform bill, the insurance industry released a report saying that it would increase premiums.
The report, and the reaction to it, reveals a great deal – about health care reform and the state of political discussion in the United States.
The analysis was done by PricewaterhouseCoopers for America's Health Insurance plans, a trade group. It looked at the effect of several provisions of the Senate Finance bill on premiums. Two are of particular note: requiring insurance companies to cover everyone without any medical underwriting, coupled with a weak mandate that all individuals purchase insurance; and the 40 percent tax on high-value plans.Click here to read more
by John Tozzi
posted by Adam Lindheim
Unlike most small employers, Boeggeman, George & Corde, a New York law firm with offices in White Plains and Albany, pays full health insurance coverage for each of its 23 employees and their families. At least for now.
Premiums are rising so quickly that partner Richard Corde has been grappling for six years with whether to make workers pay part of the cost. In that time, the health-care share of the firm's total compensation budget has doubled, to 10%. When Corde went to his insurer, Health Net (HNT), to arrange a November renewal for the firm's' policy, he was given a 22% higher rate, an increase Corde says is typical. He has switched insurers at least three times to avoid such hikes. To keep the policy affordable this year, he agreed to higher deductibles for doctors' visits and prescriptions. Even with the concessions, the firm will pay about 9% more this year—close to $200,000. "I don't know how many years of those kind of increases I can absorb," Corde says.
Washington lawmakers are trying to write legislation to contain health-care costs and expand coverage. But even if reform passes this year, any effect on the price of care won't manifest until 2011 at the earliest, according to an analysis by PricewaterhouseCoopers. Many small businesses, some closing the worst year (or two) in their histories, face hard questions about how—and how much—to pay to keep their employees and their families healthy.
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To estimate our needs ranged from our medical history to occupations of our family members. For example, if u go to the dentists very often, u would need a dental plan. If a family member does a relatively risky job like at mining sites, he would need catastrophic insurance plans. After sorting out our needs, we can then more effectively eliminate the inappropriate insurance plans and end up with choices that can cater our demand. Then our will have to find the balance between budget and need. This includes consideration of time and your goals. Some plans may be cheap but only god for the short run while others may be expensive but helps you to reach your goals in the long run. This all depends on what you are willing to forgo to get what you want and when you want it.
Due to the toug economic times, many large life insurance companies are somewhat nervous that if their numbers do not improve in the next few quarters, their policies sold already could be in danger. Metlife, one of the largest life insurance companies, had unrealized losses of nearly $17 billion out of a portfolio of $324 billion in 2008.
Policies issued by life insurance companies like Metlife are backed by state guarentee associations, and at this point in time, many states have no cash on hand, and must rely on promises to pay to life insurers. Many policy holders are selling their life insurance policies back to the insurance companies before their maturation in order to pay off mortgages to save their homes. This presents a huge obstacle to these corporations and the local state governments, because these policies are not backed by the FDIC.
Wednesday, October 14, 2009
There are over 150 types of insurance today and one kind that many people invest in is auto insurance. Because so many people have cars and may be involved in a car accident at sometime in their life, this is an important insurance to look into. Auto insurance is an agreement between the investor and the insurance company where the company will pay for financial losses in exchange for the regular premiums you pay. Many people who don’t have cars would never consider buying auto insurance but the reality is that if you ever needed to rent a car for something like getting from a plane to your vacation site, you would need auto insurance if you got in an accident. Also, auto insurance companies do not have to, but can include coverage for up to six different risks such as bodily injury and property damage. Auto insurance ads may be seen on tv all of the time because they appeal to most of the population, but unfortunately they can be slightly confusing at times. It is important however to look into the ads and the benefits of having auto insurance because at some point or another, almost everyone will be behind the wheel.
Tuesday, October 13, 2009
A Miami insurance agent was arrested for the second time in less than a month for stealing more than $14 million by submitting thousands of fraudulent premium finance contracts for fictitious policyholders, according to state officials.
Florida CFO Alex Sink said that her Division of Insurance Fraud (DIF) arrested Jose V. Peris, 52, of Miami, the owner and president of Insurance Force Corp., d/b/a FED USA Insurance Agency.
Officials allege that Peris submitted more thn 3,800 bogus premium finance contracts to numerous premium finance companies. Currently, they said, more than $7 million remains unrecovered and Peris is facing multiple counts of first degree organized scheme to defraud.
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Posted by: Christina Dove
Article by: Srividya Srinivasan
It is more and more common to hear of American’s struggling to pay health care insurance and the ridiculous fees associated with it. Insurance companies are getting more and more particular about what qualifies as a acceptable health care candidate.
In a news story by Mark Rubi in“Extreme Weight Loss Examiner”, an infant American boy was denied health care insurance just for being “obese”. At 2-months, this baby is in the 95th percentile for weight. However, the weight is in proportion to his 95th percentile height as well. Health insurers are not used to parents applying directly for coverage for their kids instead of parent's employers automatically paying for health insurance. Therefore, health insurance agencies are new to the situation of having separate health insurance plans for kids and their parents. Finding a loophole forced CareFirst to change their coverage plan to include child applicants, despite their weight.
Regardless of political support, many American’s do support Obama for the health care reform. According to John Hewko’s article in the Washington Post, he has experienced first-hand the “dysfunctional system” concerning America’s health care. An application that submitted by a completely healthy, 51-year old was not approved. "Apparently, being healthy and physically fit is not good enough for CareFirst”. The individual has a mild case of hypertension and stiff shoulders, which are easily cured by a small dosage of medicine and Advil. Though most people of that age group have these symptoms, this does not stop the insurance company from taking full advantage of this. These conditions were not means for higher premiums, but a complete denial.
For those employed Americans who are not affected by the health insurances because of employee benefits, they should remember that a job loss and a few mild symptoms leave them susceptible to the current health coverage problems that currently exist.
Article By: David Jackson
Posted By: Srividya Srinivasan
President Obama hailed today's Senate committee health care vote as a "critical milestone," but added that "the bill is not perfect and we have a lot of difficult work ahead of us."
"Now is not the time to pat ourselves on the back," Obama said, urging supporters to "dig in and work even harder to get this done."
That said, Obama praised the efforts of the Senate Finance Committee, particularly chairman Max Baucus, D-Montana. The president also saluted Sen. Olympia Snowe, R-Maine, the lone Republican to back the bill, for "both the political courage and the seriousness of purpose that she's demonstrated throughout this process."
"We are now closer than ever before to passing health reform," Obama said. "But we're not there yet."
He added: "There's still significant details and disagreements to be worked out over the next several weeks as the five separate bills from the Senate and the House are merged into one proposal," Obama said.
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Monday, October 12, 2009
Written by Marc Lifsher
Posted by Minjune Kim
Efforts to extend a state-backed auto insurance program for low-income Californians failed after Gov. Arnold Schwarzenegger vetoed a bill that would have kept it going until 2016.
State law requires all drivers to carry minumum levels of liability insurance, and the low-income policy provides affordable coverage to motorists over the age of 19 with good driving records. The current program is scheduled to expire on Jan. 1, 2011.
Schwarzenegger said he vetoed a bill by Assemblyman Dave Jones (D-Sacramento) because "the effectiveness of the program is questionable given the number of policies in effect and low participation rate amongst the insured."
The governor suggested for Jones and the bill's sponsor, California Insurance Commissioner Steve Poizner, to send him a refined proposal next year.
Consumer advocates argued that the low-cost insurance program has been effective and criticized the governor for his veto.
"This veto is out of touch with the real economy that many Californians are facing," said Douglas Heller, executive director of the Santa Monica-based Consumer Watchdog. "Why should a program that has allowed nearly 50,000 Californians to buy auto insurance instead of driving uninsured and doesn't cost the taxpayers a dime be on the governor's chopping block?"
Primus Financial, a new firm founded by Citigroup's (C.N) former investment banking head in Asia and a Chinese partner, has agreed to purchase Nan Shan Life, AIG said on Tuesday, ending a roughly five-month auction that saw several corporate and private equity bidders pursue the division.
With the Nan Shan agreement sealed, AIG is now focused on raising cash from two other major assets in Asia. Hong Kong-based life insurer AIA is seeking a more-than $2 billion initial public offering while American Life Insurance Co, which generates half its revenue in Japan, is seeking a reported $5 billion in an IPO.
Posted By: Lisa Matthys
Written By: South Florida Business Journal
A Miami insurance agent has been arrested for the second time in two months for submitting thousands of fraudulent premium finance contracts for fictitious policyholders.
Jose V. Peris, 52, is owner and president of Insurance Force Corp. dba FED USA Insurance Agency.
According to the Florida Division of Insurance Fraud, Peris submitted more than 3,800fake policies and stole more than $14 million.
More than $7 million has not yet been recovered.
Click here to read more.
Written By: Lisa Matthys
Are insurance coverage requirements too specific? One family’s story may have insurance companies reevaluate their cutoffs for insurance coverage.
Alex Lange, son of Bernie and Kelli Lange, was denied insurance coverage by an insurance underwriter for Rocky Mountain Health Plus because their baby had a pre-existing health condition, obesity. When Bernie and Kelli went shopping for better premiums, they learned that their baby’s size matters.
At four months old, baby Alex weighs 17 pounds at 25 inches tall. Based on his height and weight, he is in the 99th percentile subject to obesity most likely due to breast-feeding and his great appetite.
No matter how healthy the infant, most insurers won’t cover a baby over the 95th percentile including Rocky Mountain Health Plus. But no parent is going to deny their child food just so they can remain within the 95th percentile. Dr. Doug Speedie, medical director at Rocky Mountain Health Plus, believes that it is possible for a baby to be above the 95th percentile and still be healthy, and admits that the system is flawed.
To many supporters, this story gives reason for health reform. In a highly profitable industry, insurance companies regularly deny coverage to people with pre-existing conditions that make them a financial risk. Aware of the flaws in the system, many health-care reformers are taking aim at the practice of underwriting. With current debates and lobbyists, the health-care system will most certainly experience changes over the next few years.
An article in the British medical journal Lancet paints a devastating portrait of the collapse of Zimbabwe’s health care system, once one of Africa’s best. Although the article never mentions President Robert Mugabe by name, it suggests that his authoritarian rule, stretching back nearly three decades, is largely to blame.
Life expectancy in the country is now just 43 years, because so many young adults die of AIDS. But the article, whose lead author is Dr. Charles Todd, a former chairman of the University of Zimbabwe’s medical school, points to many failures that government could have prevented.
Maternal mortality more than quadrupled from 1990 to 2007, to 725 mothers’ deaths per 100,000 live births. In 1994, 80 percent of children received all their basic vaccines; by 2007, only 53 percent did.
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The US health insurance industry has launched a last-minute attack on Democratic healthcare reform efforts, releasing a report late yesterday predicting that insurance premiums will rise sharply if a chief proposal becomes law.
The report by accountancy PriceWaterHouseCoopers was paid for by America's Health Insurance Plans, a trade group that until now has reluctantly cooperated with president Barack Obama and the Democrats' effort to overhaul the US Healthcare system.
The trade group had been working behind the scenes to help shape legislation, and Democrats blasted the timing and authorship of the report. The report was released just two days before the Senate finance committee is set to vote on a 10-year, $829bn bill that is seen as the most likely to win congressional approval. The trade group that funded it was instrumental in sinking president Bill Clinton's healthcare reform effort in the 1990s.
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Sunday, October 11, 2009
Posted By Rico K. Setyo
By Insurance Journal
In a 9-0 decision, the Mississippi Supreme Court has ruled that so-called "all-risk" home insurance policies may cover wind damage from hurricanes, even in situations where the loss is later exacerbated by water from storm surge.
The state high court decision found that language in a policy may exclude storm damage when it is caused by a combination of wind and water acting together. But if wind and water damage can be distinguished, this exclusion does not apply. The court said a jury must decide whether the damage to the home of Margaret and Magruder Corban was caused by wind or water.
The ruling is a blow to some insurers that had argued that such damage is excluded by anti-concurrent cause (ACC) and other language in their policies. The 5th U.S. Circuit Court of Appeals had sided with insurers in previous cases.
The state's high court has now decided that the ACC clause is not applicable because the wind and water losses were separate or in sequence, and not "indivisible." Justice Michael K. Randolph wrote for the unanimous court:
"We conclude that the ACC clause has no application for losses caused by wind peril. An insurer may not abrogate its duty to indemnify for such loss by the occurrence of a subsequent, excluded cause or event."
Once the wind loss occurred, the homeowners were entitled to coverage under the policy, the Mississippi court said.