Easy-to-read (really) timeline re: health care reform

The department of Health and Human Services has put together an easy-to-read timeline re: what happens when under the federal health care reform law.

Small business health insurance tax credits, for example, started taking effect Jan. 1. The first $250 checks to 4 million senior citizens hitting the gap in Medicare prescription drug coverage were mailed in June.

The big stuff still lies ahead. A major round of provisions start taking effect Sept. 23rd: young adults can stay on their parents' health plan until age 26, there will be no pre-existing condition waiting period for children, insurers can't cancel a policy except in the case of fraud, no lifetime caps on benefits, and there will be no copays, etc. for preventive care. (In general. There are a variety of exceptions and exemptions for grandfathered plans and other factors.)

How to find flood insurance in WA's Green River Valley

About this time last year, some businesses in Washington state's Green River Valley started discovering that it was extremely difficult to get -- or afford -- flood coverage. The reason was no mystery: The Army Corps of Engineers, citing a weakened abutment to the nearby Howard Hanson Dam, pegged the risk of serious flooding at 1 in 3.

A year later, the Corps and contractors have done extensive work, and the risk is now believed to be about 1 in 60. (The normal risk is about 1 in 140.) As the Corps noted in a recent PowerPoint, the La Nina weather pattern can also bring back-to-back rainstorms, could require the Corps to rapidly draw down the pool of water behind the dam.

We're still urging homeowners in the area to strongly consider flood coverage from the National Flood Insurance Program. And although August may seem like an odd time to be thinking about flooding, the federal coverage doesn't take effect until 30 days after a policy's issued.

For businesses in particular, the federal coverage -- which is limited to $500k for the building and $500k for contents -- may not be enough. So our office launched a "Washington Flood Market Assistance Plan," which is a sort of matchmaking service connecting businesses needing coverage with insurers selling it.

More than two dozen insurance companies are participating, and the program's run by the Surplus Line Association of Washington, an industry association.

To learn more, please see our web page and FAQs on the program.

Getting health coverage for adult children

The number one health insurance problem we get calls about? People trying to find affordable coverage for their adult children. (We're the state insurance regulator in Washington.)

Starting soon -- and some major health insurers have already started to do this -- parents will generally be able to keep their kids covered up to age 26. In many cases, "soon" means next January 1, 2011. But depending on when your policy renews, it could be months later than that.

The New York Times recently did a story aiming to help parents struggling with this figure out what their options are, such as getting coverage through student health plans or buying an individual health insurance policy.

If you live in Washington state and need free help navigating this, give our consumer advocacy staff a call: 1-800-562-6900.

Dogs and homeowners insurance: Dog bites accounted for $412 million in claims last year

Dog bites accounted for more than one third of all homeowners insurance liability claims paid out last year, according to a new report from the Insurance Information Institute.

Dog bite claims totalled $412 million in 2009, the group says, with an average claim of $24,840. The cost of dog-bite-related claims has risen nearly 30 percent from 2003-2009. The frequency of claims increased slightly, from 15,823 in 2008 to 16,586 a year later.

See the link above for more data, including national stats on dog bites, victim demographics, and the several kinds of liability that dog owners face.

A typical homeowners policy provides $100,000 to $300,000 in liability coverage. And one a dog has bitten someone, the company may boost your premiums, exclude the dog from coverage, or require behavior-modification classes before they'll cover the animal.

Job opening: Senior Policy Analyst

We're trying to fill a critical vacancy in our policy and legislative affairs division: A senior policy analyst with an expertise in property and casualty insurance. From the job announcement:

This position has lead responsibility for policy related research and analysis in support of the development of OIC legislative proposals and the OIC analysis of proposed legislation involving property and casualty insurance (and related) statutes. It assists the OIC legislative liaison and other OIC staff as requested, including completing bill analyses, fiscal notes, drafting comments or testimony, developing legislative proposals, and serving as the primary policy division resource on property and casualty insurance and markets. The position also serves as the Commissioner's delegate on boards, task force, work groups or other organizations as requested by the Commissioner.

The closing date is Sept. 16, 2010 at 4:59 p.m. For more information -- salary, qualifications, how to apply, etc. -- click on the above link.

Washington state's smoking rate drops to third lowest in America

The Washington state Department of Health says that new survey results show that the state's adult smoking rate is now third lowest in the nation: 14.8 percent.

Here's their press release.

To add our two cents' worth: Smoking can significantly drive up health (and life) insurance rates. For example, look at these rates for an individual plan with Premera Blue Cross. (And note that the older you get, the larger the difference between smoker- and non-smoker rates.)

July: 432 complaint files opened and $690,000 recovered for consumers

Our telephone hotline (1-800-562-6900) fielded nearly 12,000 calls last month.

We try to help people with insurance problems, and they bring us a wide range of issues: people unable to find affordable health coverage, people arguing with their insurers over denied or delayed claims, people looking for advise in dealing with storm damage, etc.

And if you call, rest assured that we won't try to sell you anything. We're the state insurance regulatory agency for Washington state. (Not in Washington? See here for contact info in your own state.)
Among the calls last month:

-We helped resolve a problem with an insurer -- the issue was whether the person's previous insurance qualified as "creditable coverage," meaning that pre-existing conditions would be covered -- resulting in the payment of $51,190 in claims.

-We helped a student get $900 for visits to her doctor's office. The claims had initially been denied under her student plan.

-We helped one person get a premium refund on a life insurance contract ($2,482) and another resolve delays in getting an annuity surrender request honored, resulting in a $254,448 payment to the consumer.

-And we helped a woman recoup a $261 life insurance premium that the company took from her father's bank account -- after his death.

That's just a sampling. There were many others: delayed auto insurance claims, trying to resolve disputed damage amounts for homeowner's claims, helping fix billing errors, etc.

Need help? Give us a call or e-mail us at AskMike@oic.wa.gov.

Seattle woman charged with insurance fraud for claiming car in accident had been stolen

A 38-year-old Seattle woman has been charged with insurance fraud after allegedly smashing her Honda van into two parked cars, hopping into a friend's car to flee, and then filing an insurance claim saying the van had been stolen.

According to Insurance Commissioner Mike Kreidler's anti-fraud team, the Special Investigations Unit, Luom Vo was driving on Seattle's Beacon Avenue just before 2 a.m. on Nov. 27, 2009. She hit two parked vehicles -- a Volvo station wagon and a Pontiac Vibe -- causing extensive damage. The van was disabled in the crash, which caused a total of nearly $26,000 in damage to the three vehicles.

People in nearby houses heard the crash and immediately went outside to see what had happened. They said they saw Vo get out of the van and into a white Chevrolet that sped away from the scene.

Later that day, Vo filed a claim with her insurer, PEMCO, saying that the van had been stolen. She subsequently insisted to a PEMCO investigator that she was not driving it when it was involved in the collision.

The SIU investigation found that the van had not been stolen, and that she was, in fact, behind the wheel.

She was charged with insurance fraud in King County Superior Court.

Everett man charged with fraud for allegedly getting insurance AFTER accident

A 40-year-old Everett man has been charged with insurance fraud after allegedly causing a three-car wreck -- with no insurance on the vehicle -- then going online to add coverage and subsequently filing a claim.

Mike Bieniek was driving his 1999 Ford F-150 last October when the accident happened. He filed a claim with his insurer, Geico Insurance. The resulting claims total thousands of dollars in vehicle damage and injuries. The State Patrol cited Bieniek, who rear-ended the car in front of him and pushed it into the next one, for tailgating.

According to Bieniek, he'd owned the truck for about five years, loaning it to sub-contractors helping him at job sites and relying on them to get insurance when they used it. He said a friend had returned the truck to him at a grocery parking lot, at which point he pulled out his laptop, went online to Geico's website, and added coverage for the truck. Shortly after pulling out of the parking lot, he said, he was involved in the collision.

But a subsequent investigation by Insurance Commissioner Mike Kreidler's anti-fraud team, the Special Investigations Unit, determined that things didn't happen in quite that order.

The crash occurred at about 10:10 a.m., according to the police report and witnesses. It was more than half an hour later that Bieniek logged into Geico's website.

Bieniek was charged in King County Superior Court.

Can an insurer ask for my social security number?

That's a question -- or complaint, really -- that we get a lot. Consumers often aren't pleased with insurers asking for social security numbers to run insurance quotes.

Here's often why they do it: Your social security number is a key tool to quickly pull up your credit data, which is commonly used to quickly rate you as a risk and determine the rates you would pay for, say, auto insurance. (While Washington State Insurance Commissioner has repeatedly tried to ban this controversial practice, known as "credit scoring," there's nothing in Washington state or federal law to prohibit use of social security numbers by insurers.)

In other cases, however, insurers are actually required to collect it. Federal law requires many health insurers to report social security numbers in order for Medicare to properly coordinate Medicare payments with other insurance and workers' compensation benefits.

Obama cancels appearance at NAIC in Seattle

Just got word from the National Association of Insurance Commissioners:

"Due to a White House scheduling change, President Obama will not attend the NAIC Summer National Meeting on Tuesday, Aug. 17."

NY proposal to require P&C insurers to offer bedbug insurance

There's an interesting proposal out of the New York state assembly this week: Bedbug insurance. Two New York politicians reportedly intend to introduce bedbug insurance legislation that would require property and casualty insurers in that state to offer bedbug policies.

The problem, they say, is that insurers are currently classifying bedbug infestation as a standard maintenance issue -- meaning coverage is denied.

This isn't the first bedbug legislation to his Albany. New York State Assemblywoman Linda B. Rosenthal has repeatedly called for legislation to force building owners to disclose potential infestations and offer some compensation to people battling the bugs.

It's a serious problem, according to insurancenewsnet.com. Hotel owners and retailers need to think about the risks of business interruption, third-party liability claims and reputation damage, the site says.

Job opening: Health insurance rate review project manager

Insurance rates -- particularly in health care -- are coming under close scrutiny, both as a result of the new health care reform law and advocacy campaigns like the one currently underway by Consumers Union.

Due to a federal health care reform grant, we're seeking a health insurance rate review project manager to oversee the first phase of a rate review project. The pay is $84,000 annually. From the job announcement:

The successful candidate should have expert level project management experience in leading large projects. The incumbent will have broad experience leading project teams that possess diverse business and technical backgrounds and the ability to plan and facilitate stakeholder management. This candidate will need strong leadership, team building, planning and communication skills.
10 years or more experience managing large projects, preferably projects that are highly business driven. Business experience involving the insurance market domain is highly desired.

Applications are due by 4:59 p.m. on Tuesday, Aug. 24, 2010.

Obama to speak at National Insurance Commissioners Association meeting Tuesday in Seattle

President Obama will address the National Association of Insurance Commissioners at the group's summer meeting in Seattle on Tuesday, according to the White House.

Obama's topic -- and the topic of much of the six-day meeting -- will be health care reform and how the new law is being implemented. State insurance commissioners are on the front lines of implementation, trying to set up federally funded high-risk health insurance pools, overseeing insurer rate requests, preparing for health insurance exchanges, etc.

Health care was also very much the topic last September, when Vice President Joe Biden addressed the NAIC in Maryland. From that speech:

You're the people that our people look to. So I want to thank you for being here at this moment. I want to thank you for your organization's profession of support for the need to make health care more affordable, accessible, and engage in reform, because you are the most influential people in our states to deal with this.

Our Twitter feed hits a milestone...

In the spirit of Twitter, I'll keep this short:

Over the weekend, our official Twitter feed hit a milestone: 500 followers.

Time for a victory lap.

The insurance risk of vacant homes

With homeowners coverage, it's easy to think of the risks that come with day-to-day use of a home. You could cause a cooking fire. The plumbing could spring a leak. Someone could fall off your deck at a party. And so forth.

The risks are less obvious, however, when the home sits vacant. The home has a higher risk of break-ins or trespassers on the property. There's no one around to call the fire department, gas company, police or plumber if something goes wrong -- and no one around to quickly spot smoke or other trouble signs.

The National Association of Insurance Commissioners, citing the nation's struggling housing market, this week put out a press release detailing some of these hazards and steps to take. Among the key points: Homeowners policies are meant to insure homes that are occupied. Some may not pay claims if a home is vacant for 60 days or more; others automatically reduce coverage when the home sits unoccupied for a certain period of time.

The good news: According to the NAIC, many insurers will let you pay extra for an endorsement that covers unoccupied dwellings. Click the link above for more details.

Tips on finding a lost life insurance policy

The Insurance Information Institute has put out a video with tips on finding lost life insurance policies, from where to look among a deceased family member's effects to the option of hiring search firms.

Job opening: Deputy commissioner for policy and legislative affairs

Our Deputy Commissioner for Policy and Legislative Affairs is stepping down to go back to school, meaning that we need to replace her.

As the title suggests, this is the person who oversees the agency's policy and legislative staff, and has a major role in our efforts to help implement federal health care reform in Washington state. So we're looking for a high-energy strategic leader who can manage senior-level professional staffers. We're a small, busy agency with a total staff of about 214 employees.

For a more-detailed job description, discussion of benefits, etc., please see our job posting. (Also: here's a printable version with the details, although the application process is through that first link.)

The salary range is $99,908 to $105,768. The application period closes Aug. 17th.

(This post was modified to reflect a one-week extension in the application period, which was originally Aug. 10th.)

Howard Hanson Dam: $44 million in repairs approved, means "one more winter" of higher-than-normal flood risk

For the past year, we've been closely following the situation with south King County's Howard Hanson Dam. The short form: A weakened earthen abutment to the dam means that during heavy rains, the Army Corps of Engineers may have to spill more water than usual from the nearly 50-year-old dam to avoid stressing it. That extra water translates into a higher-than-normal flood risk in the Green River Valley.

Last week, President Obama signed a bill that includes $44 million for repairs to the dam. The Corps and contractors have already done substantial work to shore up the abutment with a "grout curtain," which sounds like it's sort of an underground wall of concrete.

The next step, according to a story in the Kent Reporter newspaper, is to install new drains to help relieve a leak through the earthen abutment. Col. Anthony Wright, commander of the Corps' Seattle district, told the newspaper that "After completion of these drains, I believe I can operate the dam at its full design capacity."

That will come as a relief to homeowners and business owners in the heavily developed valley. The latter, in particular, reported difficulty finding flood insurance last winter.

In response, we huddled with state lawmakers, the governor, and more than two dozen insurance companies. The result: the Washington Flood Market Assistance Plan, which is a sort of matchmaking service between Green River Valley businesses needing more flood coverage and insurers willing to sell it.

If you're a business in the area and need flood insurance advice, feel free to contact us at 1-800-562-6900. (We're not an insurer or agent; we're the Washington state agency that regulates the insurance industry.)

A look at the case files from our consumer hotline

Little-known fact: We staff a toll-free hotline where Washingtonians with insurance questions or problems can get help from our experts and analysts. The phone number is 1-800-562-6900.

What do people call about? A lot call us looking for help finding health care. And we get a flurry of calls after wind storms, floods, etc. In many cases, we help the consumers recover thousands of dollars in wrongly denied or delayed claims.

Here's a look at some cases from June, for example:

-A staffer helped an 87-year-old woman get a $3,420 claim paid on a vehicle service contract. The company said she hadn't gotten the neccessary pre-authorization. In fact, she'd called 11 times.
-We helped settle an $8,253 homeowners claim that had been delayed due to multiple revisions of repair estimates.
-Another staffer helped a consumer recover $9,506 in a third-party property damage claim for a consumer whose car had been destroyed by poor workmanship at a repair shop.
-We helped clear the record after a insurer wrongly tagged a driver's file with an at-fault accident.
-A staffer helped convince an insurer to agree to total a truck and pay an additional $54,219 on a claim, after initially paying $17,000 for the repairs.
-We helped collect an additional $7,685 in long term care benefits re: hospice care for a recently deceased parent.

Trees and homeowners insurance

It's one of the questions our consumer advocacy staff expect after every winter storm: "Will insurance pay for damage from that tree that fell on my (garage, house, car, shed, fence, etc.)? And what if it was my neighbor's tree?"

The upshot: Most damage to buildings, vehicles and contents ARE covered by your standard homeowner's policy, even if it was your neighbor's tree. (Your insurer may try to get your neighbor's insurer to pay afterward. In those cases, you might get your deductible back.)

The bad news: Unless the tree hit a structure or is blocking your driveway, your insurer probably won't pay for removal of it.

Here's advice that's more detailed: The Insurance Information Institute recently put out a video explaining what's typically covered and by whom.