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After tax evasion, insurance fraud is considered the highest-ranked among white-collar crimes. The original concept of insurance, as a for-profit endeavor, was to collect funds from a large number of people to pay for damages and accidents that involved a small percentage of the population that paid premiums. Insurance fraud is an ever-growing problem. Solving or eliminating this problem requires the resources and knowledge of individuals or associations with expertise ranging from not only insurance, but also law enforcement, legal issues and the social sciences. The concept of insurance fraud, both, by an individual and a corporation, has become so pervasive in today's society that the general population has learned to tolerate and condone these crimes.
Various organizations, funded by state and federal governments, and supported by the insurance company, are trying to increase the awareness of this problem among the general population. Annually, an average American family…
AAA, American Automobile Association. Insurance Fraud-- It Costs Consumers Billions of Dollars Every Year, but Csaa Is Fighting Back - and You Can Help. 2002. Available. October 15, 2002. http://www.csaa.com/global/articledetail/0,8055,1005000000%257C2974,00.html
CAIF, Coalition Against Insurance Fraud. Insurance Fraud: The Crime You Pay For. 2002. Available. October 25, 2002. http://www.insurancefraud.org/about_us_set.html
Phony Health Coverage -- People Left Dangerously Uncovered Throughout U.S. 2002. Available. October 27, 2002. http://www.insurancefraud.org/search_set.html
Childers, S. David, and Christy A. Chism. The Extraordinary Scope and Potential Regulatory Pitfalls of the Insurance Fraud Protection Act. 2002. Available. October 27, 2002. http://www.ibrinc.com/ifpa.html
However, as Schwarcz notes, the reasonable expectations doctrine fails in practical use for several reasons. hie th doctrine may have widespread support from insurance law commentators, "Only a handful of state courts follow the rule, and the case law endorsing it is confused and inconsistent. Moreover, contract law scholars have largely debunked the contracts-of-adhesion argument on which the reasonable expectations doctrine was originally justified. They have established that neither consumer assent nor government regulation is necessary to lead firms to design efficient standard forms when market forces work sufficiently well" (Schwarcz para. 5). Because the doctrine has a record of stunted evolution in the courts and because there has been an academic undermining of its core rationale, many view it to be both antiquated and largely irrelevant. Still, the reasonable expectations doctrine has served as the primary theoretical and doctrinal construct for the judicial regulation of insurance over the past…
Chu, Kathy. "State Farm Agrees to Pay Up for Katrina in Mississippi." USA Today (23 Jan 2007). August 11, 2007. http://www.usatoday.com/money/industries/insurance/2007-01-23-state-farm-katrina_x.htm .
Hartwig, Robert P. "Hurricane Katrina Insurance Issues: Robert P. Hartwig." Congressional Testimony (28 Feb 2007). August 10, 2007. http://www.highbeam.com/doc/1P1-135515555.html .
Homeowners Drop Insurance After Katrina." Associated Press/AP Online (19 March 2007). August 10, 2007. http://www.highbeam.com/doc/1Y1-104396426.html .
Hurricane Katrina Victims Denied Insurance Claims." Insurance Related News (08 March 2007). August 11, 2007. http://insurance.newsik.net/related/Hurricane-Katrina-Victims-Denied-Insurance-Claims-13161618.html.
All workers in the United States are covered by the Workers' Compensation Law. When an employee dies or becomes injured while working, the worker's compensation law requires that worker's compensation insurance be paid to the person or his or her surviving spouse and/or dependents. The insurance only applies to injuries and disabilities related to one's job ("What is Worker's Compensation?" 2008) Liability insurance, on the other hand, simply protects a firm from being held responsible for the other party's losses -- whether financial, physical, or otherwise. Liability insurance, unlike worker's compensation insurance, is not required by law ("What is Liability Insurance" 2008).
Occurrence claims policies and claims-made policies are two kinds of liability insurances that can be purchased by an individual or small company. Occurrence claims policies require insurance companies to pay for claims that occur during the period of coverage, regardless of when the claim occurred, while claims-made policies…
Choosing the Right Health Plan for Your Employees. 2008. Retrieved August 8, 2008, from Find Law Web Site: http://smallbusiness.findlaw.com/employment-employer/employment-employer-benefits/employment-employer-benefits-basics-health.html
How Does Insurance Work. (n.d.) Retrieved August 8, 2008, from Super Pages Web Site: http://www.superpages.com/supertips/how-does-insurance-work.html
Managed Health Care Plans 2008. Retrieved August 8, 2008, from American Heart
Association Web Site: http://www.americanheart.org/presenter.jhtml?identifier=4663
If a patient who approaches the doctor is subjected to a deductible for going outside the PPO network, then the cost incurred would be applied to the deductible. If this amount were to satisfy the deductible, then the rest would automatically be reimbursed, and this would be done at the out of network benefits plan. All insurance companies would require a valid prescription from the attending physician, along with explanations about the necessity of the plan, before they would reimburse the amount agreed upon. The patient receipt and the prescription must both be produced when the individual is billing for health care insurance under the PPO. If the insurer is a government employee, then his PPO insurance may not be able to cover this particular procedure. (Health Insurance Coverage, are the scans covered by my insurance?)
The typical costs for this type of relatively new form of insurance known as…
Affordable Healthcare: HMO, PPO, POS, FFS Definitions" Retrieved at http://www.website101.com/Health_Insurance/Affordable-healthcare.htm . Accessed 7 November, 2005
Check up on health insurance choices" Retrieved at http://www.ahrq.gov/consumer/insuranc.htm#head16Accessed 7 November, 2005
Health Insurance Coverage, are the scans covered by my insurance?" Retrieved at http://www.scandirectory.com/content/health_insurance_coverage.asp. Accessed 7 November, 2005
PPO, the Preferred Provider Organization" Retrieved at http://www.badfaithinsurance.org/reference/HL/0040m.htm . Accessed 7 November, 2005
Ace, too, bears some liability. Although they told Perfect Products plc, ostensibly in good faith, that their situation was hopeless and liquidation was the only answer, when Perfect Products decided to ignore their advice and attempt to avoid voluntary liquidation, Ace failed to use diligence in making the case for liquidation; later, when they are notified in writing that Perfect Products intends to cancel insurances, lay off workers and generally attempt to struggle along despite the opinions of two of its own directors that it cannot survive, the accountants fail to respond. In this respect, they are also failing to exercise diligence in carrying out their role as accountants to the company. Indeed, the accountants' liability would have been minimized at that point had they made a second written representation of their findings and recommendation, even recommending strongly against the hopeless efforts the Chairman was almost forcing the company to…
Bergman, D. (1998) Bosses get away with murder. New Statesman. Questia database. Accessed 20 June 2005 at www.questia.com.
Fact sheet: Sex discrimination legislation in Britain. (2005). U.K. government Web site. Accessed 20 June 2005 at http://www.womenandequalityunit.gov.uk/legislation/
Foster, P. (2001) Tracking down U.K. company information. Online. Highbeam Research. Accessed 20 June 2005 at www.highbeam.com.
Miller, S.K. (1998) Piercing the corporate veil among affiliated companies in the European Community and in the U.S.: A comparative analysis of U.S., German, and U.K. veil-piercing approaches. American Business Law Journal, 36(1). Highbeam Research. Accessed 20 June 2005 at www.questia.com.
So, with these very expensive claims related costs, it is essential that carriers surrogate as many of these costs as possible and because of the inherent relation to the claims process, claims management offices and functions should be fully responsible for investigating and implementing the subrogation process. Claims managers have the authority to oversee settlements and to point claims adjusters in the right direction for initiating any necessary investigations in regard to subrogation.
In conclusion, this report aimed to discuss how to minimize net claims payments through the process of pursuing subrogated recoveries and how this should be a central claims management responsibility. The objective of the report was to provide insights into why it is critical for carriers to understand the inherent costs of business fire claims including the ever expensive business interruption principles of subrogation. It must be emphasized that the responsibility of claims management be responsible…
As insurance companies go, the particular organization that was the subject of this study -- i.e. The place of employment for the team members involved in the research and analysis -- was fairly standard. Several different departments existed in one large room of cubicles in a building owned and wholly occupied by the company, several other departments existed in separate rooms and executives offices were on the top of the third floor building. This physical structure of the organization largely reflected the organizational structure of authority and decision making power, with this power very much concentrated at the top and command highly centralized. Though this is not generally the recommended structure for organizations involved in many industries, and particularly for manufacturing concerns that deliver more tangible products to consumers, this top-down organization and high degree of rigid hierarchy actually seems to serve the organization fairly well in many…
Advameg. (2011). Problem solving styles. Accessed 21 February 2011. http://www.referenceforbusiness.com/encyclopedia/Per-Pro/Problem-Solving-Styles.html
Kotelnikov, V. (2011). Flat organizational structure. Accessed 21 February 2011. http://www.1000ventures.com/business_guide/organization_flat.html
The number of people who need a liver transplant is currently far greater than the number of donor livers available. Unfortunately, this can lead to discrimination by insurance companies against alcoholics who they believe have caused their own ill health and are, therefore, less deserving of the liver than other individuals. However, medical principles should guide treatment procedures not prejudice. Alcoholics should have the same access to health care as anyone else.
The discrimination against alcoholics occurs because insurance companies fail to recognize the disease nature of addiction. According to the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine, "Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations."
This definition recognizes alcoholism as a disease, i.e., as an involuntary disability and accepts a genetic vulnerability in some people. Thus, to discriminate against alcoholics because…
Alcoholics Discriminated Against in Liver Transplant Programs." 03 Sept. 1999. Join Together. 09 Dec.2003. http://www.jointogether.org/sa/news/summaries/reader/0,1030,260110,00.html
Alcoholism." Infoplease.com. 09 Dec. 2003. http://www.infoplease.com/ce6/sci/A0803142.html .
Gunning, Karel F. "Why Not Euthanasia." Oregon Right to Life. 08 Dec. 2003. http://www.ortl.org/suicide/euthanasia_gunning.htm.
Alcoholics Discriminated Against in Liver Transplant Programs." 03 Sept. 1999. Join Together. 09 Dec.2003.
Using an independent sales force vs. A career sales force produces immediate and obvious advantages. Independent salespeople quickly provide more 'feet on the street,' for a company desiring to expand. They are hungry for a commission, unlike more complacent career salespeople with already established salaries and networks within the company's traditional reach. Independent salespeople bring more diverse experiences and an array of new business networks and sales connections originally inaccessible to the company.
The advantages and disadvantages of using commission vs. career sales are also relatively obvious -- the use of commission sales encourages salesmen and women to use high-pressure sales techniques to secure their salaries. However, this also encourages a high turnover rate and low company loyalty, as salaries are not secure. Fly by night rather than respectable individuals are attracted to the workforce. But career salespeople with built-in salaries tend to stick to their territories, as…
Resources conflict remains unresolved, independent contractors continue to be used to meet the increased demand within the industry.
While it could also be accomplished in group training formats, that approach is much less flexible with respect to accommodating corporate cultural nuances (George & Jones, 2008; obbins & Judge, 2009).
The optimal implementation of customer service training would comprise various stages, all of which would be conducted on-site. The first stage would be orientation; it would consist of a direct guided observation of Citizen's customer service call center agents handling communications. The observation would be guided in the sense that trainers will provide narrative guidance followed by the opportunity to connect that narrative to the actual performance of existing call center representatives.
That stage would be followed by direct one-on-one observation whereby representatives in training observe trainers conduct actual customer service interactions. The calls are discussed and the trainee takes actual calls under the supervision of the trainer. In the last stage, the trainee is allowed to perform a…
George, J.M. And Jones, G.R. (2008). Understanding and Managing Organizational
Behavior. Upper Saddle River, NJ: Prentice Hall.
Robbins, S.P. And Judge, T.A. (2009). Organizational Behavior. Upper Saddle River,
NJ: Prentice Hall.
The industry on which this paper will focus is the insurance industry, which has the NAICS code of 524133. The insurance industry is divided among a number of subsections. These subsections function roughly the same way. An insurance company identifies the risks associated with something, and then offers up insurance against the negative event. The customer pays the insurance company based on what the insurance company expects to pay out, plus whatever markup the insurance company pays. The basic premise is that if the insurance company prices risk properly, it will be profitable, but if it misprices risk, it will not be profitable.
The insurance industry's critical problem is pricing risk. There are a few interesting elements, though. One is that the insurance business is heavily regulated, and that can create specific situations that challenge the firms in the industry. An example would be the uncertainty that…
Annuities account for a great part of the protection one affords self against death. They do not follow the application of the law of large numbers as the law is traditionally utilized in life insurance. It has, therefore, been referred to as “upside-down life insurance.” When an annuitant passes away during the period of accumulation, their beneficiaries are paid a death benefit. The common treatment of annuities is to account for gross premium returns excluding interest or to account for the cash value, whichever is greater. The principle is for the principal sum to be liquidated over the annuitant’s lifetime regardless of the means of accumulation.
Annuities can fall under various classes. Traditionally, the following classifications have been used to differentiate annuities:
i. Individual vs. group annuity
ii. Fixed-dollar vs. variable annuity
iii. Deferred annuity vs. immediate annuity
iv. Installment annuity vs. single-premium annuity
v. Single life vs.…
While the U.S. enjoys the largest insurance market, U.S. companies no longer own the majority of the insurance market share in the country. Foreign companies do with 74% (Vaughan & Vaughan, 2013). This goes to show the extent to which foreign companies have grown in the insurance industry thanks to the globalization of insurance but also to the spread of wealth throughout the world. Insurance companies and finance go together as the former depends upon the latter for return on investment (ROI). Part of the problem with the globalization of insurance is that everything has been globalized—right down to investable markets. Since 2008, central banks around the world have lowered rates to the point that it is impossible for insurance funds to obtain a targeted ROI without investing in risk assets. Likewise, regulatory bodies have gone global as well with organizations like the Common Framework for the Supervision of Internationally…
The other necessary element in this process is procedure cost vs. reimbursement evaluation and proactive search of strong reimbursement for future volume. Analysis of the first element is crucial because it helps in ensuring that reimbursement documented in existing contracts is being effectively recorded. The information obtained during this stage can be used at any time of renegotiations or contribute to the development of effective alternative approaches. The assessment of the second element helps to determine how insurance contracts compare and to ensure reimbursement expectations are established within competitive market ranges. The third element can be used for defense in validating the need for higher reimbursement than the current offer.
Second Students' esponse:
As the use of managed care plans have increased in the past few years, there is an increased need for appropriate insurance contracting strategy. The existing managed care plans are primarily based on demand management through co-payments.…
Devers, K.J., Brewster, L.R. & Casalino, L.P. (2003, February). Changes in Hospital
Competitive Strategy: A New Medical Arms Race? Health Services Research, 38(1), 447-469. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360894/pdf/hesr_124.pdf
Jones, C.L. & Mills, T.L. (2006, November-December). Negotiating a Contract with a Health
Plan, Family Practice Management, 13(10), 49-55. Retrieved from http://www.aafp.org/fpm/2006/1100/p49.html
Insurance Agent for State Farm Insurance
Success as an independent insurance agent does not come easy. In this industry, success has largely got to do with hard work and an exceptional ability to handle occasional rejections. However, the benefits for those who succeed in this case are immense.
In my opinion, I would say that my success as an effective independent insurance agent for State Farm Insurance has largely been founded on not only my personal character but also my past achievements and business related experience. To begin with, I have always been a hard worker. I believe in the power of effort especially when it comes to getting things accomplished. Further, I would say I am rather talkative. I also regard myself an effective communicator. Effective communication skills are important in the insurance business largely due to the need to keep in constant contact with the public. In addition…
Insurance for Nurses
Most of us probably see the issues of overtime and insurance as being entirely separate from each other. But for nurses, there is a clear connection between the two - one that is becoming clearer all of the time. Nurses have throughout the past decades found themselves working more and more hours, often being forced to take overtime shifts. This has resulted in a decreased quality of life for the nurses themselves and often results in poorer care for patients. One of the roles that nurses have always provided is the kind of extended personal care that patients need and that doctors cannot economically provide. This is being compromised by ever-increasing patient loads and by nurses who themselves are increasingly stressed.
So what has the issue of mandatory overtime to do with insurance? Quite a lot, actually. Nurses are being used more and more often to perform…
Hartnet, Johnette. (1993). Grief in the Workplace: Forty Hours Plus Overtime. Philadelphia: Good Mourning.
A www.ahealthyme.com www.aclu.org www.buildingbetterhealth.com www.calurse.org www.dhmh.sate.md.us www.newstimes.com www.nursingworld.org www.prairielaw.com www.qnv.org.au www.telegram.com www.vhihealthe.com
Yates, Michael. (1994) Longer Hours, Fewer Jobs: Employment and Unemployment in the United States. New York: Monthly Review Press.
A www.telegram.com www.calnurse.org www.qna.org.au www.nursingworld.org (www.mlis.state.md.us).
The reasons for this greater statistical likelihood might be due to the fact that dark-colored cars are more difficult to see at night, hence people get into more accidents, or that people who buy dark colored cars, like red and black (as opposed to brown and white) drive more recklessly and get into more accidents. Regardless of the reason, or even if the statistical differential has nothing to do with recklessness or accidents, but is merely arbitrary and due to consumer buying habits (perhaps dark-colored cars are more popular this year) it does not matter to the company. All that matters to the insurance company is that if a driver with a certain kind of car is more likely to crash that car, his or her premium will be higher.
Auto Insurance Resources. (2007). Official ebsite. Retrieved 27 Sept 2007. at: http://insurance.freeadvice.com/insurance_center/auto
Auto Insurance Resources. (2007). Official Website. Retrieved 27 Sept 2007. at: http://insurance.freeadvice.com/insurance_center/auto
Moreover, because the organization heavily promotes its commitment to global and local ecological and environmental responsibility, the proposed change only lends further support to these values and demonstrates broader commitment to achieving the desired outcome through every means possible. That is equally important from the perspective of maximizing internal "buy-in" and from the perspective of presenting a comprehensive and consistent public policy externally (obbins & Judge, 2009; Stevens, 2008).
Evaluation and Conclusion
The recommended change for the organization is inherently testable by comparing the objective data of employee performance before and after implementing the suggested policy change on a case-by-case basis. Successful and productive implementation of trusted (i.e. senior) employees would provide the basis for extending the same opportunity to others. Likewise, the success of this communications initiative is also imminently testable because its success would correspond to a specific change in organizational policy according to the recommendations outlined in…
George, J.M. And Jones, G.R. (2008). Understanding and Managing Organisational
Behavior. Upper Saddle River, NJ: Prentice Hall.
Halbert, T. And Ingulli, E. (2008). Law & Ethics in the Business Environment. Cincinnati,
OH: West Legal Studies.
This information is then rated and scored, to determine the take home pay of the manager. Where, those who perform poorly on this index will see a 25% reduction in their pay. This is significant, because it shows how the system that All State uses; helps with goal setting and to promote diversity work. Where, the employee will be selected because of their talents. Then, to maintain motivation and diversity, the company will ask employees for their thoughts on these issues. Over the course of time, this will change the atmosphere of the company, as they are able to quickly address various employee and customer issues quickly.
Ashby, F. (1999). Leadership Development as a usiness Strategy. Effective Leadership Programs. (pp. 11 -- 31) Alexandria, VA: American Society for Training and Development.
Cochraine, A. (2010). All State. Retrieved July 18, 2010 from est Practices Institute website: https://bestpracticeinstitute.org/members/articles/allstate-insurance.html
Hillriegel, D. (2007).…
Ashby, F. (1999). Leadership Development as a Business Strategy. Effective Leadership Programs. (pp. 11 -- 31) Alexandria, VA: American Society for Training and Development.
Cochraine, A. (2010). All State. Retrieved July 18, 2010 from Best Practices Institute website: https://bestpracticeinstitute.org/members/articles/allstate-insurance.html
Hillriegel, D. (2007). Individual in Organizations. Organizational Behavior. (pp. 164 -- 167). Mason, OH: Thomoson.
Hillriegel, D. (2007). Individuals in Organizations. Organizational Behavior. (pp. 172 -- 173). Mason, OH: Thomason.
Features of Third-Party Payers:
How reimbursement and coding affects the healthcare system
The healthcare services market is a very unique entity from the perspective of an economist. Unlike conventional markets, where consumers can very easily compare prices, patients face a very opaque market where costs are largely concealed from them. This is further complicated by the fact that the majority of consumers do not pay for their healthcare directly; rather this payment is mediated through third-party payers in the form of for-profit or not-for-profit private health insurance companies or, in the case of Medicaid and Medicare, state and federal agencies ("Chapter 3," n.d., p. 64). Some patients obtain their care through Health Management Organization (HMOs) and Managed Care Organizations (MCOs) (both of which usually created by insurance companies), which use a system of rationed services and gatekeeping to manage costs within their network. The theory is that by integrating preventative…
Chapter 3: Paying for health services. (n.d.). ACHE. Retrieved from:
Discuss the basic types of homeowners policies that are used today. When is each type most appropriate?
Homeowners insurance policies are for people who own or are buying their own home and for people who rent a home or apartment. A homeowners policy can also include a personal liability policy, often referred to as an umbrella policy, that extends the liability limits of other policies in case a court awards higher amounts than a policyholder's limits. Personal property riders for expensive property can be added to a homeowners policy to cover items and belongings that are higher risk for damage or theft. Special riders can also be purchased to cover natural disasters that may be excluded from homeowners policies, such as earthquake, flood, or tornado; minimally, a homeowner should be sure that their property is not underinsured.
Discuss the pros and cons of purchasing the rental car damage…
____. (20111). Chapter 20: Individual Health Insurance Coverages. Pearson Education, Inc. Retreived http://wps.pearsoned.co.uk/wps/media/objects/9306/9529451/study_guide/M20_REJD_GE_11E_SG_C20.pdf
Zeckhauser, Richard (2008). "Insurance." In David R. Henderson (ed.). Concise Encyclopedia of Economics (2nd ed.). Indianapolis: Library of Economics and Liberty.
community rating in insurance?
Under which pricing system do insurers have an incentive to engage in preferred risk selection?"
Health insurance providers use the rating system to calculate the charge for their insurance. ating systems such as community rating and experience rating use difference statistical method to estimate the amount a given individual or a group will pay for the healthcare insurance. Using the rating system, health insurance providers have been able to determine the amount an individual or a group will pay for their insurance.
Experience rating is defined as the practice of setting a rate for an individual or a group based on the benefits paid on behalf of that group, and experience rating adjusts future premium based on benefit utilization and experience. In insurance, experience rating is based on the traditional insurance concept, which base the premium of a group individual on the probability of the loss…
Enthoven, A.C. (1980). Health Plan: The Practical Solution to the Soaring Cost of Medical Care. Beard Books. USA.
Feldstein, .P.J. (2011). Health Care Economics. Cengage Learning, USA.
Follmann, J.F. (1962). Experience Rating vs. Community Rating. The Journal of Insurance. 29,(3): 403-415.
Mahdavi, G. (2008). Adverse Selection vs. Advantageous Selection in Life Insurance Market. Graduate School of Economics, Kyoto University, Yoshida-Honmachi, Sakyo-ku, Kyoto.
Discount Scheme for Health Insurance
No Claim Discount (NCD) Schemes are Frequency-rating systems and are commonly used in insurance. NCD schemes represent an attempt to categorize policyholders into relatively homogeneous risk groups who pay premiums relative to their claims experience. Those who have made few claims in recent years are rewarded with discounts on their initial premium, and hence are enticed to stay with the company (Boland, 2006). Depending on the rules in the scheme, new policyholders may be required to pay the full premium initially and then will obtain discounts in the future as a result of claim free years. The general insurance actuary modeling an NCD scheme would frequently use Markov chain methods to investigate how premiums and movements take place over time.
No Claims Discount scheme is a form of frequency rating used in health insurance; the practice is to consider the number of years since the…
Boland, P.J. (2006). Statistical Methods in General Insurance. Dublin: National University of Ireland.
Denuit, M., Marechal, X., Pitrebois, S., & Walhin, J.-F. (2007). Actuarial Modeling of Claim Counts: Risk Classification, Credibility and Bonus-Malus Systems. New York: John Wiley & Sons Limited.
MONETOS. (2012). No Claims Discount / NCD. Retrieved September 10, 2012, from www.monetos.co.uk: http://www.monetos.co.uk/insurance/car-insurance/cost/cutting/ncd/
Pinquet, J. (2012). Experience Rating in Non-Life Insurance. Paris: Universite Paris.
Under Anglo-American common law, Ungern-Sternberg (2004) reports that, "When a property has changed owner, it is quite possible that no insurer is liable for subsidence damage, even though it has been permanently insured. Many homeowners suffer from the illusion that their building insurance will automatically pick up the whole bill but some have found this an expensive pipe dream" (p. 49). In reality, when consumers purchase a new home, it is carefully inspected and all known faults are identified, but unknown faults are also inherited in the transaction (Ungern-Sternberg, 2004).
Consequently, the experiences of many homeowners to date have been encounters with previous policyholder's insurance company disavowing responsibility for such damage as well as the new insurance company that will argue the damages are the result of pre-existing conditions. This nebulous area of building insurance remains controversial, and Ungern-Sternberg (2004) emphasizes that the practice continues to adversely affect building purchasers.…
Are you fully insured? (2011, March). Society of Chartered Surveyors. Retrieved from http://www.scsi.ie/publications/Downloadreport/hri2011 .
Black's law dictionary. (1991). St. Paul, MN: West Publishing Co.
Bonato, D. & Zweifel, P. (2002). Information about multiple risks: the case of building and content insurance. Journal of Risk and Insurance, 69(4), 469-471.
Hoffman, a.V. (2003). House by house, block by block: The rebirth of America's urban neighborhoods. New York: Oxford University Press.
The concept of Marine insurance is something that has been developing at a fast rate of late. (Marine Insurance: Barlow, Lyde and Gilbert) What exactly is insurance and how long has the concept been recognized? Insurance can be defined as a form of provision of a safety net for the distribution of risks. This is generally made in the form of a financial provision that is meant to protect against losses that may occur due to certain unavoidable reasons. Insurance works like this: a person who wishes to insure an object or possession or belonging of his will pay a certain amount of money that has already been fixed by the insurance agent in order to offer the security of the money to distribute the risks when the insurer happens, by misfortune, to lose his possession or damage it because of an unavoidable reason. The insurer, by the…
Admiralty Law.com" Retrieved at http://www.admiraltylaw.com/papers/2000.htm. Accessed on 19 September, 2004
Averagium" Retrieved at http://harvey-ashby.co.uk/Averagium%20-%20Winter%202002.pdf. Accessed on 19 September, 2004
Commercial Hull" (2004) Retrieved at http://www.veromarine.co.nz/dirvz/marine/marine.nsf/content/ProductsHullCommercialHullAccessed on 19 September, 2004
English Marine Insurance Act 1906" Retrieved at http://www.solarnavigator.net/english_marine_insurance_act_1906.htm . Accessed on 19 September, 2004
isk and Insurance Management
isk is believed to be a newly coined word of assurance (for example, Ewald, 1991: 198). One of the broadly shared suppositions regarding insurance is that it spins around an instrumental concept of risk. Possibility and the amount of influence make up a technical concept of hazard/risk and hazard administration is chiefly worried about reviewing these possibilities and influences (for an overview see Gratt, 1987). For instance, external profits of financial or political occurrences lay down thresholds for the availability of associated risk guesstimates or reckonings (Huber, 2002).
So, the range of the risk groups cannot be clarified by risk judgment single-handedly; peripheral circumstances that could be political, financial or inclusive of image, arts and manners, are also required to be taken into account. Therefore, if risks are not be present, per se, but are deliberately selected, we can go a step ahead and presume them…
Douglas, M. And Wildavsky, A. (1982) Risk and Culture. An Essay on the Selection of Technical and Environmental Dangers. Berkeley: University of California Press.
Evers, A. And Nowotny, H. (1987) Uber den Umgang mit Unsicherheit. Die Entdeckung der Gestaltbarkeit von Gesellschaft. Frankfurt / Main: Suhrkamp.
Ewald, F. (1991) 'Insurance and Risk' in Burchell, G., Gordon, C. And Miller, P. (eds.) The Foucault Effect: studies in governmentality . London: Harvester Wheatsheaf.
Gratt, L.B. (1987) 'Risk Analysis or Risk Assessment: a proposal for consistent definitions' in Covello, V. And Lave, L. (eds.) Uncertainty in Risk Assessment, Risk Management and Decision Making, Advances in Risk Analysis (4). New York: Plenum Press.
Texas Department of Insurance illustrates why and when the Texas Department of Insurance was formed and how much it has accomplished since the time it was established. This paper highlights the number of people employed by the TDI, their annual budget and their board of governors.
The Texas Department Of Insurance
The prime purpose of the Texas Department of Insurance is to efficiently manage files on all the insurance carriers in Texas. These files are categorized by their respective types and region and are provided to other school districts upon request. The Texas Department of Insurance is divided in such a way that each group governs each insurance type. "For example, property and casualty, life and health, and workers' compensation are each separate departments with teams of experts capable of answering inquiries and complaints about each of those specific types of insurance" (Texas Comptroller Of Public Accounts, Purchase School District…
SLSOT Procedures Manual. Available on the address http://www.slsot.org/pman1.htm.
Accessed on 9 Feb. 2004.
Texas Comptroller Of Public Accounts. Purchase School District Insurance Through
Cooperative Agreements. Available on the address http://www.window.state.tx.us/tpr/tpr4/c1.ed/c105.html . Accessed on 9 Feb. 2004.
Title insurance covers both the buyer and the mortgage company from a number of defects in title. The many benefits of title insurance includes better protection than a lawyer's opinion, at a similar price, piece of mind, and protection from unforseen claims on title. However, title insurance can have some disadvantages, including a slightly higher cost than a lawyer's opinion. Title insurance enables constructive notice, and is useful to reduce workload and liability in a legal environment.
Title Insurance is simply an insurance product like many others. In the simplest possible terms, the insured pays money (a premium) to an insurance company in exchange for an insurance policy that quarantines that the insured has a valid, marketable title to the insured property.
Title insurance does not absolve the insured (or at least the insured's layers) from needing to conduct a number of title searches, as specified by the insurer. However,…
California Land Title Association.
Bulletin 03/04-26, September 2, 2003. CLTA News
Express. 21 http://www.clta.org/News/NewsExpress/bull0304-26_LatestLegalDevelopments.htm
Eyton-Jones, Charles. How we work - Questions and Answers. 21 November 2003. http://www.my14law.com/howwework.html
Another alternative for companies with uninsurable risks is mutualization. However, this category of insurance carries further risks that may not be suitable for all companies. The main problem is that mutual insurers require participants to be from a homogenous population, making this alternative unviable for a variety of clients. Some companies are however working on overcoming such problems to make mutualization less problematic for their investors.
Some insurance companies now recognize the main concern of organizations for cash flow in the event of a major loss. These insurers then offer such organizations solutions that guarantee cash flow in the form of a possible loan alternative, which is then to be repaid at a later time, when the company has mitigated its loss. Cash flow insurance can then be based upon income factors such as future royalties or rental income, that are generally not shown on current income statements.
Health Insurance Consumer Knowledge
Do most people know everything about their health insurance plans?
The two plans investigated for this assignment are Blue Cross Blue Shield and Humana, two of the most widely used and recognized health insurance companies in the United States.
Do you think that in general most people know everything about their health insurance plans?
The healthcare reform act of 2009 sought to make the healthcare system in the United States more navigable for Americans and to prevent health insurance companies from taking advantage of their customers. It seems, however, that the dense amount of legal and financial information embedding in the policies published by most companies is beyond the comprehension of most Americans (Gabel et al. 1987). Most people probably are aware of their emergency and primary care coverage but might not know about other less publicized and critical elements of insurance coverage plans which may…
Anthem. (2011)Anthem Connecticut Health Plans. Retrieved from: http://www.anthem.com/health-insurance/plans-and-benefits/health-insurance-plan/CT
J Gabel, C Jajich-Toth, K Williams, S Loughran and K. Haugh. (1987). "The commercial health insurance industry in transition" Health Affairs, 6, no.3:46-60
Humana. (2011). Individual Insurance Plans from Humana. Retrieved from: http://www.humana.com/individual_insurance/insurance_products/humanaone_medical_plans.aspx
United States Government. (2011). Healthcare.gov. Retrieved from: www.Healthcare.gov
Though the study used computer and camera equipment to measure "elevated gravitational-force events," or g-force events, researchers said what may be most important is that monitoring and feedback happen at all -- whether they come from a device or a person.
"In a way this reminds us how important it is that parents monitor their young person's early driving, and have some sense of how they're doing," Shope said.
Researchers led by Bruce Simons-Morton from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, outfitted the cars of 42 new teen drivers in Virginia with equipment to record high g-force events, such as quick starts and sharp, screeching turns.
They monitored the drivers for 18 months, also keeping track of any crashes or near crashes the teens had.
For every 100 miles of driving, the equipment recorded from close to zero to about…
In an ideal world, every single person would be able to afford the medical care and attention they need throughout their lifespan. The Affordable Care Act, colloquially called Obamacare, set as its goal eventual universal healthcare coverage. Unfortunately, Obamacare has not promoted the ultimate goal of providing affordable healthcare for all Americans. Mandating healthcare insurance does help reduce disparities in access to affordable and necessary interventions, tests, and treatments. As idealistic as Obamacare is, the policy has not reduced the costs of healthcare but it does represent a step in the right direction towards distinguishing between the profit motive in healthcare insurance and the ethical obligation to create a more caring and egalitarian society.
The Affordable Care Act used mandated insurance coverage as its main policy initiative for several reasons, both fiscal and humanitarian. As Gruber (2012) points out, about 12 million employed Americans were not receiving coverage from their…
To rebuild their image, the company would try a number of different strategies, none of which would prove to be successful. This would hurt the market share of Gap to the point that many analysts now believe that it may be advantageous to spin off the company's: Old Navy, anana Republic and Gap stores. What this shows, is how a company can begin to lose its way when it is not focused on adjusting to changes in consumer tastes and trends. In the case of Ann Taylor, they need to be aware of this hazard, as it can have an adverse impact on the long-term viability of their business. (Reingold)
A second challenge that Ann Taylor can be wrestling with is a lack of focus on the part of management. In this case, managers must understand the role that their decisions will have on their organization. Where, executives must clearly…
10Q. Ann Taylor, 2010. Print.
Ann Taylor Stores. Yahoo Finance, 2010. Web. 31 Oct. 2010
Ann Taylor Stores. Yahoo Finance, 2010. Web. 31 Oct. 2010
Ann Taylor Stores. Yahoo Finance, 2010. Web. 31 Oct. 2010
2. Second, the deductibility of mortgage interest and property tax payments serves to lower the after-tax cost of homeownership, also contributing to owners' ability to increase savings or consumption. Many low-income owners may not benefit from these provisions, however, because the standard deduction often exceeds interest and property tax
3. Third, homeownership allows a borrower to tap into secured lending against his or her home, which, all else equal, is often at a lower rate of interest than unsecured lending. All these financial benefits are possible but in no way assured. As discussed in the following text, the proper way to view homeownership is as an investment that carries with it significant risks and uncertainties. For any number of reasons, homeowners can end up losing money on their homes or earn less of a return than if they had rented over some period." (Herbert and elsky, 2008, p. 9)
Quigley, John M. (2005) Federal Credit and Insurance Programs: Housing. University of California, Berkeley.
Evolution of the U.S. Housing Finance System: A Historical Survey and Lessons For Emerging Mortgage Markets (2004) U.S. Department of Housing and Urban Development. 31 Mar 2006.
Affordable Housing Policies in the U.S. (2009) Department of Housing and Urban Development. 2 Mar 2009.
Herbert, Chris E. And Belsky, Eric S. (2008) The Homeownership Experience of Low-Income and Minority Households: A Review and Synthesis of the Literature. Cityscape: A Journal of Policy Development and Research • Volume 10, Number 2 • 2008 U.S. Department of Housing and Urban Development • Office of Policy Development and Research
Insurance companies enjoy large profit margins in the insurance industry. A reason for these margins would be the project management ability of firm employees to effectively management risk. Project management tools enable managers to effectively manage inherent risk with project implementation and management.
An example of a project management issue at an insurance firm is provided by Pula & Stone (2003), "The authors' research shows that customer relationship management (CM) projects can achieve higher rates of return by work on data quality. Existing and new data need to be integrated and shared, with updates synchronised among many different systems. These systems (including operational, analytical and customer contact applications and databases) were rarely designed to work together and the data they collect and use are not normally collected, structured or quality-assessed for the CM purposes for which they are eventually used." (Pula, Stone, 2003)
The block quote is to…
Chase-Jacobs-Aquifano: Operations Management for Competitive Advantage, 11th Edition. The McGraw Hill Companies, 2005
Lind, D., Marchal W., Wathen S. (2010). Statistical Techniques in Business & Economics. 14th Edition. McGraw-Hill Irwin
Pula, E.N., Stone, M., & Foss, B. (2003). Customer data management in practice: An insurance case study. Journal of Database Marketing & Customer Strategy Management, 10(4), 327. Retrieved fromhttp://search.proquest.com/docview/233337595?accountid=13044
Intelligence seeks to illuminate the unknown. y definition, intelligence analysis deals with highly ambiguous situations. Despite maximum striving for objectivity, the intelligence analyst's own preconceptions are likely to exert a greater impact on the analytical product than in other fields where an analyst is working with less ambiguous and less discordant information.[footnoteRef:1] [1: http://www.au.af.mil/au/awc/awcgate/psych-intel/art5.html ]
In this specific case, CityPlus Insurance has approached with a number of suspicious automobile accident claims. It has gathered and obtained all the relevant information: injured parties, witnesses, vehicle descriptions, license plates, Vehicle Identification Numbers and registered owners, and dates and locations of the incidents.
The injured parties are all claiming soft tissue injuries and filing medical claims through a select group of chiropractors. There also seems to be a particular group of attorneys involved in this process acting on behalf of the injured parties.
In the above situation, to know about the…
Artis, M., M. Ayso, and M. Guillen, 1999. Modeling Different Types of Automobile Insurance Fraud Behavior in Spanish Market, Insurance: Mathematics and Economics, 24(1-2): 67-81.
Brockett, P.L., Xia, X., and Derrig, R.A., 1998. Using Kohonen's Self-Organizing Feature Map to Uncover Automobile Bodily Injury Claims Fraud, Journal of Risk and Insurance, 65: 2.
Clark, M., 1990. The control of Insurance Fraud: A Comparative View, The British Journal of Criminoilogy, 30: 1-23.
Insurance settlement proceeds are treated as operating cash flows under ASC 230. Thus the receipt of the $20 million would be operating. The investment of the $20 million into the company's pension fund would also be an operating cash flow. hile normally investing money into the market is considered an investment flow, that is only when the beneficiary in the corporation. In this instance, the beneficiaries are the company's employees and the defined-benefit plan is a form of employee compensation. All employee compensation is considered an operating cash flow under ASC 230.
The flow should not be classified as an investing cash flow for two reasons. The first is that all insurance disbursements are classed as operating flows. The second is that employee benefits are also operating flows. If the funds were used to rebuild the facility, then that spending may be classed as an investing flow. However,…
No author (2010). U.S. GAAP accounting standards: 230: Statement of cash flows. Accounting Info.com. Retrieved December 6, 2010 from http://accountinginfo.com/financial-accounting-standards/asc-200/230-cash-flows.htm
Humana was founded in 1961, and was originally a nursing home company (Investor, 2013). David A. Jones, Sr. And Wendell Cherry were the founders (Investor, 2013). In the beginning, the company was called Extendicare (Investor, 2013). In the early 1970s the company moved into purchasing hospitals, and had become the largest hospital company in the world by the 1980s (Investor, 2013). In 1974 the Humana name was taken by the company, and in 1978 the size of the company was doubled because it took over American Medicorp (Investor, 2013). A fast-track plan was used throughout the 1970s, and during that time the company was opening one hospital every month (Investor, 2013). That is much faster than the norm for the industry, and Humana did something else very significant during that time. It developed a design for hospitals that used a double corridor instead of just a single one (Investor, 2013).…
Home Page. (2013). Humana. Retrieved from https://www.humana.com/ .
Humana Annual Report. (2011). Humana.
Investor Relations. (2013). Humana. Retrieved from http://phx.corporate-ir.net/phoenix.zhtml?c=92913&p=irol-irhome
Medicare Coverage. (2013). Humana. Retrieved from http://www.humana-medicare.com/
Inventory apacity and Whether Insurance and osts of Storage Increase as Inventory Increases
At least $6,010.00, again this number may change depending on how many orders the company places per year.
Generally, $1,000 depending upon whether this number increases to meet a larger inventory capacity.
couldn't answer it…turned in early so the client would have enough time to answer it himself.
The earliest due date rule requires the job with the earliest due date to be selected. The job with the earliest due date is selected first. The user inputs the number of jobs along with their names, processing time and due dates of each job or the use the data values given at the starting point. Next one sorts out the earliest due date among the jobs. Then calculate each jobs flow time by using the processing time; the flow time is the accumulations of processing time for each…
Chase, Richard B, Jacobs, Robert F. Operations and Supply Chain Management Textbook: Operations and Supply Chain Management; 13th edition
Krajewski, Lee, The value of production schedule integration in supply chains, Decision Sciences, Monday, October 1, 2001
Vokurka, R.J., & O'Leary-Kelly, S.W. (2000). A review of empirical research on manufacturing flexibility. Journal of Operations Management, 18(4), 485501.
Insurance options available to the patient depend upon the policy held by the patient and what is covered by the insurer. Some insurance companies will cover life-saving operations, while others will not (oizen, 2015). Yet even if the operation is covered, there may be a substantial deductible that will have to paid out of pocket; again, this all depends on the type of insurance coverage that the individual possesses. In a time like this, it is difficult to think of finances especially when a loved one's life is at stake. Fortunately, even if the deductible is high, or -- in a worst case scenario -- the insurance company will not cover the operation, there are hospitals that will provide financial aid to applicants.
At the same time, government insurance options are available, such as Medicare and Medicaid. If the patient is 65 years of age or older, he…
Durden, T. (2016). Obamacare update: Insurance premiums set to explode higher in
2017. ZeroHedge. Retrieved from http://www.zerohedge.com/news/2016-05-09/obamacare-update-insurance-premiums-set-explode-higher-2017
Roizen, M. (2015). Will my insurance cover my liver transplant cost? Sharecare.
Retrieved from https://www.sharecare.com/health/digestive-health/transplant-cost-liver-insurance
" (National Conference of State Legislatures Forum for State Health Policy Leadership, 2007). However, regardless of state, the applicants have to meet certain qualifications. First, applicants have to be both uninsured and not eligible for Medicaid for other forms of state sponsored insurance. In addition, not all S-CHIP recipients have to be children; states can get waivers to use S-CHIP funds to cover adults. These other recipients are generally adults who are responsible for S-CHIP eligible children, and/or pregnant women. However, "at the end of 2005, four states had waivers to use SCHIP to cover childless adults, and nine states cover unborn children who will be eligible for SCHIP at birth as well as prenatal and childbirth services for the mother of the child." (National Conference of State Legislatures Forum for State Health Policy Leadership, 2007). The fact that states have chosen to do this reaffirms the concept that the…
DeNavas-Walt, C., B. Proctor, and J. Smith. (2007). Income, poverty, and health insurance coverage in the United States: 2006. Washington: U.S. Census Bureau.
Dubay, L. (2007).
Making sense of recent estimates of eligible but uninsured children.
Retrieved January 28, 2008 from the Henry J. Kaiser Family Foundation
Healthy Employee Pay Less for Insurance Premiums?
Statement of the Issue
The objective of this work is to examine whether the healthy employee should contribute less towards their health insurance premium than employees who are less healthy. Employers are more often offering wellness and health promotion programs focused on promoting good health among their employees and employee's families. Driving this movement is the rising cost of health insurance, as well as disability leave and sick leave benefits. Added to these cots are those associated with lost productivity due to employees being off from work. The position of this writer prior to examining this issue is that employers would benefit from reducing health insurance costs for employees who are healthy and who follow a good health program.
Background of the Issue
The position taken and supported in this work in writing is that immediate actions should be taken by expanding public…
Dowd, B.E. And Feldman, R. (1987) Voluntary Reduction in Health Insurance Coverage: A Theoretical Analysis. Eastern Economic Journal, Vol. 13, No. 3 (Jul. - Sep., 1987), pp. 215-232
Casey, L. (2009) Incentives for Healthy Employees. The Health Council of the North Texas Region. 11 Jun 2009. Retrieved from: http://www.healthindustrycouncil.org/articles/incentives-for-healthy-employees.html
Molly French, MS, Shifting course of our nation's health, American Public Health Association April 2009. Retrieved from: www.apha.org
Appendix F -- Incentives for Healthy Behavior. Office of the Assistant Secretary for Planning and Evaluation - Office of Health Policy. Retrieved from: http://aspe.hhs.gov/health/blueprint/appendixf.shtml
Commercial Insurance, Medicaid, and MEDICARE
Commercial health insurance provides coverage to individual's medical expenses and groups. An example of individual medical expenses is private health insurance whereas an example of group health insurance is employer group health insurance. However, these insurance programs have varying premiums and benefits depending on the specific kind of plan. Moreover, individual private health insurance plans are usually more costly than group health insurance. There are several commercial insurance companies and plans that offer health insurance to individuals and groups such as Aetna and TRICARE respectively. Aetna is a group of TriWest Healthcare Alliance and Blue plans that differs from TRICARE insurance plans.
One of the similarities between Aetna and TRICARE is their purpose of providing health insurance to individuals and groups. Similar to TRICARE, one of the products and services provided by Aetna is health insurance coverage at low, reasonable prices. However, the commercial insurance…
Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration (HCFA), that by the time 2011, health care expenditure will arrive at $2.8 trillion, as well as it will bill for 17% of the Gross Domestic Product. As a result, it is no revelation that white-collar offenders observe health care deception as a rewarding effort. Certainly, the General Accounting Office ("GAO") quotes that such deception accounts for up to 10% of entire health care expense (3).
As health care deception outlays taxpayers almost $100 billion a year, federal, as well as state agencies have given health care fraud tribunal a key center of attention. All through her term, Attorney General Janet Reno made impeaching health care fraud a top precedence at the Department of Justice ("DOJ"), subsequent only to brutal offenses (3).
The government focuses its pains to perceive, as well as take legal action against health care fraud…
(1) Adelaide Few & Jay Trezevant, Fighting the Battle Against Health Care Fraud & Federal Enforcement Actions, 72 FLA. B.J. 34, 34-6 (1998)
(2) Alice A. Love, Leniency Offered Health Care Providers that Admit Federal Fraud, S.D. Union Trib., Oct. 22, 1998
(3) Andy Bunds, The results of the Health Insurance Regulations on Health Care Fraud and Abuse, 72 Mont L. Rev. 63, 72 (2001)
(4) Brian A. Kaset, Sailing Without Safe Harbors: Physician Recruitment and the Law of Fraud and Abuse, 9 Healths Span. 9, 9 (1992)
The implication of this situation is, as employers look to defer more and more of the cost of health insurance to the employees, and as those jobs that provide healthcare benefits to employees become more scarce, the young people in America will not have access to care, and will suffer the physical neglect of that situation.
"In 1994, Congress failed to act on employer-mandated health insurance coverage. This insurance would have benefited mostly poor, working Americans -- those working in small businesses that did not provide health insurance. Medicare and Medicaid, for the most part, cover the older population and those on public assistance. Large businesses cover virtually all their employees. With few exceptions, people who are uncovered are employed by small businesses. Each year since 1994, over 1 million additional American workers, virtually all in small businesses, lost their health insurance coverage. This trend will continue because the…
Anderson, S.G., & Eamon, M.K. (2005). Stability of Health Care Coverage among Low-Income Working Women. Health and Social Work, 30(1), 7+. Retrieved September 9, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5009236500
Galambos, C. (2005). The Uninsured: A Forgotten Population. Health and Social Work, 30(1), 3+. Retrieved September 9, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5009236495
Hirschberg, D. (2001). The Job-Generation Issue and Its Impact on Health Insurance Policy. Challenge, 44(4), 82. Retrieved September 9, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5000854093
Meanwhile, without any competition, such as n the form of a public healthcare insurance system, the private healthcare insurance industry also continually increases premium fees virtually at will (Kennedy, 2006; eid, 2009). Furthermore, by refusing policies to high-risk patients, private health insurers essentially "cherry pick" the lowest risk patients while leaving the most expensive medical services to be furnished at the public's expense by public funds available to provide healthcare for low-income individuals (Kennedy, 2006; eid, 2009). That is why, at the very least. The future of American healthcare insurance must include a public option (Kennedy, 2006).
The Issue of Government Healthcare Insurance Lobbying
The principal way that the private healthcare insurance industry maintains its control over American healthcare is through political lobbying of government representatives (Kennedy, 2006). In fact, there are approximately six healthcare industry lobbyists in Washington for every publicly elected representative. Throughout the 2009 negotiations in Washington…
Kennedy, E. (2006). America: Back on Track. Viking: New York.
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Affordable Health Insurance
The Need for State Participation in Health Care Insurance Exchanges to Provide for Affordable Health Care for Millions of Americans in Need
In the United States, we have basic rights to life and liberty. Yet, many major health care companies are infringing on those rights because they are exploiting health care insurance rates, which has left millions of Americans either underinsured or not insured all together. This puts their lives directly at risk with limited access to essential care. In order to best provide for their uninsured or underinsured citizens, states need to work with the regulations of the Affordable Care Act and open up exchanges to provide for affordable health insurance to the millions of Americans who are currently in need under the ineffective system that is operating today.
In the current situation, there is a lack of affordable health insurance options.
Moreover, health insurance companies…
Health Care for America Now. (2009). Health Insurance Company Abuses: How the Relentless Drive for Profit Endangers Americans. Web. Retrieved November 26, 2012 from http://hcfan.3cdn.net/48b73f19dac6bc9fa7_vzm6iijoh.pdf
Paddock, Catherine. (2007). 47 million Americans without health insurance, census report. Medical News Today. Web. Retrieved November 26, 2012 from http://www.medicalnewstoday.com/articles/80897.php
State of California. (2012). Stakeholders. California Benefit Exchange. Web. Retrieved November 26, 2012 from http://www.healthexchange.ca.gov/StakeHolders/Pages/Default.aspx
The White House. (2012). Affordable Care Act: The New Health Care Law at Two Years. Care Act. Web. Retrieved November 26, 2012 from http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf
OBRA Health Insurance
How OBRA Works
Davis was terminated from his employment because of long absence from work and not because he voluntarily resigned or any gross negligence on his part. Therefore, he and his family are eligible for health insurance coverage under the onsolidated Omnibus Budget Reconciliation Act (OBRA) provided his company maintains its group health plan and still has 20 or more employees for which they currently have 100. If his former employer were to have fewer than 20 employees, then he might still be eligible for what is called mini-OBRA. The OBRA Act was put into law in 1986 in order to provide continuation of group health coverage for workers who have lost their jobs. The Act allows for the unemployed individual to avoid any gaps in coverage that would prevent them from having pre-existing conditions excluded once they were able to obtain group health…
Challenges Facing the State or Local Government
It has been estimated that 46 million Americans were uninsured in during 2006-2007 (Gulley, 2011 p. 368). Chronically ill adults often require expensive health care services, which put a drain on available resources available to provide health care to uninsured, low-income individuals. When these adults forego the care they need, they become sicker and will then require increased health services, which will incur additional expense. These expenses need to be covered somehow and under the law; hospitals cannot refuse to provide treatment to individuals who are in need of emergent care to save the life of or to stabilize a critically ill patient. State governments are required to fund programs such as Medicaid, which provides coverage for low-income persons who cannot afford to pay for health care. Individuals with chronic health issues that require extensive medical care cause a drain on that system. Studies have also shown that patients on Medicaid often are underinsured and receive a poorer quality of care, which has raised mortality rates among those individuals (McWilliams, p. 479).
A solution to providing better coverage to chronically ill patients would be to reform health care through the Affordable Care Act at the state level by opening up the availability of state-sponsored health insurance programs such as Medicaid. The state's have the option of receiving extra funding from the federal government, however some have chosen not to receive it. (Jacobi, 2011, p.69). In the case
Communication Memo - Protest of Health Insurance Fees
What is the purpose of your memo?
This memo presents the position of the Campus WHATEVER Club that single employees should not be charged the same insurance fees as married people paying for family coverage.
Describe your primary audience.
The primary audience is the president of the University.
Is there a secondary audience for the memo?
The memo could also be sent to the Board of Trustees, Vice President for Administration and the head of the Human Resources department, who are all responsible for decisions regarding employee insurance benefits.
Brainstorm for a few moments, jotting down points to be covered in the memo.
The proposal discriminates against single employees.
Married people with those with family coverage will incur more medical expenses and should be asked to pay additional premiums per family member. The proposal causes low morale among single employees. Some may…
HCC Life Insurance vs. Coventry
Purpose of the INSUANCE COMPANY: The purpose of HCC Life Insurance Company is to provide Short-Term Health Insurance for a period of six months. Applicants must reapply for a policy every six months. The purpose of Coventry Health Care of South Florida is to provide Health Insurance that fulfills the Patient and Affordable Care Act (Coventry, 2015). It provides insurance for a period of 12 months, after which the insured must reapply for a new policy.
Benefits offered: Urgent Care, Hospital oom and Board, Local Ambulance, Intensive Care, Physical Therapy, Mental and Nervous Disorders, Home Health Care, Extended Care. Primary Care, Specialist Care, Other Practitioner Care, Preventive Care, Screening, Immunizations, Diagnostic Tests, Imaging, Drugs, Facility Fees (Outpatients and Hospitals), Surgeon/Physician Fees, Emergency oom Services, Emergency Medical Transportation, Urgent Care, Mental Behavior Health, Substance Use Disorders, Prenatal and Postnatal Pregnancy Care, Home Health Care, ehabilitative Services,…
Coventry Health Care. (2015). Federal health care reform. http://www.coventryhealthcare.com Retrieved from http://www.coventryhealthcare.com/federal-health-care-reform/index.htm
HCC Medical Insurance Services. (2015). Short-term medical insurance. http://www.hccmis.com Retrieved from
Proponents of national health insurance propose several hypotheses to support universal coverage. The primary argument is that national health insurance would help to improve the health of the population by increasing access to care (Fuchs, 1991). With national health insurance, more people obtain access to insurance coverage that they could use to access better healthcare. The second hypothesis is that national health insurance would eliminate the negative features of private insurance such as the denial of coverage for those with preexisting conditions (Dalen et al., 2015). According to Dalen et al (2015), the number of Americans without health insurance decreased from 18 percent in July 2013 to 13.4 percent in June 2014 following the adoption of the Affordable Care Act (ACA). Proponents of national health insurance also argue that national health insurance would reduce the number of persons living without health insurance, thus reducing differentials across socioeconomic groups (Fuchs, 1991).…
Dalen, J. E., Waterbrook, K., & Alpert, J. S. (2015). Why do So Many Americans Oppose the Affordable Care Act? American Journal of Medicine, 128(8), 807-10.
Fuchs, V. (1991). National Health Insurance Revisited. Health Affairs, 10(4), 7-17.
Goodman, J. C. (2014). What Seniors have to Fear from Obamacare. Forbes. Retrieved from https://www.forbes.com/sites/johngoodman/2014/10/28/what-seniors-have-to-fear-from-obamacare/?sh=501f9b264562
United States and National Healthcare Insurance:
A Winning Proposition?
Physical health and well-being are among the most basic needs and desires of human beings. We all hope that neither ourselves nor our families will ever be the victims of sickness, incapacitation, or any other malady. We hope too that if we ever do require the services of professional Healthcare providers we will not be bankrupted by the expense. Yet, it is a fact of life, that good Healthcare does not come cheaply. Especially in the United States, physicians hospitals, and other forms of medical care are extremely expensive. Like their counterparts in so many other fields, American medical practitioners are among the most highly paid in the world. A serious illness, especially one requiring hospitalization, can spell financial ruin. It is of course for these reasons that so many Americans have Healthcare insurance. Nevertheless even this insurance is very costly.…
1. Allen, Mike. (14 September 2004). "Bush Assails Kerry on Health Care; Democrat's Plan Would Mean More Taxes, He Says." The Washington Post.
2. Clark, C., & Mceldowney, R. (2000). The Performance of National Health Care Systems: A "Good News, Bad News" Finding for Reform Possibilities. Policy Studies Review, 17(4), 133.
3. Kaus, M. (1995). The End of Equality (2nd ed.). New York: Basic Books.
4. (1996). Living as Equals (P. Barker, Ed.). Oxford: Oxford University Press.
You paid for a single page speech. This company writes 275 words per page. You received a document of 313 words--more than you were allotted--with examples in the first two paragraphs.
If you want more examples, more points, and some format which you did not specify in the additional instructions, I suggest you contact the administration about additional pages for this assignment, or purchase a new order.
New instructions, such as this format you\\\\\\\'re now talking about and which wasn\\\\\\\'t in the original instructions, require a new order or additional pages.
Patient and Affordable Care
Opener: I know people whose health care insurance rates tripled in 2014, when all the components of the Patient and Affordable Care Act were enacted into law. It is worth noting that one person in particular (my neighbor) was in perfect health, had no pre-existing conditions, and had not even utilized his health care plan…
The issues related to healthcare insurance have become a very polarizing and contentious issue over the last few years. Namely, the COVID- pandemic has exacerbated an already antagonistic issue between the healthcare industry, consumers and government. Here rising healthcare costs are harming the discretionary income of both consumers and society at large. Currently healthcare expenditures as a percentage of GDP is roughly 17%. Projections indicate that by the year 2030 healthcare costs will be 20% of GDP. The COVID-19 pandemic saw higher healthcare expenditures as consumers battled life threatening viruses and complications. High levels of inflection, reluctance from consumers to adhere to mask mandates, and a general ambivalence towards the virus helped to cause further increases in healthcare costs. This was ultimately compounded by business closures but further pressures on individual incomes and savings rates. Ultimately, this all culminated into a short, yet severe economic contraction throughout the world (Beam,…
References 1. Beam, B. T., McFadden, J. J., and Stefano, K., Editor. Employee Benefits, 9th Edition. Rosenbloom, a Kaplan Real Estate Education Company, 2012.2. Bikolf, L., Luczak-Kennedy, K., King, M., Panszyck, L; Pope, E; Potaczek, C; Turan, T; U.S. Master Employee Benefits Guide, 2013; PublisherWolters Kluwer.3. Biswas, B. D. Compensation & Benefits Design, Applying Finance and Accounting Principles to Global Human Resource Systems. FT Press, 2012.
Turning the Tide on Insurance Rates: Issues to Consider
Whereas it may seem that utilizing credit reports is a fair and effective method of determining rate structures for potential consumers, it may have some drawbacks that prove to be very costly. According to the Conning & Company study, auto insurers now employ credit scores as an accurate predictor of a person's risk profile and subsequent driving acumen. Although a person's budgetary history may shed some light on his/her spending habits, there is no direct correlation to that person's driving record and his/her chance of making a claim. In lieu of a distinct and direct causative link between credit history and auto insurance risk, auto insurers must take the following factors into consideration: age at the onset of credit history and a built-in institutional bias based on race and culture.
In contemporary America, more than half of all college-aged students possess…
I'm sickened and saddened by what I've become, and I'm staggered by the speed at which I've fallen" (Grisham, 1996, p. 140). Much of the book is realistic, but any good work of fiction takes license in some areas, and this work does, as well. A lawyer getting so involved with a client that he kills an abusive husband would probably be disbarred just about anywhere in the country, and yet udy looks like a hero when the story is finished. That is certainly not realistic.
Grisham supports his thesis against insurance companies throughout the work, by portraying the company and its representatives as greedy, uncaring, and only out for one thing - profits. Grisham writes, "So this is how the uninsured die. In a society filled with wealthy doctors and gleaming hospitals and state-of-the-art medical gadgetry and the bulk of the world's Nobel winners, it seems outrageous to allow…
Grisham, J. (1996). The rainmaker. New York: Dell.
For instance, any retraining measures should focus primarily on the Medical Provider Network and the Independent Medical Evaluator as these issues will be where a majority of client questions will come in. When a potential client calls with a question regarding getting medical treatment for a work injury, a staff member must be capable of both providing accurate information and in convincing the caller that professional legal services are needed. To do this, all staff involved in the workers' compensation process must be trained on the new rules and policies and procedures of Senate ill 899.
Penalties for Noncompliance
In order to limit corruption and profiting from the system, Senate ill 899 has included strict compliance regulations and stiff penalties for noncompliance. Thus, staff training becomes even more important. Training a legal assistant or associate attorney in compliance and giving them the job of compliance assurance will be beneficial as…
California Division of Workers' Compensation. (2005): "Workers' Compensation Reforms Under Senate Bill 899: First Annual Report of Progress. www.dir.ca.gov/dwc/SB899/SB899Review2005.pdf.
Nuckols, Teryl K. And Barbara O. Wynn. (2005): Evaluating Medical Treatment Guideline Sets for Injured workers in California. RAND Corporation.
Pace, Nicholas, Galway, Lionel and Robert Reville. (2003): Improving Dispute Resolution for California's Injured Workers. RAND Corporation.
Peterson, Mark a., Berth, Peter S., Reville, Robert T. And Rachel K. Stern. (2005): Compensating Permanent WorkPlace Injuries: A Study of the California System. RAND Corporation.
California Health Insurance Exchange Website, Covered CA
Covered California (2015) describes itself as a user friendly market place that implements the federal Patient Protection and Affordable Care Act in California. Its website provides useful information to current and prospective clients - such as its history, the health insurance options it offers, how an individual can match an insurance option with their needs, and its financial reports. In 2014, approximately 1.3 million Californians used Covered California to choose health insurance, while millions others used Medi-Cal to check the health coverage they qualified for (Covered California, 2015).
The Covered California website is appropriate for a person at the eighth grade level. First it is divided to four major sections, namely; explore, apply, preview and get help, which allows the users to locate the particular section they may be interested in, in order to explore them further. The explore section clearly articulates the…
Covered California (2015). About Covered California. Retrieved 28 July 2015 from http://www.coveredca.com/about/
Covered California (2015). The 2015 Covered California Shop and Compare Tool. Retrieved 28 July 2015 from http://www.coveredca.com/shopandcompare/2015/#calculator
Strengths of the Korean Long-Term Care Insurance Scheme (LTCI)
As Kang, Park, and Lee (2012) point out, “with the rapid aging of the population, Korea introduced public long-term care insurance for older people in 2008.” It is important to note that South Korea’s long-term care insurance (LTIC) has a number of strengths. These will be highlighted in this text.
First, the United Nations Economic and Social Commission for Asia and the Pacific – UNESCAP (2016) points out that the LTCI scheme has greatly enhanced the welfare of not only the aging population, but also families taking care of older persons. This, according to the UNESCAP, is more so the case given that with the LTCI scheme, the country effectively transformed the long-term care services which were largely residual and selective into universal care services. It is important to note that prior to the introduction of the LTCI scheme, older person…
Perils, Hazards, And isks
In common non-insurance settings, the terms "peril," "hazard," and "risk" are more often than not used synonymously. It is however important to note that in insurance, most particularly risk management, "hazards" and "perils" are not referred to as "risk" as is the case in common English conversations. In this text, I concern myself with the distinction between these key terms. Further, I classify the possible risks I am facing not only as a normal student but also as Vice President of student council.
Perils, Hazards, and isk
In seeking to distinguish these key terms, it would be prudent to first take into consideration how various authors have defined the said terms in the past. To begin with, a peril in the words of Chew (2008, p.35) is "a natural, man-made, or economic situation that may cause a personal or property loss." On the other hand, the…
Chew, DH (Ed.). (2008). Corporate Risk Management. New York: Colombia University Press.
Dorfman, M.S. (2002). Introduction to Risk Management and Insurance. Upper Saddle River, NJ: Prentice Hall.