It may not be the scam it sounds like.
We've been hearing a lot lately from consumers who've received letters from life insurance companies saying that they're the beneficiary on a long-deceased loved one's policy.
The letters often include a form that the consumers need to fill out to receive the money, and the form requires them to provide sensitive personal information.
Not surprisingly, many consumers have been skeptical about these letters. But while it may sound too good to be true, the letters may be legitimate. (Keep reading and we'll tell you how to check.)
Here's the background: Until recently, many large life insurers didn't aggressively research whether policyholders had died, even when the person's date of birth suggested that they were almost certainly dead. (This isn't as easy as it sounds, particularly with records that predate the widespread use of social security numbers as an identifier.) Last year, insurance regulators and consumer groups started challenging the insurers to do a better job.
As a result, many life insurers have started checking the names of policyholders against the Social Security Administration's Death Master File. When the companies find an apparent match, they contact the person/s listed as the beneficiary.
But how to be sure that the letter is real? If you live in Washington state, you can contact us at 1-800-562-6900 or reach us 24/7 via our online complaint and information form. We'll get in touch with our contact person at the insurance company who can verify that the letter you received is legitimate.
If you don't live in Washington, here's the contact information for your own state's insurance regulator, who may be able to help.
Tuesday, July 31, 2012
Monday, July 30, 2012
Insurance agent's license revoked; charged with identify theft
Insurance Commissioner Mike Kreidler has revoked the license of a Federal Way insurance agent who forged documents and stole tens of thousands of dollars from a client.
Cecelia Villanueva, who's been selling insurance in Washington since 1994, has also been charged by the King County Prosecutor's Office with two counts of identity theft. Her arraignment is pending. (She's listed in the court filing as Cecilia Cabasco Sawyer.)
In 2002, Villaneuva, sold an annuity that was ultimately worth more than $148,000 to an elderly woman and the woman's neice. She wrongly listed the neice's ex-husband as the primary beneficiary.
The elderly woman passed away in 2005. According to investigators, Villaneuva got a copy of the woman's death certificate, and forging the ex-husband's signature, she filed a claim with the insurer for the annuity proceeds. She steered the money into a bank account that she'd opened in the ex-husband's name, and repeatedly forged his name on checks.
The bank records show that she spent tens of thousands of dollars on groceries, cell phone service, at a drugstore. One of the largest checks, for $6,000, was simply made out to herself.
Eventually, the neice asked about the annuity. Villanueva claimed that due to the poor economy, the value of the annuity had dwindled to just $83,000.
The insurance company that Villaneuva worked for says it is working with the family to repay the stolen money.
Villanueva's insurance license was revoked under the state's insurance laws barring agents from improperly witholding or misappropriating clients' money, demonstrating untrustworthiness, and for forging signatures.
Cecelia Villanueva, who's been selling insurance in Washington since 1994, has also been charged by the King County Prosecutor's Office with two counts of identity theft. Her arraignment is pending. (She's listed in the court filing as Cecilia Cabasco Sawyer.)
In 2002, Villaneuva, sold an annuity that was ultimately worth more than $148,000 to an elderly woman and the woman's neice. She wrongly listed the neice's ex-husband as the primary beneficiary.
The elderly woman passed away in 2005. According to investigators, Villaneuva got a copy of the woman's death certificate, and forging the ex-husband's signature, she filed a claim with the insurer for the annuity proceeds. She steered the money into a bank account that she'd opened in the ex-husband's name, and repeatedly forged his name on checks.
The bank records show that she spent tens of thousands of dollars on groceries, cell phone service, at a drugstore. One of the largest checks, for $6,000, was simply made out to herself.
Eventually, the neice asked about the annuity. Villanueva claimed that due to the poor economy, the value of the annuity had dwindled to just $83,000.
The insurance company that Villaneuva worked for says it is working with the family to repay the stolen money.
Villanueva's insurance license was revoked under the state's insurance laws barring agents from improperly witholding or misappropriating clients' money, demonstrating untrustworthiness, and for forging signatures.
Thursday, July 26, 2012
"I need insurance. Who would you recommend?"
We get this question all the time. And sorry, but we can't steer you to a particular agent, broker or insurer. We're the state agency that regulates the insurance industry in Washington state, and in that role, it's not our place to endorse particular companies or agents.
That said, we do have some online tools that can help you pick who you want to deal with.
We have this agent and company lookup, where you can find local agents, companies that sell specific types of coverage, etc. If you look up a company, you can also see the number of complaints by year. And the agent/broker listings include any disciplinary actions taken against that person.
If you want to find out how many complaints we get about particular insurers, here's our complaint comparison tool. It helps you find out out how insurers compare to one another. You can compare health insurers, for example, or auto, or life, etc.
And because market share varies dramatically, we include a "complaint index" that makes it easier to make apples-to-apples comparisons between different companies.
Lastly, it's always a good idea to double-check by running the name of an insurer, agent or broker through our disciplinary orders database. It goes back to 2002, and includes details on violations, fines, and other orders we've issued.
That said, we do have some online tools that can help you pick who you want to deal with.
We have this agent and company lookup, where you can find local agents, companies that sell specific types of coverage, etc. If you look up a company, you can also see the number of complaints by year. And the agent/broker listings include any disciplinary actions taken against that person.
If you want to find out how many complaints we get about particular insurers, here's our complaint comparison tool. It helps you find out out how insurers compare to one another. You can compare health insurers, for example, or auto, or life, etc.
And because market share varies dramatically, we include a "complaint index" that makes it easier to make apples-to-apples comparisons between different companies.
Lastly, it's always a good idea to double-check by running the name of an insurer, agent or broker through our disciplinary orders database. It goes back to 2002, and includes details on violations, fines, and other orders we've issued.
Wednesday, July 25, 2012
My kid's delivering pizzas in his car. Does he need extra insurance?
Sorry, but the answer's usually yes. Most personal auto insurance policies won't cover you if you're getting paid to use your own car to transport people or property for business purposes.
In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.
If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.
In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.
If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.
Monday, July 23, 2012
Eastern Washington storm damage and insurance claims
Large parts of eastern and northeastern Washington suffered significant storm damage on Friday, when high winds and heavy rains ripped through the region, toppling trees, cutting power lines and damaging cars and homes. Flash floods also damaged some areas.
As homeowners, businesses and vehicle owners pick up the pieces, here are some key things to know about insurance claims:
Direct damage to insured structures by wind, wind-driven debris and falling trees is generally covered under standard homeowners and business coverage.
As for vehicles: If you have comprehensive coverage, that will also generally cover damage to a car or truck from falling limbs, etc.
Immediately contact your agent or insurer, who can help walk you through the claims process. If the damage is severe enough that you cannot remain in the home, your policy may include some coverage for temporary living quarters.
Flood damage is usually only covered if you had flood insurance. Contrary to what many people think, flood coverage is NOT part of a standard homeowners policy. In Washington, the first stop for flood coverage is often the National Flood Insurance Program, a federal insurance program sold through local agents.
As for the damage, be sure to take pictures. Avoid making permanent repairs or discarding damaged property until claims officials can document the damage or loss. If you can safely do it, try to minimize further damage, such as covering broken windows.
Here's a more-detailed list of tips for filing an insurance claim after a natural disaster.
As homeowners, businesses and vehicle owners pick up the pieces, here are some key things to know about insurance claims:
Direct damage to insured structures by wind, wind-driven debris and falling trees is generally covered under standard homeowners and business coverage.
As for vehicles: If you have comprehensive coverage, that will also generally cover damage to a car or truck from falling limbs, etc.
Immediately contact your agent or insurer, who can help walk you through the claims process. If the damage is severe enough that you cannot remain in the home, your policy may include some coverage for temporary living quarters.
Flood damage is usually only covered if you had flood insurance. Contrary to what many people think, flood coverage is NOT part of a standard homeowners policy. In Washington, the first stop for flood coverage is often the National Flood Insurance Program, a federal insurance program sold through local agents.
As for the damage, be sure to take pictures. Avoid making permanent repairs or discarding damaged property until claims officials can document the damage or loss. If you can safely do it, try to minimize further damage, such as covering broken windows.
Here's a more-detailed list of tips for filing an insurance claim after a natural disaster.
Thursday, July 19, 2012
Insurance tips: Sudden discovery...of a longtime problem
Consumers routinely call to file a complaint about denied homeowners insurance claims in which the problem is that they just discovered a long term problem. These tend to be things like mold, rot, mildew or deterioration.
The problem for these homeowners is that Insurance is designed to cover sudden and accidental damage, but not wear and tear for home care and maintenance that any homeowner is expected to address on their own. Some policies may allow coverage for damage caused within a matter of weeks -- and they may mean that plural literally, as in just two weeks -- to be considered sudden and accidental.
Generally, an insurer will inspect the damage to determine if it could have been caused suddenly or over a period of time. An example is mold damage that resulted from a leaking hot water heater, or a refrigerator water line that's been leaking, slowly rotting the kitchen floor joists.
The upshot is this: the longer an underlying problem has existed, the harder it is to successfully claim that the damage was sudden.
Update (9/25/2012): Here's a classic case of this sort of problem.
The problem for these homeowners is that Insurance is designed to cover sudden and accidental damage, but not wear and tear for home care and maintenance that any homeowner is expected to address on their own. Some policies may allow coverage for damage caused within a matter of weeks -- and they may mean that plural literally, as in just two weeks -- to be considered sudden and accidental.
Generally, an insurer will inspect the damage to determine if it could have been caused suddenly or over a period of time. An example is mold damage that resulted from a leaking hot water heater, or a refrigerator water line that's been leaking, slowly rotting the kitchen floor joists.
The upshot is this: the longer an underlying problem has existed, the harder it is to successfully claim that the damage was sudden.
Update (9/25/2012): Here's a classic case of this sort of problem.
Wednesday, July 18, 2012
Rule making starts for essential health benefits
In 2014, when the rest of the Affordable Care Act kicks in, all health plans - whether they're sold inside the new online health exchange or outside - will be required to cover certain essential health benefits.
The essential health benefits will be based on the largest health plan in the small employer market -- Regence's Innova plan and must include all current state mandated benefits.
Specific coverages and any gaps that need to be filled will be determined through the rule making process started earlier this month, but all plans must include the following categories:
The essential health benefits will be based on the largest health plan in the small employer market -- Regence's Innova plan and must include all current state mandated benefits.
Specific coverages and any gaps that need to be filled will be determined through the rule making process started earlier this month, but all plans must include the following categories:
- ambulatory patient services
- emergency services
- hospitalization
- maternity and newborn care
- mental health and substance abuse disorder services - including behavioral health treatment
- prescription drugs
- rehabilitative and habilitative services and devices
- laboratory services
- preventive and wellness services
- chronic disease management
- pediatric services, including oral and vision care
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