There was a large landslide on Whidbey Island early this morning, reportedly knocking one home off its foundation, destroying a road and threatening multiple other homes. Photos from the scene -- like this one, or this one -- are pretty amazing.
Anytime this happens in the rainy Northwest -- and it does happen with some regularity -- we get phone calls from people wondering if their homeowners insurance covers landslides.
The answer: Sorry, but probably not.
Mudslides and landslides are NOT covered by a standard homeowners policy, which is what most people have. So it can be very difficult to collect for losses caused by any form of land movement.
So what can you do if you're worried about a potential landslide affecting your home? You may be able to buy a special rider -- i.e. an add-on -- to your homeowners policy that includes coverage for contents for all perils, including earth movement, unless the policy specifically excludes it. But these types of riders typically only cover the contents of your home, not the structure, and some insurers don't offer this option at all.
For the structure, you may be able to buy separate earth-movement coverage from what's known as the "surplus lines" market, meaning insurers who specialize in risks that the traditional insurance industry doesn't cover. But know that if your home is on a steep hillside, it may be difficult to get this kind of coverage.
For the folks affected by the slide this morning, it would be worth checking with their lenders. Mortgage lenders in some cases require earth-movement coverage as a condition of a loan. Although such insurance protects the lender, rather than the homeowner, it could help if the home is no longer useable.
Complicating things for folks close to a landslide, insurers often declare moratoriums on new coverage until a particular event is completely over. We've seen this with earthquakes (due to the fear of aftershocks) and sometimes during wildfire season in parts of Eastern Washington.
Wednesday, March 27, 2013
"Wait a minute -- I thought insurance companies can't have waiting periods for pre-existing conditions!"
We’re hearing this a lot these days, because people are aware that the federal health care reform law affects pre-existing condition waiting periods.
For kids under 19, this part of the health care reform law has already gone into effect. So insurance companies cannot apply pre-existing condition waiting periods when kids go on health insurance policies.
Here's where the confusion comes in: the rules are different for adults. But not for long.
Starting Jan. 1, 2014, the same rule that now applies to kids -- no waiting period for pre-existing conditions -- will apply to adults. For now, however, insurance companies can, and do, apply pre-existing condition waiting periods when adults go on policies.
So hang in there. Starting in January, health insurance companies have to cover treatment for pre-existing conditions starting as soon as you go on the policy.
For kids under 19, this part of the health care reform law has already gone into effect. So insurance companies cannot apply pre-existing condition waiting periods when kids go on health insurance policies.
Here's where the confusion comes in: the rules are different for adults. But not for long.
Starting Jan. 1, 2014, the same rule that now applies to kids -- no waiting period for pre-existing conditions -- will apply to adults. For now, however, insurance companies can, and do, apply pre-existing condition waiting periods when adults go on policies.
So hang in there. Starting in January, health insurance companies have to cover treatment for pre-existing conditions starting as soon as you go on the policy.
Tuesday, March 26, 2013
Report: Claims cost of individual health insurance in WA likely to rise 13.7 percent by 2017
A new report by the Society of Actuaries predicts that medical claims costs for individual health insurance plans -- meaning coverage that people have to buy on their own, rather than get through an employer or government program -- will rise 13.7 percent in Washington by 2017. That's substantially less than in many other states.
About 300,000 Washingtonians now buy their own insurance on the individual market. That number's expected to increase sharply next year as people who are now uninsured start buying coverage.
It's too soon at this point to say what the final rates will be. We don't expect to see the first rate proposals for these policies until next month, and premiums include more than just medical claims costs.
There is, however, some good news for many of these folks. The report does not attempt, for example, to factor in the federal subsidies that many people in the individual market will qualify for, starting in January. Under federal health care reform, a family of four earning up to $94,200 could qualify for help paying for their insurance.
Also, under health care reform, the vast majority of policies will cover much more than they do today. It's rare, for example, to find an individual health plan that covers prescription drugs. Many don't cover the birth of a child. Starting in January, most policies will have to cover those things and more.
Lastly, the sad fact is that the individual health insurance market is no stranger to big increases in rates. In 2009 -- well before health care reform -- those policies in Washington rose an average of 16.5 percent. That's in a single year. And the year before that was even worse: an average increase of 18 percent.
About 300,000 Washingtonians now buy their own insurance on the individual market. That number's expected to increase sharply next year as people who are now uninsured start buying coverage.
It's too soon at this point to say what the final rates will be. We don't expect to see the first rate proposals for these policies until next month, and premiums include more than just medical claims costs.
There is, however, some good news for many of these folks. The report does not attempt, for example, to factor in the federal subsidies that many people in the individual market will qualify for, starting in January. Under federal health care reform, a family of four earning up to $94,200 could qualify for help paying for their insurance.
Also, under health care reform, the vast majority of policies will cover much more than they do today. It's rare, for example, to find an individual health plan that covers prescription drugs. Many don't cover the birth of a child. Starting in January, most policies will have to cover those things and more.
Lastly, the sad fact is that the individual health insurance market is no stranger to big increases in rates. In 2009 -- well before health care reform -- those policies in Washington rose an average of 16.5 percent. That's in a single year. And the year before that was even worse: an average increase of 18 percent.
Tacoma man arrested for insurance fraud
A 24-year-old man facing multiple charges in an insurance fraud case was arrested this morning by the King County Warrant Team at a residence in Tacoma.
Andre Romeo Zamora Sarmiento was charged last year with second-degree theft, forgery and insurance fraud for allegedly filing altered and fake medical bills after a car accident. He failed to appear for arraignment on Dec. 24, 2012, resulting in the warrant that led to his arrest this morning.
The fraud case involves a November 2011 auto collision in Tacoma. A car turned in front of Zamora's car, cutting him off, and leading to the crash.
Zamora subsequently filed a claim with the other driver's insurer for injuries to his back and $2,542 for vehicle damage to his vehicle. For the medical claims, Zamora filed several bills totalling $14,857.
A subsequent investigation by our anti-fraud Special Investigations Unit revealed that several bills were altered and grossly inflated. A bill for $360, for example, had a "9" added, to make it look like a bill for $9,360. A bill for $33.50 was turned into what looked like a bill for $3,358.80.
All told, Zamora submitted claims for $13,236 more than he actually paid. The insurer paid Zamora $5,497 before discovering that the bills were fraudulent.
Andre Romeo Zamora Sarmiento was charged last year with second-degree theft, forgery and insurance fraud for allegedly filing altered and fake medical bills after a car accident. He failed to appear for arraignment on Dec. 24, 2012, resulting in the warrant that led to his arrest this morning.
The fraud case involves a November 2011 auto collision in Tacoma. A car turned in front of Zamora's car, cutting him off, and leading to the crash.
Zamora subsequently filed a claim with the other driver's insurer for injuries to his back and $2,542 for vehicle damage to his vehicle. For the medical claims, Zamora filed several bills totalling $14,857.
A subsequent investigation by our anti-fraud Special Investigations Unit revealed that several bills were altered and grossly inflated. A bill for $360, for example, had a "9" added, to make it look like a bill for $9,360. A bill for $33.50 was turned into what looked like a bill for $3,358.80.
All told, Zamora submitted claims for $13,236 more than he actually paid. The insurer paid Zamora $5,497 before discovering that the bills were fraudulent.
Monday, March 25, 2013
Q: "My homeowners insurer sent an inspector to look at my home. Can they do this?"
It is not unusual for home insurers to periodically inspect the homes they insure.
Generally an inspection might be done after years of providing insurance when an insurer may ask if it's still insuring the same risk that it started out with.
The company might ask your agent to do a site inspection, or might hire an independent company to do site inspections and write reports about what they see, such as maintenance, property/landscape care, and any dangerous conditions that might increase the chance of a loss or injury at your home or on your premises.
There are no insurance laws that prohibit site inspections. Of course you’ll want to set up an appointment so you can be there when the site inspection is made. If a site inspection is made on a ‘drive by’ basis, there is a chance that a report may not be accurate, as you won’t be there to answer questions about any issues that could cause an inspector to be concerned, maybe unnecessarily. If you have questions about the process, we recommend that discuss the issue with your agent.
Generally an inspection might be done after years of providing insurance when an insurer may ask if it's still insuring the same risk that it started out with.
The company might ask your agent to do a site inspection, or might hire an independent company to do site inspections and write reports about what they see, such as maintenance, property/landscape care, and any dangerous conditions that might increase the chance of a loss or injury at your home or on your premises.
There are no insurance laws that prohibit site inspections. Of course you’ll want to set up an appointment so you can be there when the site inspection is made. If a site inspection is made on a ‘drive by’ basis, there is a chance that a report may not be accurate, as you won’t be there to answer questions about any issues that could cause an inspector to be concerned, maybe unnecessarily. If you have questions about the process, we recommend that discuss the issue with your agent.
Thursday, March 21, 2013
Job opening: Deputy insurance commissioner for legal affairs
Due to a retirement, we're recruiting for one of the top jobs at the Office of the Insurance Commissioner: the deputy commissioner for legal affairs.
The person will be responsible for forming the agency's legal positions related to enforcing compliance with the state insurance code and related federal laws, including matters related to insurers, agents, brokers and unauthorized insurance transactions.
He or she will manage a division of 20 employees and serve as general counsel for the insurance commissioner. The division includes staff attorneys and investigators who support the agency's consumer protection mission.
For more, including detailed responsibilities, requirements, salary and application process, please see the full job listing.
The person will be responsible for forming the agency's legal positions related to enforcing compliance with the state insurance code and related federal laws, including matters related to insurers, agents, brokers and unauthorized insurance transactions.
He or she will manage a division of 20 employees and serve as general counsel for the insurance commissioner. The division includes staff attorneys and investigators who support the agency's consumer protection mission.
For more, including detailed responsibilities, requirements, salary and application process, please see the full job listing.
Insurance questions: "What's an `examination under oath,' and do I have to take it?"
Q: "My insurer asked me to attend an `examination under oath.' Can they make me do this?"
A: The company has the right to request that you be examined under oath, but it's your decision whether to actually attend and participate. So you can refuse. But keep reading.
Here's the big caveat: As the insured person, you have a responsibility to cooperate with your insurer during an investigation and to provide support for your claim. If you refuse to attend an examination under oath -- these are often known by the shorthand "EUO" in insurance documents -- your insurer has the right to deny your claim and close their case based on what they will call non-cooperation.
The upshot: We recommend that you attend an examination under oath and that you cooperate with your insurer in support of your claim.
After your insurer has the information it's requested and has completed the exam, then it's their responsibility to provide you with a timely coverage decision. If they deny your claim, they need to clearly explain to you why they made that decision.
If you live in Washington state and have insurance questions or want to file a insurance complaint, you can reach us by e-mail or call us at 1-800-562-6900. You can also file a complaint 24/7 through our new online complaint form.
If you live in a different state, here's how to reach your state's insurance regulator.
A: The company has the right to request that you be examined under oath, but it's your decision whether to actually attend and participate. So you can refuse. But keep reading.
Here's the big caveat: As the insured person, you have a responsibility to cooperate with your insurer during an investigation and to provide support for your claim. If you refuse to attend an examination under oath -- these are often known by the shorthand "EUO" in insurance documents -- your insurer has the right to deny your claim and close their case based on what they will call non-cooperation.
The upshot: We recommend that you attend an examination under oath and that you cooperate with your insurer in support of your claim.
After your insurer has the information it's requested and has completed the exam, then it's their responsibility to provide you with a timely coverage decision. If they deny your claim, they need to clearly explain to you why they made that decision.
If you live in Washington state and have insurance questions or want to file a insurance complaint, you can reach us by e-mail or call us at 1-800-562-6900. You can also file a complaint 24/7 through our new online complaint form.
If you live in a different state, here's how to reach your state's insurance regulator.
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