The Issue of Insurers: Consider the Conundrum

I was reading an LA Times article earlier this morning about insurers that failed to pay death benefits on accepted policies.
None of this surprises me because longtime a insider in insurance law tells us that these companies love collecting their premiums from you yet don't like paying out claim.
These tricks are certainly an issue of concern in the health insurance debacle.
Just wait until 2011.

Insurers Test Data Profiles to Identify Risky Clients

Life insurers are testing an intensely personal new use for the vast dossiers of data being amassed about Americans: predicting people's longevity.

Read more: http://online.wsj.com/article/SB10001424052748704648604575620750998072986.html#ixzz15vnmlh6p

Insurers have long used blood and urine tests to assess people's health-a
costly process. Today, however, data-gathering companies have such extensive
files on most U.S. consumers-online shopping details, catalog purchases,
magazine subscriptions, leisure activities and information from
social-networking sites-that some insurers are exploring whether data can
reveal nearly as much about a person as a lab analysis of their bodily
fluids.

Related

*    Inside Deloitte's Life-Insurance Assessment Technology
<http://online.wsj.com/article/SB10001424052748704104104575622531084755588.h
tml> 
*
<http://online.wsj.com/public/page/what-they-know-digital-privacy.html>
Complete Coverage: What They Know

In one of the biggest tests, the U.S. arm of British insurer Aviva
<http://online.wsj.com/public/quotes/main.html?type=djn&symbol=AV>  PLC
looked at 60,000 recent insurance applicants. It found that a new,
"predictive modeling" system, based partly on consumer-marketing data, was
"persuasive" in its ability to mimic traditional techniques.

The research heralds a remarkable expansion of the use of consumer-marketing
data, which is traditionally used for advertising purposes.

This data increasingly is gathered online, often with consumers only vaguely
aware that separate bits of information about them are being collected and
collated in ways that can be surprisingly revealing. The growing trade in
personal information is the subject of a Wall Street Journal investigation
into online privacy.

A key part of the Aviva test, run by Deloitte Consulting LLP, was estimating
a person's risk for illnesses such as high blood pressure and depression.
Deloitte's models assume that many diseases relate to lifestyle factors such
as exercise habits and fast-food diets.

This kind of analysis, proponents argue, could lower insurance costs and
eliminate an off-putting aspect of the insurance sale for some people.

"Requiring every customer to provide additional, and often unnecessary,
information" such as blood or urine samples, "simply makes the process less
efficient and less customer-friendly," says John Currier, chief actuary for
Aviva USA.

Other insurers exploring similar technology include American International
Group <http://online.wsj.com/public/quotes/main.html?type=djn&symbol=AIG>
Inc. and Prudential Financial
<http://online.wsj.com/public/quotes/main.html?type=djn&symbol=PRU>  Inc.,
executives for those firms confirm. Deloitte, a big backer of the concept,
has pitched it in recent months to numerous insurers.

NO CHANGE: Big Insurance

18 September 

Aetna granted 19% increase

Aetna gets OK to hike rates on individual health policies in California
The increase will average 19% and will take effect Oct. 1 along with double-digit hikes by Anthem Blue Cross, Blue Shield of California and Health Net that also had been reviewed by the Department of Insurance.

United Health is promoted by AARP and owned in a major part by Big PhRMA Novartis.

California regulators seek up to $10 billion in fines from PacifiCare

The health insurer violated state law nearly 1 million times from 2006 to 2008 after it was bought by UnitedHealth Group, the Department of Insurance says.

by Duke Helfand

California regulators are seeking fines of up to $10 billion from health insurer PacifiCare over allegations that it repeatedly mismanaged medical claims, lost thousands of patient documents, failed to pay doctors what they were owed and ignored calls to fix the problems.

In court filings and other documents, the California Department of Insurance says PacifiCare violated state law nearly 1 million times from 2006 to 2008 after it was purchased by UnitedHealth Group Inc., the nation's largest health insurance company by revenue.

Regulators say the companies broke promises to maintain smooth operations for 130,000 of PacifiCare's customers, resulting in what insurance regulators nationwide believe is the largest fine ever sought against a U.S. health insurer.

Another Health Reform Bill Conundrum

As I understand it, hidden deep inside the 2700 or more pages of the recently passed health bill is a small detail I think my readers should know.

As you may know the issue of pre-existing conditions was a major PR focus in the efforts to ram this bill through Congress, and get the citizenry to think they were really getting something.

What's missing is this tiny detail I fell upon in the past day or so about exactly what happens to one of the Big Insurance carriers that will be allowed in the "pool" to sell you something that will continue to give their CEO at least $13 million a year in salary without perks.

And you might end up not getting your claims paid if you happen to have one of these items, obscure and otherwise, deemed "pre-existing" by insurance profiteers.

It just so happens that whomever has been writing this bill, and of late it always seems that industry is writing the legislation, they sure seem to favor industry over Joe or Jane Citizen.

The slap on the hand for denying coverage for "pre-existing" is a paltry $100 a day. To Big Insurance the $100 a day fine doesn't even measure up to pocket change.

In the interim, you or a loved one could die.

Don't you think it might be a good idea to start taking back responsibility for your health?

See also "health care problem is far from solved"