Waiting Period

Waiting Period

Waiting period refers to the time between the period of registration filing with the SEC and the time of the declaration of the registration statement effective by the SEC. It is also known as “quiet period” and sometimes “cooling-off period”. In heath insurance waiting period is referred to as the period of time stated in a health insurance policy, which should be passed before all the coverage of the health care can begin. There are three types of waiting periods in health insurance. First is the employer waiting periods, then the affiliation periods, and lastly the pre-existing condition exclusion periods.

Employer waiting periods is the most common type of waiting period. It is found in the employer group plan, where in a new employee must in given period of time, often times it is within three months before a person can be qualified for health care benefits. On the other hand affiliation period is the one imposed by an HMO instead of an employer. Affiliation period does not last longer than three months and it is attached with a specific rules. While the pre-existing condition type period involves those people who have a condition within the six months before the signing of the health insurance. The insurance coverage of this type of waiting period can be excluded or limited for pre-existing condition.

In finance, an example of waiting period is when filing of documents in a government regulatory agency is done. Typical case is that company should file its intentions in an appropriate government agency, and gain approval in issuing the offering, then observe a span of time before the company begins to announce to the public. This kind of waiting period is applicable for three calendar months. With regards to insurance claims, the waiting time depends on the time from the filing of the claim up to the point where in the insurance company settles the particular claim; it can be in a form of rejecting the claim or paying it. Most insurance coverage gives specific provisions in relation to the filing of claims; it also includes the waiting period of the insured party for the claim to be finally settled.

One advantage of waiting period is that all parties are allowed to be involved in the deal while investigating the claims of the proposed action. Insurance companies have also its own share of benefits form using waiting period or elimination, because it gives time to verify the information related to the claim and determining if the payment to the other insured party is in order as what is stated in the terms and conditions of the his or her insurance policy. It is in the insurance policy that the obligations of the insurer to a premium-paying policy holder. Using waiting period can help minimize the possible occurrence of insurance fraud, where in it can save an insurance company from losing a big amount of money. Likewise the use of elimination or waiting period does not directly help in lowering the insurance premiums compared to what they would be.

Utilization

Utilization

The word utilization is a numerical idea and an initial measure in business for the rental realm. In terms of equipment rental firms, utilization is an initial means whereby the performance asset is estimated and business progress is established. In elementary terms, it is estimated on the actual income earned from assets from the probable income that could be earned. Rental utilization is separated into numerous measurements and not every firm works exactly the similar manner. Generally, there are two key measurements; one is the physical utilization of assets, which is estimated basing on the quantity of accessible days for rental up against the quantity of days of actual rent. This can also be calculated by hours for particular kinds of tools, hence the financial use on asset by which estimated as rental income gained beyond a phase of time up against the possible income that have been gained basing on a standard or non-discounted rate. Physical utilization is at times referred as spot utilization, wherein a rental firm views at it existing use of assets basing on a lone instant of time.

In terms of utilization review, it is referred to as a health insurance firm’s privilege to go over a suggestion for medical treatment. The rationale of the evaluation is to see to it that the program allows coverage for medical services. It also aids the firm lessens expenses and establish if the commended medication is accurate. A utilization analysis also offers the advantage to verify that a health program offers enough coverage for certain condition. When the company rejects the coverage as a consequence of utilization analysis, one can appeal such decision as always.

The word utilization management is frequently used in exchange with utilization review. Though both engage the analysis of care founded on medical need. Utilization management typically refers to suggests for consent of forth coming medical necessities, whereas utilization review pass on to the analysis of past medical remedy. Consequently, utilization management is the procedure of pre-authorization for medical service. Analysis of appeals falls also under utilization management.

Therefore, the terminology utilization reviews pass on to a retrospective analysis, the evaluation of medications or services which have been established and the assessment of medical records in comparison with medication guidelines. The details retrieved in a utilization analysis could be utilized as fraction of a system which produced the insurance firm’s rules in a given situation. In producing such documents, insurance firms do not only utilize a person’s experiences yet also analyze how experts, hospitals and labs handle with care their patients.

In some outcome of review over empirical researches which measures fundamental relations both health care utilization and health insurance and health results consistently imparts that health insurance heightens utilization and enhanced health. Preferably, health insurance had effects on the manner of use of preventive services, physician services, self-reported status and mortality situations on disease and injury. These outcome between confirm and contradict outputs from health insurance tests, the gold standard on relations of both health insurance, health and utilization.

Insurance: Tort

Insurance: Tort

Under common law, a tort refers to a wrong act committed to someone as a violation of civil duties that do not arise from statutes or contracts. It is distinguished from wrongdoings executed contravening the duty due to the general society, such as crimes, although numerous acts are considered both crimes and torts. The only difference is that actions against crimes are the state’s responsibility. Anybody who becomes a victim of tort can file a civil lawsuit to the person causing the mischief, or the tortfeasor. In civil law, torts are commonly known as delicts.

“Damages” is the legal term for monetary compensation that is awarded to the person suffering an injury out of torts. It is paid by the person liable or responsible for such injuries. Injuries can either be body or property injuries. Torts are governed by tort law, which gives out the definition for legal injury, and the factors that could make a person liable for such legal injuries.

Aside from physical injuries, legal injuries also include reputational, economic, and emotional injuries, in addition to violations of property, constitutional rights, and privacy. Defamation, vehicle accidents, copyright infringement, toxic torts or environmental pollution, false imprisonment, and product liability, are few examples of tort cases.

Negligence is the most prominent liability in torts. The phrase can be synonymous to recklessness or carelessness. The person acting negligently can be described as someone who fell out of his duty to act with due care, or, reasonable care. Someone who files a case to injuries suffered as a result of another person’s negligence must prove in the civil courts that the latter behaved without reasonable care. Once proven, the person at fault must provide compensation to the injured person, as specified in tort law. Negligence is classified as an unintentional kind of tort. An example of this is a Tax professional who failed in filing tax returns for his/her client according to acceptable tax laws.

Intentional torts, on the other hand, represent omissions or deliberate acts. These include trespass, assault, libel, false imprisonment, battery, and conversion.

In insurance, the coverage to be employed against tort cases is the tort liability insurance. This provides solutions to persons found at fault with tort, in most cases, due to negligence. Generally, education professionals acquire tort liability insurance before venturing in the field. In this case, the insurance carrier of the teachers will be the one to cover damages in case they are confirmed culpable of torts. In the case of autos, the insurance company of a driver who caused an accident will be the one to pay the victim’s medical expenses and other damages.

Another insurance pertaining to torts is the tort auto insurance system, which tolerates victims of vehicle collision to compel the person causing the accident to pay for damages, losses, and medical bills.

However, most states have their own tort system, permitting any tort victim to file legal proceedings. Once the person responsible is proven guilty, then it is here that liability insurance coverage comes out to protect the person insured against further harm.

Successive Periods

Successive Periods

In insurance, successive periods happen when hospital confinements in hospital income protections are considered a portion of the same confinement period because such are due to related or the same grounds and are divided by a smaller amount of a contractually predetermined period.

Hospital income insurance is availed to compensate hospitalization expenses that are not covered in a certain insurance plan, such as costs of private room, phone calls, personal nurse or medical assistance, coinsurance, and deductibles. Child care, meals out, lawn care, house care, and pet care, are the purposes in which the benefits can be employed.

When an insured person is admitted in a hospital, hospital insurance will compensate a benefit. Irrespective of the real expenses incurred, hospital insurance pays, as fixed in the insurance contract, a monthly, weekly, or daily benefit directly to the person insured. Other names for hospital insurance are “hospital indemnity”, “supplemental medical insurance”, and “hospital confinement insurance”.

In case the insured individual is under intensive care, emergency treatment, or cancer confinement, hospital insurance policies normally pay more benefits. Renewable premium rates are offered in this type of insurance, in which the insured cannot be evaluated with a higher premium charge each year if not each person in the category are also charged with higher rates. Once the insured reaches the age 65 or 70, the benefits will be possibly reduced.

Not all states offer hospital income insurance. Well off individuals need not to avail of this indemnity since it is only considered as a supplemental coverage. Thus, any person planning to benefit from such must carefully weigh the impending benefits versus the costs.

Hospital insurance premiums differ for each age because of the varying risks associated. Younger individuals pay lower premiums while older ones shell out higher charges. Hospital insurance can be paid through personal payments or payroll deductions.

In case of a disability, successive periods are regarded as portions of the preceding disabilities if following the receipt of disability benefits covered in such policy, one resumed to work within two constant weeks and became incapacitated again due to the same disease. A 20% loss of a person’s monthly earnings is required to be qualified for successive periods of disability. Thus, the disability’s successive period will be viewed as its new period once an individual returns to his/her job in two incessant weeks. In other words, he/she should finish another elimination cycle in order to be considered eligible for such benefits.

Aside from successive periods, other essential terms embraced in hospital protection insurance are annual administrative fee, attained age, concurrent periods, and pre-existing condition.

Annual administrative fees refer to expenses pertaining to the management of benefit plans for group employees. Attained age represent the insured person’s age for a particular period, since physical examinations are not typically necessitated for younger individuals but are mandatory for older persons. Concurrent periods signify a situation where a patient is admitted to the hospital by reason of multiple illnesses or injuries simultaneously and the paid benefits are made such that the disability is a result of a sole cause only. Pre-existing conditions, in contrast, characterize limitations in a coverage stipulating certain mental or physical conditions not to be covered in the recent policy for a given time, whether those requiring treatment prior to its issuance or those which have been diagnosed previously.

All about Accident and Health Insurance

All about Accident and Health Insurance

Investing on insurance is one thing that you must take into consideration especially in times of crisis. Sometimes, it is important to anticipate things than to be sorry. However, one must take the initiative to know what kind of insurance to invest to maximize their money. Nowadays, it is much better to be wise as we do not know what circumstances will occur. Saving your money by buying the right insurance for you will do well instead of spending expensive hospital bills and medications in times you do not expect things to happen.

One kind of insurance that you would have to invest is the accident and health insurance. This can assure someone that he can avoid such high cost of medical bills and for unexpected circumstances. However, there are also different kinds of accident and health insurance so it will be better to ask your insurance agent to explain the details of which is applicable to you. Different kinds of accident and health insurance also have different limitations, coverage and price range too.

Kinds of Accident and Health Insurance
There are lots of kinds of accident and health insurance policies that you could choose from. This is not just for individuals but also from companies as well. Some are designed for corporate clients depending on the size and general make up of the company. Most businessmen prefer to have this kind of policy to protect not only their business but also their important asset which is their employees. Not to mention that in United States, it is required by the law for most companies to provide this kind of insurance to their employees.

For the individuals, to make your self secure from unexpected event or circumstances, it would be better to avail the accident and health insurance to cover you from excessive charges of hospital bills. It covers doctor’s fee, medical procedures, prescription drugs and others. You can also avail of one time insurance or one time event like a trip to make you feel safe and secured.

Other Facts about the Insurance
Most insurance like this kind has high deductible that you must pay in exchange for any service regarding to your health or to any accidents. It has also a limited amount as to how much they could cover the expenses for you. It would be better to know more about it and let your insurance agent answer all the questions you have in mind related to this kind of insurance prior to acquiring this insurance policy. Having information about what to buy will give you more option to choose which is applicable to you and get the best deal.

In general, securing your investments like your house, car and even your jewelries is important as you want to make sure that all your possessions will be safe and secured. However, you should not also forget to protect yourself which is the most important aside from all the investments you have. Investing on something that will be very useful to you when such circumstances occur will definitely be worth spending for.

Accident and Sickness Insurance

Accident and Sickness Insurance

Take a crack at imagining on how your household may cope up financially if your income can be lost or compromise because of your engagement to an accident or yourself getting sick and that you are momentarily incapable to continue your work.

If and when you cannot work because of an illness or accident, experiencing such conditions of having sickness or in bad health and engaging into an unexpected accident might give you an extra
money support to assist you through such a hard phase of your life for a period set depending on your insurance policy. You select the precise amount of insurance cover you prefer settling on whether you desire to be covered for the sickness, injury, redundancy or both of them and whenever you prefer to safeguard your salary, mortgage repayments, rents or loan repayments. What is mostly important is that you must safeguard yourself today for anything which tomorrow might bring…

The “ASU cover” or the “Accident Sickness and Unemployment Cover” refers to a personal policy in insurance which can pay you a per month income free from tax, if ever you are incapable of working due to reasons of sickness or accident. This just means that when the unforeseeable or unfortunate things will happen on you, then your income proceedings cannot be affected entirely, thus you will be adept to proceed with your financial commitments and bills like, mortgage, payment for rents and other personal finances like for example, credit agreements, car finance, personal loans and especially to the expenses for your day to day living. You can obtain also the choice of adding “Unemployment Insurance” into your sickness insurance plan on which it will cover you from the unemployment status without fault in your part.

However, there are advantages and disadvantages in the above mentioned facts. Income protection insurance plan could be expensive and it is much vital to shop on for the great deals. By means of utilizing the internet, you can distinguish protection to look at insurance policies which fits the person’s needs and for a reasonable price. A disadvantage is that, though the spare fund is welcomed for hard situations, yet, it is unlikely for the coverage to finish the monthly outgoings. In majority of cases, income protection insurance plans offers seventy five (75%) percent of one’s monthly income and in other cases as few as fifty (50%) percent.

Further, if you are incapable of working because of sickness, involuntary unemployment or accident but having a sickness, unemployment and accident insurance program offers you a tax free per month privilege.

In terms of health issues, if one may undergo of a health problem, it can be much harder for him or her to acquire insurance, whereas, insurance agents will not however, cover particular conditions and illnesses because of the natural side effects. Nevertheless, by making it sure that one can gain the appropriate insurance coverage is far more significant. Take a look at some insurance guide so as to make it certain you may be aware of what you’re peeking for when you shop for your income protection insurance plan.

State of Domicile

State of Domicile

State of domicile can be defined as the state in which the insurance company is chartered and licensed to operate under the state’s insurance regulations and statutes. A company is permitted by its state of domicile to operate for the lines of business for which it is certified.

Every state is responsible on regulating and controlling all aspects of insurance. It is committed to ensuring that the consumers are protected and that the insurance companies keep the promises stipulated in the policy contract. Part of the insurance regulation is to make sure that all insurance companies domiciled in the state adhere and uphold the insurance laws governing the state. Company licensing, consumer services, producer licensing, product regulation, financial regulation and market conduct are among the main functions which are included in the insurance regulation structure. All business which caters insurance products and services are required to make policies and terms and condition in accordance with the insurance regulation in their state of domicile.

An insurance company cannot legally operate in a state without obtaining a license first. Individual state laws mandate that all insurance providers as well as insurance-related businesses must be licensed first before selling and providing their products and services to the public. There are an estimated number of 7,200 insurance companies licensed to operate in different areas of the United States. All of these businesses are subject to the laws and regulations of the state where they are licensed to sell insurance. In the event that an insurer, in any manner and for whatever reason fails to comply with the mandated insurance regulations, its license will be a subject to suspension or revocation. The states also impose fines to those who violate insurance regulations in their state of domicile. In 2000, there was a recorded of almost 300 companies in the United States who had their license suspended or revoked. A company licensing system of the National Association of Insurance Commissioners called the Uniform Certificate of Authority Application (UCAA) helps each state in speeding up the review process of releasing new company licenses. There is also a NAIC database developed to assist insurance regulators in maintaining a cost-efficient regulatory process.

Insurance Companies as mentioned are not just required to obtain a license but also to comply with the individual state regulations and laws governing their operations or activities. The state of domicile of all insurance companies ensure that everything in the policy contract and all matters relating to the products and services which insurers provide are offered for the benefit of the consumers. The insurance departments in all states safeguard the interests of the consumers before and after every insurance transaction.

The insurance company’s state of domicile, through its state regulators protects consumers by ascertaining that all provision are unequivocally stated in the contract policy and do not leave any space for misinterpretation that might leave consumers unprotected. The state insurance regulators ensure that the insurance benefits will commensurate to the premiums paid by consumers and that everything in the policy contract is reasonable and fair to the consumers. The regulatory powers exercised by each state may not be uniform because state regulations may vary from one state to another. However, these powers are there not just to protect consumers but also safeguard the condition of every insurance company. The state of domicile ensures that insurance companies are financially sound to be able to provide the benefits promised. If an insurer is experiencing financial trouble, the state will then assist in the process of rehabilitation to restore the former financial condition of the company.

Risk Retention Group

Risk Retention Group

Insurance industry is a vast business world composed of individuals, partners and groups offering different types of insurance policies for continues operation. One of these is the Risk Retention Group

Risk retention group is one type of insurance enterprise that is operated and owned by the members of the group. It is created to essentially help people and businesses that have troubles in acquiring a liability insurance in a traditional insurance enterprise. The members of this group would gather together and share effectively the risks that are closely related to the business.

Risk retention groups have been authorized by the United States under Liability Risk Retention Act. This act was established in 1986 to answer the growing problems in the insurance industry by which either caused by a refusal to provide liability insurance by the company or due to high premiums.

The Risk Retention group is considered to be legal as the bear taker and the insurer of the risks the policies may indicate. In addition, the members of the risk retention group are the only group that will be insured against liability damages and losses like compensation and legal costs from claims caused by faulty products and professional mistakes. It will not cover any personal insurance which includes auto insurance for employees and directors as well as health insurance. It does not also include the coverage for property insurance like theft or fire.

Risk retention group members are obliged to be involved with the same type of insurance in general within the industry. If in case uncertainty may rise of whether the group qualifies, take a look at the liability risks it bears if it is similar or not.

Advantages and Disadvantages of Risk Retention Group
Advantages:
• Avoidance of licensing requirements and multiple state filing
• Member control against litigation management problems and risks
• Establishment of unchanging market for rates and coverage
• No fronting expense fees.

Disadvantages:
• Risks are solely limited to liability insurance
• Not allowed to write any business outside
• No available guarantee funds for its members

The major advantage of the risk retention group is that the firms would be able to acquire liability insurance at the most reasonable price rates as compared to getting it individually. At the same time these firms may act as both the client and the insurer which means that these firms can take control of a greater care to prevent situation that would ignite a claim and thus will improve professional standards.

Risk retention group should be registered by the state and must be governed by laws. Once this had been done, the group can now start taking on and invite and cover members all over the country. The Risk Retention group are exempted to numerous state regulations under the Liability Risk Retention Act. Generally speaking, the state’s power over this group are only limited to the collection to taxes and forcing the group to follow the basic insurance practices which includes settling any claim in a proper manner.

Risk Management

Risk Management

Risk Management is described as a logical approach that is geared towards eliminating and minimizing the risk level closely related to the world of business operation. It is the process of identifying, analyzing and acceptance and lessening of any uncertainty prior to the decision0making in the business. The process usually starts on the identification of the situation that could possibly result to damages to the resources of the company which includes the personnel and moreover take necessary tips to correct the said factors that are highly fronting damages.

The basic core of an effective risk management method is the passion to find specific ways to facilitate the level of uncertainty which exists in every business enterprise. The first move in the process is directly focusing evaluation of the company’s utilization of their resources as what they currently stand. This first step includes comprehension on the logical flow as it associates to the successful production of goods and services to be sold to the customers as well as the process of production. Once understanding takes place of the functions of the organization, it is now possible to take the next step of refining towards managing the uncertainty variable.

Once the framework of the business is best understood, it is now possible to recognize the different risks that are available in the production process which includes the bringing of the good and services to the customers. As these risks are already identified, analysis of that risk is followed to achieve a good result while minimizing the risk level or if possible be removed. Risk management is a complicated process and it calls for the owners to be ready in making minor adjustments.

For instance, risk management is associated to the production process that may involve acts like recreating the schedule of maintenance for machinery in order to ensure that minimum opportunity for a possible malfunction or breakdown be achieved. Employees in this way may be asked to bring and wear goggles, earplugs and gloves for safety in order to avoid damages and minimize the possibilities of any injury brought by the negligence of the company.

Risk management does not only focus on minimizing possible injury to the employees but it also includes the reduction of improper use of other financial forms and money abusively. By ensuring that the resources are used in an efficient, safe and logical manner, the profit index of the company would most likely increase and the member would surely be motivated upon knowing this.

The real process of risk management depends from company to another. The main focus can be on the machinery maintenance or the employee’s safety. In some other companies, the level of risk management may demand a better alternative when it comes to procedures and policies in order to prevent the environment of the company at stake of risk situations. Risk management basically required the need of support from the owners and the present management team to be able to refine the whole operation and to be able to acquire the minimum level of risk as much as possible.

Residual Benefit

Residual Benefit

Insurances are provided for the purpose of safeguarding the financial interest of an individual for future losses. One of the most important types of insurance that the working population should have is the disability insurance. This type of insurance pays for any lost of income in the event that the person insured is not able to work because of injury or sickness. Disability insurance are commonly offered by companies to their employee and rates as well as coverage vary from one insurance provider to another. There is a particular insurance feature in the disability insurance which specializes in covering partial disabilities and this feature is called residual benefit.

What is residual benefit?
Residual Benefit is an insurance feature which provides payment for loss of income if the insured individual is unable to perform the duties and responsibilities or incapacitated to work fulltime due to the disability suffered. Residual benefit s is provided for partial disability claims from insured persons who need to be financially protected from income loss due to illnesses or injuries. This insurance feature is one of the most important benefits in a disability insurance coverage.

The residual benefit is payable if the person is under the care of a physician and if he or she suffers more than 20% of income loss as a result of the disability. This insurance feature typically requires that the person insured suffer income loss before he or she can become eligible to take advantage of the disability payments. However, some insurance providers require that there is both a loss of time or duties and loss of income.

It should be noted that the amount of benefits awarded to the insured individual should be directly proportional to the loss of income. If for example, the insured person suffers a disability which prevents him or her to work full-time and upon returning to work the person receives 30% less than the regular wage before the disability, the residual benefits will cover the 30% loss suffered by the insured person. Almost all of residual benefits offer a minimum rate of 50% of the overall monthly benefit. It is important to remember that some insurance providers have different benefit structures during the first 6 months to one year of a claim. There are insurance companies who have a minimum of 50% benefit payment in the first 6 months even if the income loss is below 50%. Other insurance providers, instead of covering the proportionate benefit, pay the total income loss plus 100% of the covered compensation.

The disability payments of residual benefits should cover at least six months. Unlike partial disability which is payable for 12 months or less, residual benefit could last for years as it is designed to be payable for the entire duration of the benefit period. There are insurance policies with residual benefits that cover recovery benefits for the entire policy benefit period. Although some insurance providers impose certain limitations with regard to recover benefits anytime from 1 year to 3 years.