Sammarusich Blog

This February, the Department of Health and Human Resources has issued a report identifying an alarming trend for insurance companies to seek premium rate increases. This is not limited to one or two states. This is not limited to one or two percentage increases in the rates. This is all the leading insurance companies asking for the right to significantly higher premiums: in Michigan hikes of 56%, in California hikes of 39%, and so on. If this only affected small numbers of policyholders, it might have passed unnoticed. But, with millions of policyholders affected across the country, these rate increase requests have attracted the full scrutiny of the federal government. Secretary Sibelius has been leading the attack, using the requests to push the reform agenda forward.

Because of the national anger, some companies have paused. WellPoint had proposed the increases take effect from March 1. Any increases, even if approved by the states, will now be delayed until May at the earliest. This decision is partly in response to the summons of WellPoint’s chief executive officer to Washington to justify the requested increases. Insurance companies find themselves in a difficult political situation. Their management teams accept a duty to maximize profits for the benefit of the stockholders. They look around at an America seriously affected by the recession. Increasing numbers of people are unable to afford the premiums, some because of unemployment, others because of a squeeze on credit. More worrying from the insurance industry is that more healthy people are deciding not to insure at all. This means the group of people left holding policies has a higher percentage of those with existing health problems. Without more healthy people in the group paying premiums and not claiming, it becomes more expensive to insure those less healthy people who remain. It is also a verified fact that hospitals and healthcare service professionals have also been increasing their fees and charges. The pharmaceutical companies have increased the price of almost all the most commonly used drugs. The insurance industry is under pressure from both sides. As Secretary Sibelius points out, however, this is not a completely accurate picture. Every year, insurance companies are required to submit reports to all the US states in which they are licensed to sell policies. This data shows many companies actually increased the number of policyholders during 2009.

The market in health insurance plans is complicated by the political situation. Democrats and Republicans are two armies unable to agree a truce long enough for some reform to be made. As it stands, there is no immediate likelihood that medical costs will be controlled. If the costs continue to rise faster than inflation, insurers will have no choice other than increasing their premiums. If they do not, they will not have enough cash in hand to pay out on all the claims. This means, for the average person, it will become increasingly difficult to find cheap health insurance. For those with a pre-existing condition, group health insurance will be the only option but, for those plans, premiums are rising at their fastest rates. For years, it has been obvious that the healthcare industry is broken. It would be ironic if, having come this close to some meaningful reforms, we not only saw the reform bills lost in Washington, but also found every major insurer imposing massive premium increases. That really would be the final nail in the coffin.

There are so many different versions of the idiom. Try, “Expect the worst. Hope for the best.” or “Expect the worst and you’ll never be disappointed.” or “Prepare for the worst. Plan for the best.” You get the idea, particularly when it comes to dealing with your insurance company. It’s a strange reality but, no matter where you go, insurance companies always seem to have a reputation that, as a policy holder making a claim, you will end up like something the cat dragged in. The problem we all face is the profit motive. Although it would be great if every large corporation was full of the milk of human kindness, the directors and executives are driven by the desire for more wealth.

They seize every opportunity to take the extra dollar for giving us less. In the case of insurance, the companies are rather like the big bad wolf that blows your house down rather than paying to repair the leaking roof. So you always have to plan on the basis you will be in for a fight if you make a claim. That means opening and keeping an up-to-date file on everything you say to the insurer about the policy and any claims you might make. The more comprehensive your records the better. If you must speak to a representative of the company, whether in the flesh or on the phone, get a name and always write a letter confirming what was said and what, if anything, was agreed. Yes, it will take up a few minutes of your time. But you should always be able to produce contemporaneous records – a day-by-day record of representations, promises and action.

You are rolling your eyes. All that hassle. Why bother? Let’s take Massachusetts as an example. Five of the largest companies insuring vehicles all managed to make the same data entry mistake. There is this wonderful “place” called the Comprehensive Loss Underwriting Exchange (CLUE). All companies pool information about the drivers they insure. One of the more important pieces of data is whether the driver is “at fault” in a traffic accident. If you are found the “guilty” party, this justifies loading your premium with an increase. What happened in this US state was the five insurers routinely recorded anyone making a claim as being “at fault”. There was no investigation, no court case with a judge deciding one party was at fault. The insurers simply wanted to justify increasing the premiums so assumed fault from the fact of the claim. Fortunately, the people of Massachusetts are well organized. They had a paper trail for every claim and, when they reported the behavior of the insurers to the State Attorney General, this resulted in fines paid by the companies and a recalculation of all the premiums with a full refund to everyone affected.

Sadly, auto insurance is a bear pit and, if you are going to come within range of the bear, you had better be prepared with full information. It does not matter whether you are on cheap car insurance, usually the mandatory liability minimum, or a comprehensive/collision policy with all the bells and whistles, document every aspect of your relationship with the insurer and every detail of any claim you make. If anything goes wrong, every state has a Department or Office of Insurance. Make a formal complaint if you think you are losing out. If you learn of others, complain to the State Attorney General. Failure to fight means the companies will trample on your rights.

The market for insurance in the US is somewhat very different from the other world. In most every other line of business, companies are allowed to compete with each other across state lines. This helps to keep pricing to lower levels and the quality of the product to higher levels and protect the consumer. But unfortunetaly the insurance industry is licensed and regulated state-by-state. There’s no such thing as a federal insurance policy. You have to buy a policy written by a company licensed in the state where you live. This is slightly frustrating because, if you live near the border, your friends and colleagues at work probably tell you how little they pay or complain you have the better deals. Either way, it’s not very fair. Worse, the companies often decide not to set up in all fifty states, but pick and choose where they will operate. The result is that many states only have a small number of licensed insurance companies. Because there is no real competition, their premium rates tend to be high. This produces a big political divide. In Republican states, this is the free market at work and no intervention is necessary.

If you do not like this, move to another state which has lower rates. In Democratic states, there is more interest in protecting consumer interests. Some states have intervened in their local markets to introduce “managed competition”. Needless to say, this has outraged the insurance industry and the insurance agents who survive on the commission earned from the insurers. There have been heated debates between the lawmakers. Where the local Department or Office of Insurance has produced new rules, they have been referred to the local courts. Who would have thought helping millions of average people to save money on their premium rates would produce so much heat.

Anyway, the latest state to surface in this national debate is Massachusetts. In some ways, this state differs because of the dominance of the local agents who handle about 80% of the insurance business. Agents have more to lose if the markets are opened up to competition. Not surprisingly, they have been the fastest to the courts in the fight to protect their business. We have just had the decision of the Massachusetts Supreme Court on two rule changes made by the state’s Insurance Commissioner Nonnie Burnes. Let’s start with the effect of the move to open up the state to competition. Before the rule changes, there were nineteen insurers writing car insurance policies. Twelve more companies have now entered the markets. In most cases, premium rates have been stable as insurers cut their costs and accepted a reduced profit. But agents have been hit because the opportunities to earn commission have been reduced.

The Massachusetts Supreme Court has supported the reforms, finding the effect of managed competition is sufficiently beneficial that it should represent the prevailing public policy in the state. Put another way, the judges think the many consumers should pay less rather than the few corporate officers and stockholders earn excessive profits. Because one of the agent’s automatic rights to a commission has disappeared, they will be looking to recover their losses in other ways. There are two morals to this story. The first is that, if you want to find cheap car insurance, support the lawmakers in those states who promise to introduce more competition into the car insurance market. Secondly, always get your auto insurance quotes through a site like this and avoid agents who earn commission.

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2009 turns into 2010, the winter ice and snow has been particularly hard this year. It even affected Florida which shows how climate change is related to local weather patterns. Needless to say, the number of traffic accidents has been at an all-time high. No-one is ever ready for ice on the roads. Yet, all round the country, ice is coming through the mail boxes. The insurance companies are sending out notices chilling our desire to drive – premium rates are being hiked. And this time, it’s not just a few percent. In most states, it’s averaging at around 10%. So we are not talking peanuts. This is serious money while the US is in recession and millions of people are out of work. What’s the result? If it comes down to a choice between food on the table and an insurance policy, food wins every time. Everyone has to eat and everyone needs a vehicle – even in the bigger cities, public transport is a joke. So, when push comes to shove, more people will drive uninsured. That’s bad news for the rest of us. Our premiums will rise with fewer policy holders sharing the rising costs of claims. If only the insurers would hold the premiums steady, more people could pay, and rates would stay lower for longer. If only…

So why are insurance companies hiking the rates? There are two common issues. The first is the broken healthcare service. Whenever there’s a more serious traffic accident, most people go to hospital. The obvious injuries are treated. Bodies are examined to ensure there are no other injuries. Except, the moment anyone steps through the door of a hospital or clinic, the medical expenses meter starts to run. Despite the recession, the drugs industry and healthcare service suppliers have been increasing their prices. There have been some high-profile disputes between insurers and hospital groups in CA and CO. The current fight is between the Continuum Health Partners of New York and United Healthcare. The hospitals have agreed pay increases with the labor unions, new technology is expensive to instal and operate. They want more money. The insurer is looking for a reduction in charges of between 7 and 10%. It’s sad to admit but, in this fight, the insurers are actually protecting us policy holders.

The second problem is equally easy to explain. When we claim, the insurer should have the money to pay. This money comes from cash reserves and all the different state Insurance Departments monitor the amounts held to ensure there’s always sufficient set aside. It’s standard for insurers to hold this money on investment so, when the recession came, they were slow to move out of stocks and bonds, and all the larger insurers lost a slice of their capital. Commissioners are offering their local insurers a choice. Either reduce the number of people holding policies or add more to your cash reserves. This forces companies to raise premiums and so, sadly, it’s getting more difficult to find affordable auto insurance. Even with the use of this site’s excellent search engine, it’s hard to find policies with lower rates. When you get the multiple auto insurance quotes, check through to find those with lower premiums. For good terms, look at the discounts available from these companies. Think about accepting a higher deductible. Using the auto insurance quotes as a starting point, negotiate directly with the insurers. Affordable policies are out there. You just have to work harder to find them.