Archive for November 29, 2010
Worker’s Compensation and Social Security Disability
November 29, 2010 | Author admin
If I am on workers’ comp, should I also apply for Social Security Disability?
This is a very good question, but can be a very complicated one. In many situations, if you have sustained significant work injuries that may be life-changing and/or that prevent you from returning to work, then it is probably a good idea to apply for social security. For example, let’s say you suffered from a very significant spinal injury, a very significant brain injury, or perhaps some kind of severe leg, arm, or back injury. Well, if your injury is very significant and definitely has taken you out of work, then applying for social security is probably a good bet.
But, if you are going to try and get both workers’ comp and social security benefits, it is also advisable to hire an attorney who understands both. You and your attorney need to understand the Social Security Disability part of your claim as well as the Worker’s Compensation aspect so as to ensure no problems arise from getting both. Not to mention you will need an attorney to help you navigate the process of getting both.
There are complicated situations which can arise, which makes it all the more wise to have an attorney. For example, several years ago, Medicare required that individuals who applied for Social Security Disability while on Worker’s Compensation, and who subsequently settled their case, had to put some workers’ comp money aside in what’s called a Medicare Set Aside Account (MSA). The MSA is very complicated and can be hard to understand if you are not familiar with it. In any event, the MSA will impact your settlement and your Worker’s Compensation case as you proceed through it, so you just need to be sure that everything is running smoothly and as it should be. An attorney can help with that.
My suggestion and advice to you, since this is a fairly short explanation on workers’ comp and social security, is that you do call an attorney, who can help you to understand the impact of filing for Social Security Disability while you have a Worker’s Compensation claim pending. It is significant on the potential of how long the case may take and the type of settlement that you might receive in a lump sum because of that MSA set aside.
Life and Critical Illness Insurance – never withhold information as it will invalidate a claim.
November 29, 2010 | Author admin
Withholding information is the single most common cause of a life or critical illness insurance claim being rejected by the insurer. We have a true story to tell you that will effectively highlight this issue, but to preserve the identity of the policyholder, we have changed the name and a few other details.
Mrs C had surgery to remove cancerous lymph nodes from her groin; while recovering from the operation, she fell ill with a secondary infection. At this difficult time, she received some extra bad news. Her claim under her critical illness insurance policy had been rejected, and she could not expect to receive the $200,000 payout. To understand why her claim was rejected, we need to look at the background to these events.
In June 2001, Mrs C discovered a patch of flaky skin on her back, and she went to the doctor thinking it was eczema. Her GP wasn’t sure and referred her to a specialist dermatologist for an expert opinion. However, Mrs C cancelled the appointment with the dermatologist because the flaky skin cleared up before the date of the appointment. Mrs C thought no more about it, especially as the GP did not communicate any particular urgency to her about the matter.
In August 2001, nine weeks after the GP appointment, Mrs C received a routine sales visit from her life insurance company, Standard Life. The sales representative reviewed her situation due to the fact she now had a young family, and recommended she purchase a $200,000 Critical Illness policy. Mrs C signed up to the new policy without hesitation.
The sales representative went through the application form with Mrs C, filling in the answers for her as they progressed through the questions. When asked to provide details of incidences when she had been referred to a specialist for tests or treatments, Mrs C asked the sales representative what Standard Life meant by that. Mrs C alleges that the representative stated that only referrals relating to serious conditions needed to be mentioned. Since Mrs C’s referral related to what she thought was eczema, she didn’t believe it to be a serious condition, so she did not mention it and it did not go on the form. They completed the form together and Mrs C signed the form believing that she had provided all the information that Standard Life had asked for.
Several days later Mrs C’s application was successful and she was issued with a Critical Illness Insurance policy for $200,000.
Two years down the line, Mrs C was diagnosed with skin cancer. She had to undergo major surgery to try and remove the cancer. Mrs C made a claim on her critical illness insurance policy believing that she had a valid claim.
Mrs C’s claim was rejected, Standard Life cited reckless non-disclosure as the cause the insurer’s way of saying that Mrs C purposely withheld information about her referral to a dermatologist.
How did this happen?
It is clear by now that Mrs C should have mentioned the fact that she had been referred to a dermatologist – so why didn’t she?
Two events brought about this unfortunate situation:
1. When Mrs C asked what kind of referrals needed to go on the form, the Standard Life sales representative told her that she only needed to mention serious conditions. This was completely wrong the application form question stated all occasions her GP had referred her for tests or treatments. The key words here are ALL OCCASIONS. ALL means ALL and there is no flexibility for an applicant to consider if the referral is worth mentioning or not. The sales representative provided Mrs C with the wrong advice.
2. Mrs C was not made aware by the GP that the flaky skin was potentially a serious matter. The GP later admitted that this was the case. If Mrs C did not realize that the referral was a potentially serious matter, then surely she cannot be said to have been withholding information when completing the application form. Remember, the sales representative told her that only serious conditions need to be mentioned.
It is our opinion that Mrs C should not be held accountable for what was a genuine mistake. The Standard Life representative provided incorrect advice at a crucial moment, and Mrs C followed it. We think that Standard Life should take these events into account, and validate the claim.
How to avoid the same happening to you
When you are filling out a life or critical illness insurance application form, read each question very carefully and provide an accurate and full answer. Do not consider withholding any information, because if you fail to disclose something that later comes to light, you will be held accountable as withholding that information on purpose. You may think that withholding that information could result in lower premiums, but it’s not a risk worth taking.
We’ve got our fingers crossed that Standard Life will relent and pay out on Mrs C’s policy. She was unfortunate in receiving poor advice, and did not willfully mislead the insurer.
However, people that do withhold information on purpose can expect everything they get on making a claim nothing .
NB : 5% of critical illness claims are rejected by Standard due to non-disclosure. They’re not the highest: Friends Provident rejects 15% of claims for the same reason, and Legal & General rejects 16%. The insurance industry is addressing this situation at the moment by improving the way they obtain the information from applicants, any by providing clear information about the penalties for non-disclosure.
via Life and Critical Illness Insurance – never withhold information as it will invalidate a claim..
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The Use Of Critical Illness Insurance
November 29, 2010 | Author admin
Critical illness insurance made its first apparition in South Africa in 1983 and was known as dread disease insurance. Before 1983, policies having the name cancer policy may have been sold in the USA providing cover for certain types of cancer. These cancer policies may be considered as the foundation of critical illness insurance. Gradually, critical illness insurance went worldwide and nowadays plays an important role in markets such as UK, Canada, East Asia, Israel, etc.
Critical illness insurance may award a tax free lump sum if the insured person is diagnosed with one of the critical illness conditions defined by the policy. Almost all critical illness policies offer cover for cancer, stroke, heart attack, kidney failure and coronary artery bypass surgery. While some insurance companies may cover only seven or eight critical illness conditions, others may offer cover for up to 35 diseases. Critical illness insurance may help someone cope with the financial imbalance especially after diagnosis of a life threatening illness. The financial support may as a matter of fact help to manage a changed lifestyle.
Critical illness insurance was called dread disease insurance long ago in South Africa. The term being too strong and unsuitable for many markets as well as marketing purposes, made many companies refrain from applying its usage. However, critical illness insurance may be preferably referred as crisis cover, trauma cover or living insurance. The rules which stipulate that critical illness cover must cover only severe conditions may no longer apply. It may also be used as a means for financial security against numerous critical illness conditions. Insurers therefore tend to provide a wider choice of critical illnesses covered under their critical illness plans. By doing so, they hope to target a wider audience and also to compete effectively in the insurance market.
Moreover, critical illness insurance may be useful to people who have social insurance that does not pay big to cater for a serious illness. A critical illness can imply high costs for treatment purposes. As a matter of fact, critical illness cover may be mostly wanted in countries where the state social security systems are inadequate. Even if a good health security system exists many people may still want critical illness insurance. The reason may be because everyone wants to get the best medical care and treatments. Thus, critical illness insurance payout will allow them to do that either in a renowned clinic or overseas.
Furthermore, the additional benefits in the form of critical illness insurance may not necessarily mean paying for medical charges. The aftermath of a critical illness may sometimes be considerable. The house or living environment may have to be altered to accommodate the life a disabled person. A car can also become an important factor as a mean for facilitating mobility needs. Also, after enduring a critical illness, in most of the cases a person becomes unable to attend work. Critical illness insurance payout can once more stabilize financial pressure by settling debts or mortgage.
Critical illness insurance policy may be presented in a professional manner to the client providing him with every information that he needs. By doing so, a much friendly approach may be created while confidence over the product may arise. This may therefore lead to many critical illness cover sales.
Types of Life Insurance Riders
November 29, 2010 | Author admin
Insurance riders provide benefits over and above those given by a basic insurance policy. Riders are not free and come at an additional cost, but the cost is relatively less compared to that involved in taking a separate insurance policy to cover the same requirements. Some of the very essential and well known riders include accidental death rider and critical illness rider. Beside these, other important riders (their importance varies from person to person) depending upon one’s age, stage of life and future goals, include accidental death, disability or dismemberment rider, level term rider, waiver of premium rider, guaranteed insurability rider and family income benefit rider.
Accidental Death Rider: The rider provides extra benefits equal to the minimum sum assured while taking the base policy. It is applicable only if the insured dies during the policy term due to accident. Since in most cases the rider benefit promises a sum same as the underlying policy assured amount, it is also called Double Indemnity Rider.
Critical Illness Rider: Also known as Accelerated Death benefit, this rider allows an insured who is diagnosed with terminal illness and may require long term medical care or who requires confinement to medical home permanently; to withdraw part or whole amount of death benefit from the basic insurance policy. The basic insurance policy reduces by the amount withdrawn under rider. The rider helps the insured and his family meet immediate financial needs of medical treatment and loss of regular income generated by the insured. The rider generally specifies the amount available to insured in such cases and can be withdrawn by him during term of policy.
Accidental Death, Disability or Dismemberment Rider: The accidental death rider can be sometimes extended to include any permanent or long term disability lasting at least for 6 months or loss of limbs or sight due to accident.
Level Term Rider: With this rider you can attach a fixed amount of term insurance to your basic permanent life insurance policy for a certain period. The amount of benefit assured can be multiple times the basic death benefit from the original policy.
Waiver of Premium Rider: This rider helps the insured to continue with his insurance policy even if he/ she are unable to pay regular premiums due to long term or permanent disability. By default a life insurance policy can expire if the premium is not regularly paid. In case if the insured suffers from a disability that prevents him from earning a regular source of income, the insurance policy premiums become difficult to bear. This rider allows the insured to take waiver from premium payments until the disability lasts or for the entire policy period in case of permanent disability. The terms of proving disability and its valid duration vary from company to company and across different policies.
Guaranteed Insurability Rider: Also known as Renewal provision, this rider allows you to buy extra insurance at certain periods during the specified term of rider. Without letting your existing policy elapse, you can purchase additional insurance or convert basic term insurance without proving insurability or having to undergo fresh medical examination. The rider is most beneficial to those who may experience major medical illnesses or loss of health due to advancing age, as there is no need for fresh underwriting. It also allows to add more insurance with changing life circumstances like marriage or arrival of newborn.
Family Income Benefit Rider: This rider provides a cushion in case of sudden death of the insured during policy term. While taking the rider, the insured needs to select the time frame for which he wants his family to continue receiving benefits. According to their comfort level, the beneficiaries will have the option of receiving regular monthly income or taking the entire benefit as lump sum after the death of the policy taker. As the insured grows old the duration of rider decreases. This rider is most beneficial to families with single bread winner.
What is Waiver of Premium Insurance Rider?
November 29, 2010 | Author admin
Most people are aware of the advantages and take out some or other form of insurance policy depending on their needs. The most basic situation for which a life insurance policy is generally taken is loss of income due to death of bread winner of the family. But many overlook the possibility of a worse situation arising due to permanent disability that could make regular premium payments difficult and result in the termination of the insurance policy.
Definition – The situation is easily remedied by opting for a Waiver of Premium Insurance Rider that can be easily attached to almost any insurance policy. According to the rider, an insured can claim relief from paying future premiums in case he/she becomes permanently disabled or is unable to earn a living due to disability during the term of the policy and the disability lasts for at least 6 months. With this rider, the insured can continue to enjoy the benefits of the base policy without paying any more premiums till the time the disability lasts. Once the insured recovers, he can start paying premium again.
Benefits and Restrictions – The best part of the rider is that since it attaches only to the security part of the total insurance taken, the extra premium to be paid is quite minimal. The rider can be especially useful in case if the premium payments are quite high and will ensure that the policy continues even in case of debilitating illness or accident. To be able to claim premium waiver, the insured must prove that they have been suffering from the disability for atleast 6 months or any other minimum period as mentioned in their rider terms. Also, the rider benefits are available only until a certain age, generally 60 or 65 years. Post the maximum age limit, the insured cannot opt for this rider. The rider is valid only till the term of policy. Once the policy reached term, the rider is terminated. Thus it is beneficial to opt for the rider right at the time of taking out an insurance policy to safeguard your financial investment planning objective.
Disability – Disability definition as per the waiver of premium rider specifies that the insured must be so disabled that he / she is unable to pursue the profession they were engaged in when they became disabled. It varies from one insurance India company to another whether they consider the person disabled to carry out their particular occupation or unable to pursue any occupation in general. It is thus advisable to expressly clarify the point with the insurance company and read related documents carefully before opting for the rider.
All insurers clearly mention the conditions under which the insured will be considered disabled and eligible for the waiver of premium rider. Where some only accept permanent and irrecoverable disability, others may consider the insured disabled even if they are able to engage in work in some cases. Loss of limbs like hands, legs and eyes generally qualify a person for the rider benefit. Besides, a person who suddenly loses his ability to speak or hear due to illness or accident also sometimes qualifies.
How Your Car Quote Is Calculated
November 29, 2010 | Author admin
There are quite a number of considerations taken to affect premium pricing on new car insurance. Insurance companies vet an individual’s cars to ascertain risk factors which in this case influence the cost of car insurance. Some of the factors taken into when purchasing a new car insurance premium are;
Car insurance group
All cars have a group cluster rating issued by the insuring body; these ratings are normally based on the risk component of the vehicle. Some of the factors used to determine a car’s group ratings are:
The value of the car
Spare parts costs
Availability of spare parts
Engine performance and specifications
Standard security features fitted the car manufacturer
Past insurance history of the model of the car
Cars with low category cluster as per the mentioned points attract less insurance premium.
Driver’s license information
Drivers with clean driving records are seen as less likely to be involved in car accidents. Supporting driving certificates from recognized driving institutions can also help in lowering insurance costs.
Insurance claim history
An applicant with a record of recurring insurance claims is seen as potential high risk to the insurance. Insurance companies quote a higher premium for such new car insurance applicants.
Medical Condition and history
Insurance do not charge extra for individuals with certain medical conditions, however an individual with a restricted license may have the insurance company review the policy hence an adjustment to the car insurance costs. It is very important to reveal any medical condition that may be of concern to your driving abilities.
Car security
Most insurance companies will insist on additional car securities such as car alarms and engine immobilizers. Some insurance companies insist expensive to have cars to have satellite tracking systems. It is very important to have such installation done by professional car security personnel and a certificate issued to that effect.
The applicant occupation
Individual on certain occupation tend be of higher risks than others. For instance, golfers and sportsmen can carry around gadgets which may put the car at potential risk, whereas a college lecturer may not have anything of worth to carry around.
Your address and car parking details
Insurance companies gathers information about the applicant address, this base the risk component influenced by the applicant surrounding. It is very important communicate with your car insurance company whenever you move to a new address. Stating where you park the car at night will also affect the kind of premium charged
