Personal Injury Care Line

What is Disability Insurance?
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
-Social Security web site, June 2006

The Social Security office will want to check your medical history to be sure you qualify for disability benefits. The Social Security office is one way to get disability benefits, but in most cases these benefits will not be substantial enough for families.

Disability insurance can be obtained through any number of insurance companies. In the event that you are disabled, this insurance will serve as financial protection. You will receive a percentage of your gross income from your disability insurance policy, income that will ensure your own financial safety.

You do not have to go through the Social Security Office to take out a disability insurance policy, nor to receive the benefits from that policy. The Social Security disability program is not related to any disability insurance policy that you take out.

Individual disability insurance is truly a basic concept. It is an insurance product designed to replace anywhere from 45-60% of your gross income on a tax-free basis should a sickness or illness prevent you from earning an income in your occupation. Every disability insurance policy from every insurance company is very different, this is not a product to simply shop for the most competitive rate. To buy the cheapest disability insurance policy on the market is to throw money away. The odds of getting paid a monthly benefit under a cheap contract may be significantly lower than receiving benefits from a quality contract.
-About Disability Insurance web site, June 2006

Types of Disability Insurance
Most people are familiar with two types of disability insurance: short-term disability, and long-term disability. Short-term disability insurance is included as part of a benefits package with many different employers, and usually provides an income in the early part of disability. Short-term disability insurance generally provides coverage for a period of several weeks, and does not exceed a two-year term.

Long-term disability, however, can last for a period of several years. These types of policies may be included as a part of employment, in a benefits package, but many purchase these disability insurance policies individually.

As far as disability insurance goes, however, there are still more policies to learn about. One type of disability insurance is the Own-Occupation Disability Insurance. The definition of this policy reads:

The inability to perform the material and substantial duties of your regular occupation, the insurance company will consider your occupation to be the occupation you are engaged in at the time you become disabled, they will pay the claim even if you are working in some other capacity.

Another kind of disability insurance is the Income Replacement Insurance. This is a very popular type of disability insurance, and most insurance agents are familiar with this policy. The language of this type of disability insurance reads:

Because of sickness or injury you are unable to perform the material and substantial duties of your occupation, and are not engaged in any other occupation.

Common in employee benefits packages, Gainful Occupation Coverage is another popular form of disability insurance. The language here is worded very carefully:

Because of sickness or injury you are unable to perform the material and substantial duties or your occupation, or any occupation for which you are deemed reasonably qualified by education, training, or experience.

Car Insurance Quote – Things To Know To Get Very Cheap Car Insurance And Quotes

Auto insurance premiums vary widely from state to state and even within states. The same person may find swings of as much as $700 on the cost of an annual policy. Insurance agents are not legally bound to tell a perspective customer about discounts which may apply to his/her insurance. There are, however, things the consumer can do which may lower the price paid for auto insurance.

Higher deductibles

The single quickest and easiest way to lower your insurance premium is to raise your premium. Having a $1000 or even a $1500 deductible can lower premiums 15 to 20 percent. If you decide to go this route, consider putting the money saved the first year into an account earmarked to pay the deductible should you have any accident.

Investigate auto records

Your driving record may be unblemished but the record of the car model you own can also have an affect on your premiums. Insurance copies compile extensive reports on the way cars respond in accidents and how popular certain cars are with thieves. Cars with poor crash test ratings and cars that are frequently stolen cost more to insure. When buying a new car use an auto buyers guide to compare crash test and theft rankings.

Use the same insurance company

If you have more than one vehicle insure all of them with the same company. Almost all insurance companies offer multi-car discounts. Many companies offer further discounts if you use any other products they offer such as homeowners insurance and life insurance.

Getting many quotes and comparing them is the best way to check pricing, coverage and save money.

And, dont forget, the best way to lower your car insurance premium is to drive safely.

Please see our recommended sources for insurance quotes from multiple providers. We have done the research so you don’t have to.

Battling an Unfair Health Insurance Claim Can Really Pay Off

Are you having trouble getting your insurance company to pay your medical health costs? Join the club. When managed care entered the insurance scene a decade ago, its mandate was to contain rising medical costs. One way to do that is to deny claims, even when claims are legitimate. The consumer backlash led to many states establishing independent review panels and requiring insurance companies to develop in-house appeal procedures. Forty-two states now have independent review boards whose decisions can override those of insurance companies. Most consumers don’t even realize these review boards exist.

Another problem is that too many people just give up when their insurance claim is denied initially. The appeals process can be long and frustrating and many people don’t have the patience or time to pursue a claim no matter how legitimate. People must be persistent and they can win. Particularly if there’s substantial money involved, the time you dedicate to appealing insurance company decisions can pay off usually more quickly than you think. A Kaiser Family Foundation study recently found that 52% of patients won their first appeal for each claim made. The insurance companies aren’t getting with out paying anymore.

If your first appeal gets turned down, press on. The study found that those who appealed a second time won 44% of the time. Those who appealed a third time won in 45% of cases. Which means the odds are in your favor no matter how long it take. Remember that every time you appeal it costs the insurance company more money to fight you and they are not only going to lose money to you, but also in court costs. Medical health benefits are particularly tricky because insurance companies usually have a cap on the amount of money they’ll spend in a given year, or on the amount of visits they’ll pay for. But there’s often some flexibility when you can document that you or your child’s health warrants more care than your policy usually covers. Here’s how to get started:

Do Your Homework

Read your Policy: What are the benefits? Which kinds of services are included? Outpatient or inpatient care? Is it a serious or “non-serious” diagnosis?

Know the law: Contact your local Health Association to determine your states legal requirements regarding insurance payments for all illness. Does your state require full or partial parity? Are parity benefits available only to patients with “Serious Illness” or is a so-called non-serious illness also included?

Provide written documentation: Some insurance companies may not consider some diagnosis’s serious. In this case, you will need documentation to validate required services. Obtain a letter of medical necessity from your doctor and get test results showing the medical need for you or your child to receive certain services, based on the diagnosis.

Keep good records: Remember, you’ll be dealing with a bureaucracy. Keep the names and numbers of everyone with whom you speak, the dates on which you spoke, and what transpired in the conversation.

Start early: If you can, start the appeals process prior to initiating treatment. If the doctor says your child will need to be seen once a week for a year, begin immediately to appeal your insurance company’s policy of reimbursing only 20 visits a year.

Call and Ask the Insurance Company:

What are the prerequisites for receiving health benefits?

How many visits are allowed annually for you or your child’s diagnosis? Can multiple services be combined on one day and be counted as only one day or one visit?

Which services must be pre-certified–by whom?

Be positive, polite and patient with the customer service representative. Remember that he/she is only the messenger, not the decision-maker. They are the gatekeepers and can either provide you with access to a decision maker or make your life miserable, depending on how you interact with them.

Be persistent. There are no magic bullets. Be like a dog with a bone and don’t give up until you get the answer you want. If you get nowhere after several calls, ask for a supervisor or a nurse in the pre-certification department.

Remember that you do have the right to appeal if your claim is denied. Most consumers get discouraged and will not continue to pursue a claim that should or could be paid. Insurance companies count on that happening, so get out there and claim what’s justifiably belong to you.

Your Auto Accident Insurance Loss – Dealing With Your Company On A Disputed Loss

#1. If your agent is unable to solve your problem, get the name and phone number of your insurance companies Claims Department. Its usually an 800 number. Call and ask if they have a Consumer Complaint Department? Most do. If so, talk to them because they may be able to help you. Dont hang up until you get the specific name of the person with whom you spoke. (Make a note of the person you talked with and hold onto that until youve finished with your dispute).

#2. Be ready to support your case by sending a covering letter (to that individual whom you spoke with) which contains all the documents you have to back up your position.

#3. All insurance companies have either an Appraisal Service or Arbitration Service to help settle differences and/or disputes. Your policy should explain these options.(If you cant find either of these ask your agent to find them for you)!

#4. If youve followed their rules for resolving your dispute, and youre still not satisfied, your own states insurance department should be able to help you.

#5. If, after hearing from your own insurance companys people (your confident that youve not been handled properly) you should call 1 800 942-4242 ( a toll-free Consumer Information Service) sponsored by the insurance industry.

Trained personnel are available to assist consumers who have complaints. THIS HELP LINE OPERATES ON EASTERN TIME, MONDAY THRU FRIDAY, 8:00 AM – 8:00 PM.

#6. ALSO: An Independent Arbitrator, who allegedly has experience in insurance problems, can decide if what youve been told (or offered to settle your claim) is fair. You can get to them by calling THE AMERICAN ARBITRATION ASSOCIATION 1 212 484-4000 or they can be contacted (via the internet) at .

#7. MEDIATION: More often than not the Mediator does not have the authority to make a binding decision or issue an award to either party. The mediator only recommends a solution.

Mediation is a solid first step because it can negate the need for further expense on both sides. The first thing you should do is check the language in your auto insurance policy where it will spell out who will mediate (and/or arbitrate) a claim. You should submit a DEMAND FOR ARBITRATION FORM to whoever is listed in your policy. On that Demand for Arbitration Form you can specify whether you want MEDIATION or ARBITRATION.

DEMAND FOR ARBITRATION FORMS are available from your states Department Of Insurance, or you can print a copy of a Demand Form from the American Arbitration Associations web site – - which can be found (as Ive listed above in Number #6) at .

AS YOU MOVE ALONG WITH THE ABOVE YOU MUST NEVER FORGET THESE TWO FOLLOWING (A & B = Below) CRUCIAL FACTS:

A. Mediation is much less expensive than Arbitration.

B. The Mediation Decisions are only considered to be advisory. However, The Arbitration Rulings are absolutely binding!

DISCLAIMER: The only purpose of this article YOUR AUTO ACCIDENT INSURANCE LOSS – DEALING WITH YOUR COMPANY ON A DISPUTED CLAIM is to help people understand the motor vehicle accident claim process. Neither Dan Baldyga, Peter Go nor ARTICLE CITY make any guarantee of any kind whatsoever; NOR do the purport to engage in rendering any legal service; NOR to substitute for a lawyer, an insurance adjuster, claims consultant, or the like. Where such professional help is desired it is THE INDIVIDUALS RESPONSIBILITY to obtain said services.

Medical Review Companies Role in Your Insurance Claims – Your Health, Your Coverage, Your Guarantee

A medical review company supplies more than a second opinion. The unbiased nature of a medical review company is critical not only to the bottom dollar, but to the final result. Too often, patients think they are just numbers in a file or bits of information in a computer program. The maligned image of an insurance companys automatic denial of claims without really understanding the patients need contributes consumer dissatisfaction and frustration.

What Does It Have to Do With You?

Patients are people and when they need healthcare, they dont want to read the fine print or a medical dictionary, they just want their claims covered. Most often, its unlikely they would realize that their insurance claim went through an Insurance Review Organizations medical insurance review process. In fact, they probably just fill out the forms, hand a receptionist their insurance card and sign on the necessary release forms.

One of the most common complaints about needing healthcare is the cost followed closely by the complications of paperwork generated through authorization forms, claim forms and more. An insurance review organization is an intermediary company that insurance companies may outsource their claims to in order to determine with medical and insurance coverage accuracy the validity of a claim filed by someone insured by their company.

Your Health Matters

Insurance companies who deny a claim are often portrayed as heartless or more interested in the bottom dollar than they are about showing compassion. This perception is only augmented when an insurance company rejects a claim for anecdotal evidence. When a claim goes through a medical review companys insurance review process it will not be rejected or denied based on anecdotal evidence.

For example, a patient suffers from shoulder, back and neck pain as well as bra strap grooving and eczema. Her medical history indicates years of chiropractic treatment as well as advice for non-steroidal anti-inflammatory drugs (i.e. Tylenol, Advil) and worn specialized support bras to support a 34DD frame and all of it to no success. Excessively large breasts can cause many of the symptoms the womans medical history indicated.

The doctor recommended a breast reduction procedure to alleviate the problem and the symptoms.

Your Coverage Matters

When the claim is submitted to the insurance company, the policy may not cover elective cosmetic procedures. Many policies do not. Claim managers lacking medical expertise will often compare a procedure request against a list of approved procedures. If cosmetic procedures are not covered, it is likely the claim will be denied. The patient is left either choosing to pay for the procedure out of pocket or continuing to suffer.

If the claim is submitted to a third party intermediary such as a medical review company, the answer will be different. The medical review company has access to a large number of medical specialist and insurance experts. The medical specialists will review the patients medical history and the doctors recommendations. When her file is reviewed, the third-party specialist will take into account the history of shoulder, neck and back pain. They will note the visits to a chiropractor and other pertinent symptoms.

If the medical specialist agrees with the patients physician that she is suffering from Macromastia (excessively large breasts), then he or she will understand that the cosmetic surgery of breast reduction provides the patient with the best option for the patients relief.

Confidence Matters

The review process may be transparent to patients whose insurance company uses a medical review company; but the effect is profound. Their coverage premiums will likely be lower. Their medical needs will be addressed. They will not see their healthcare costs rise due to the underwriting of unnecessary procedures. When it comes right down to it, a medical review company gives patients confidence that both their medical and insurance needs will be met. They wont have to suffer misery unnecessarily nor face collections over mounting debt.

Health Insurance Up 78 Percent Since 2000, Along With Policy Terminations!

Health insurance went up 7.7 percent this year, thats twice the rate of inflation. Premiums have increased by 78 percent since the year 2000 compare that to salary increases of just 20 percent and the real picture starts to have an impact.

Individuals are now averaging a little over $4000 a year in premiums with American families paying out almost $11,500 this year. Companies offering health care benefits now stands at 61 percent this is down from 69 percent in 2000. It’s estimated that over 155 million Americans will get their health care benefits from their employers. To lower the over-all cost of the insurance plans many companies are now offering benefit packages with higher deductibles. It should be noted that this report comes out after a recent Census reported that 1.3 million Americans where added to the ranks of the uninsured during 2005. What becomes clear here is the long term trend towards the decline of coverage supplied by small businesses from their employees.

To working people and business owners, a reduction in an already very high rate of increase just means you’re still paying more said Dr Drew Altman, president and chief executive of the Kaiser Foundation.

Insurance companies have been under attack recently for dumping families that build up large medical bills. In an ongoing case in California the state is investigating a claim against Blue Cross who stopped coverage for a family when it’s medical bills reached $20,000. The family have been left with outstanding medical bills of over $60,000. The company have accused the family of failing to disclose in their coverage application an undiagnosed lump on one of the children’s chins. The family say they (or their physician) knew nothing of any tumor when they made the application.

These types of cancellations of coverage have now created a massive backlash towards the insurance companies and resulted in a number of ongoing lawsuits. The policyholders are saying their polices were illegally terminated which resulted in substantial financial hardship. State regulators are investigating and have said they are now preparing to take action against Blue Cross.

Something needs to be done to protect (us) the public against these (insurance) companies. The hardship caused when a family is faced with these medical bills at a time when they really need the most support is nothing short of criminal. Having taken our money every month for years on end they should not have the right to terminate our coverage. They should by law be forced to honor the agreement they wrote and we agreed too.

A serious injury accident can leave you not only physically injured, but can also leave you financially injured. Most of us think that we have insurance to cover such events, and while this is partly true, the insurance companies are primarily concerned with paying as little as possible while transferring the burden of the costs to you.

Many people do not fully understand the in’s and out’s of how insurance companies really work. Insurance companies are generally looking to improve their bottom line and thus their stockholders shares. Let us take a look at how insurance companies work with hospitals to save money and transfer costs to you, the insured.

If you are in a serious injury accident and break your leg, the insurance company will pay the hospital a percentage of the cost to treat your broken leg. Hypothetically, if you break your leg and decide to pay the hospital in full out of your own pocket, the cost would be $5,000. Now most of us assume that our insurance company pays the hospital the full $5,000, but that is not the case. The insurance company will only pay a portion. For example they may pay $4,000 for the procedure. This happens because insurance companies create complex contracts with the hospitals at a discounted rate. If the hospital does not agree to offer a substantial discount, the insurance company will not allow the hospital to be in their covered network of providers. This means that the hospital will generally not be able to treat any of the people covered by the insurance company. This could potentially be thousands of patients for that hospital.

Due to the insurance companies having the upper hand in contract negotiations with the hospitals, the hospital always negotiates and agrees to some form of a discount. Either way, the insurance company will always pay less than full cost for the procedure.

Depending on your insurance policy and coverage exemptions, you will most likely be required to pay for a portion of your medical care. This can include the deductible and any other special circumstances. Your policy may indicate that you are responsible for the first $1,000 of an inpatient stay (plus your deductible) and that the insurance company will pay the remainder. These amounts vary dependent upon your specific policy.

If your insurance company can, they will shift as much of the costs to you as possible in a serious injury accident. This can result in you suffering huge financial difficulties. This is even truer if your insurance company agrees to only pay a percentage of the cost of your treatment. For example, they may agree to pay 85% of cost. Now if you have a serious injury accident and the bill comes to $225,000 (which is not unheard of) then you would be responsible for $33,750 of the total bill.

If another person is at fault in your serious injury accident then you face battling that person’s insurance company. These companies will look for quick cheap settlements (or no settlement) and will try to take advantage of your lack of knowledge of what you are actually entitled to receive. Another example would be if both you and the person who is at fault have the same insurance company. This creates a whole new, and not uncommon, circumstance where your insurance company will try to save money on both sides of the issue.

If you suffer from a serious personal injury, you need a competent and experienced lawyer to watch out for your best interests. Regardless of whether or not someone else is at fault for your injury you need a lawyer to help you through the process. Everyday thousands of Americans are getting a raw deal from their insurance company and most never even realize it; they just simply accept it as the way things work. A lawyer will help sift through the complex insurance coverage policies and will help you to find the parts of the policy that provide you with the most comprehensive coverage.

When faced with a serious personal injury the last thing you should have to worry about is how you are going to pay your medical bills. Unfortunately, it is a reality that you need to take steps to make sure that you will not be stuck with an outrageous bill that your insurance company should cover. A lawyer is the only one who is truly on your side when you are faced with a serious personal injury, because he or she is working for you and no one else.

Medical Review Companies Role in Your Insurance Claims – Your Health, Your Coverage, Your Guarantee

A medical review company supplies more than a second opinion. The unbiased nature of a medical review company is critical not only to the bottom dollar, but to the final result. Too often, patients think they are just numbers in a file or bits of information in a computer program. The maligned image of an insurance companys automatic denial of claims without really understanding the patients need contributes consumer dissatisfaction and frustration.

What Does It Have to Do With You?

Patients are people and when they need healthcare, they dont want to read the fine print or a medical dictionary, they just want their claims covered. Most often, its unlikely they would realize that their insurance claim went through an Insurance Review Organizations medical insurance review process. In fact, they probably just fill out the forms, hand a receptionist their insurance card and sign on the necessary release forms.

One of the most common complaints about needing healthcare is the cost followed closely by the complications of paperwork generated through authorization forms, claim forms and more. An insurance review organization is an intermediary company that insurance companies may outsource their claims to in order to determine with medical and insurance coverage accuracy the validity of a claim filed by someone insured by their company.

Your Health Matters

Insurance companies who deny a claim are often portrayed as heartless or more interested in the bottom dollar than they are about showing compassion. This perception is only augmented when an insurance company rejects a claim for anecdotal evidence. When a claim goes through a medical review companys insurance review process it will not be rejected or denied based on anecdotal evidence.

For example, a patient suffers from shoulder, back and neck pain as well as bra strap grooving and eczema. Her medical history indicates years of chiropractic treatment as well as advice for non-steroidal anti-inflammatory drugs (i.e. Tylenol, Advil) and worn specialized support bras to support a 34DD frame and all of it to no success. Excessively large breasts can cause many of the symptoms the womans medical history indicated.

The doctor recommended a breast reduction procedure to alleviate the problem and the symptoms.

Your Coverage Matters

When the claim is submitted to the insurance company, the policy may not cover elective cosmetic procedures. Many policies do not. Claim managers lacking medical expertise will often compare a procedure request against a list of approved procedures. If cosmetic procedures are not covered, it is likely the claim will be denied. The patient is left either choosing to pay for the procedure out of pocket or continuing to suffer.

If the claim is submitted to a third party intermediary such as a medical review company, the answer will be different. The medical review company has access to a large number of medical specialist and insurance experts. The medical specialists will review the patients medical history and the doctors recommendations. When her file is reviewed, the third-party specialist will take into account the history of shoulder, neck and back pain. They will note the visits to a chiropractor and other pertinent symptoms.

If the medical specialist agrees with the patients physician that she is suffering from Macromastia (excessively large breasts), then he or she will understand that the cosmetic surgery of breast reduction provides the patient with the best option for the patients relief.

Confidence Matters

The review process may be transparent to patients whose insurance company uses a medical review company; but the effect is profound. Their coverage premiums will likely be lower. Their medical needs will be addressed. They will not see their healthcare costs rise due to the underwriting of unnecessary procedures. When it comes right down to it, a medical review company gives patients confidence that both their medical and insurance needs will be met. They wont have to suffer misery unnecessarily nor face collections over mounting debt.

Picture it… 2006 Your teenage son has just obtained his drivers license and you as a parent are now faced with the task of finding cheap auto insurance to cover him and protect you both.

Insurance premiums can vary dramatically. Keep reading to find how to you can find a good cheap auto insurance policy.

Let’s face it. At this age, your teenager hasn’t had the experience necessary for insurance companies to consider them anything but a high risk. But there are a few things you can do to find good cheap insurance and help keep your premiums down.

Knowledge is power. And it’s our responsibility as parents to pass on this knowledge to our children.

Driver Safety
The first and most important thing you as a parent need to stress to your newly licensed teenager is the importance of safety. Lack of safety is the cause of too many unnecessary deaths in the United States and other countries every year.

If you can’t impart this information to them, send them to a driving school where they can learn from professionals. Most highschools offer their students a drivers education class.

Clean Driving Record
Your teenagers driving record will have a direct impact on the cost of your insurance premiums. With no violations or accidents, the premiums will decrease over time.

Type of Vehicle
If your teenager wants a 2 door red sport about, be prepared to pay a hefty increase in premiums. Cars with 2 doors are considered sports cars and stastics show us that red cars are involved in more accidents than any other color. Cheap auto insurance may not be an option for you with this choices.

Safety Features
Choose a vehicle that is rich in safety features and well built to help reduce your costs.

Deductables
You can also reduce your rates by selecting a higher deductable. Generally the higher the deductable, the lower the monthly premium.

Discounts
When you’re searching for cheap auto insurance and getting quotes from various companies, find out what discounts are available for things like, multiple car policies, drivers education credits, defensive driving coarses completed and clean driving records. The competition in the automobile insurance industry is fierce. Some companies are willing to offer bigger discounts than others.

Finding Cheap Auto Insurance Online
The easiest way to zero in on a company who offers cheap auto insurance is to get quotes from more than one company and compare their offers. Esurance.com and Insurance.com are two great places to do this.

Getting A Good Car Insurance Rate For Your Teen – Saving Money When You Need It Most

If you’d like to insure your teenager to drive your car, be prepared to pay through the nose. It’s an unfortunate fact of life that young people tend to have more accidents than their older counterparts, and insurance companies know this all too well.

There may be some variance in the Teen rate your insurance company provides depending on the sex of the child, with males being a higher risk than females, and therefore more expensive to insure. Over all, the likelihood of someone between the ages of 16 and 19 having an accident is four times higher than those over 19. It’s hard to blame insurance companies for charging more to cover themselves and your family.

Teen insurance is expensive, but if your child has good grades, this can count towards a discount. Teenagers who maintain a B average or higher will often cost their parent three quarters of what a less academically able student would cost to insure. Also make sure your teen has learned good driving skills and completed safety courses. Having certification from these courses may save you up to 10%, which can be a tidy little sum.

The other important factor in saving money on premiums goes for teens and adults. Keep it clean! Your driving record that is. Tickets and traffic infringements can send your premiums skyrocketing. Once again, gender becomes an issue, with females experiencing less increase in premiums per offense when compared with males.

It does seem unfair and biased, but you have to remember that it’s nothing personal. Insurance companies let the numbers do the talking, so if you want the lowest insurance costs for your teen, regardless of gender, just remember to make sure they’ve completed a driving course, they keep out of trouble with traffic and the law, and keep their grades up.