Personal Injury Care Line

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.

In the UK around 7 million people spend around 3 billion a year on medical insurance. One in seven policies are taken out by individuals with the balance being put in place by their employers. The problem is that Medical Insurance is complex and few policyholders take the time to really study the details of their cover. As a result, many misunderstand what will be covered. If you expect medical insurance to pay every health claim, you’re mistaken.

Medical Insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you’ll know what to look out for!

Sorry it’s a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it’s a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic – and no, you won’t be covered.

But deciding whether a condition is acute or chronic is fraught with problems. It’s rarely a black and white decision and this can lead to a major area of conflict between policyholder and insurer.

It’s clear that asthma and diabetes are chronic conditions as you’re almost certain to suffer from them for the rest of your life. So those categories of illness are not covered.

Problems arise when Doctors initially consider a patients’ condition to be curable, but the condition later deteriorates and the medical team changes its’ mind, it’s now become incurable. This can sometimes happen, especially in the treatment of certain types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic – and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry – it’s too long term
The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define long-term. You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry it’s preventative
Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and Standard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry the drug is not approved
Two of the main attractions for taking out medical insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there’s a rider.

The Institute for Health and Clinical Excellence exists to approve the use of new drugs by the NHS in England and Wales. Until that body has approved the drug your insurer is unlikely to pay for its use. The problem is that the Institute’s brief is to perform a cost/benefit analysis to ensure that the financial benefits to the nation from using the drug, outweigh the costs of using it in the NHS. A difficult brief and it has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if your medical policy won’t pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry it’s a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition pre-exists the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you twisted your knee playing tennis. It appeared to recover but now it turns out that you have a torn cruciate ligament and it needs to be operated on. Your medical insurance company could argue that the ligament damage was a pre-existing condition and you have to pay for the operation.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you’ve suffered from within the last 5 years, they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry its not covered

Medical Insurance is an annual contract just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it’s possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers’ pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there’s also a trend for new treatments to cost more Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So if you’re tempted to buy Medical Insurance, be aware that everything is not always black and white. If you’ve got insurance and need treatment, you’re well advised to contact your insurer without delay and get them to confirm that they will meet the cost of your proposed treatment.

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.

Getting Health Insurance Quotes By Phone
Though calling around for insurance quotes can be a very time-consuming task, it is a good way to get your questions answered about the policy by a professional. In many cases, calling an insurance company for a quote will lead to an automated session and then being placed on hold. This is the kind of frustration that you will face, over and over, when trying to receive any kind of insurance quote by phone.

It does take up a lot of time and you do have to keep notes about each quote you receive, but there are some good reasons for obtaining health insurance quotes by phone:

You can talk to a professional in real time
Eventually, you will get through to an actual human being on the other end of the phone. This person can explain the policy to you in detail, answering any questions you may have as they come up.

You can learn about different premiums and options on the same policy
When a certain health insurance policy interests you, you may be able to talk to someone about adjusting the premium and/or deductible on the policy, tailoring it to better suit your needs.

You can purchase a policy right away
By using a check by phone or your credit card, you can purchase a policy based on the health insurance quotes you receive over the phone. This process is generally quick, including a brief question-and-answer session.

Getting Health Insurance Quotes Online
For those who prefer a quick and easy method of insurance shopping, the Internet is definitely your best option. Using the Internet, you can go to a specific companys site and learn more about their policies by receiving free online health insurance quotes, or compare and contrast the policies offered by several companies at once.

The Internet allows you to receive many more health insurance quotes, in a much shorter period of time than you would be receiving quotes over the phone. There are many benefits to shopping for health insurance quotes online:

You can get many health insurance quotes, quick
When time is a factor, the Internet is your best friend. You can look at several different health insurance quotes at the same time online, much more quickly than it takes to get through most phone automated systems.

You can compare lots of health insurance quotes at once
Side-by-side or page-by-page, with the Internet you can compare health insurance quotes from several different health insurance companies at once. This makes comparison shopping a breeze.

Ease of purchase
You can often purchase a health insurance policy online, using a secured method and your credit card. This allows you to get your health insurance policy quickly, so that coverage can start right away.

An Independent Agent
When doing your own research, finding different quotes, calling around or even using the Internet to shop just isnt your thing, youll want to use an independent insurance agent. These agents do not work for any specific company but for you. They use their time to shop around for you, finding you the best possible policy based upon the health insurance quotes they receive.

Often, independent agents can get much better rates than the average customer. This is because insurance company offer agents deals and discounts simply for brining in new business. An independent agent will work for you to find the best health insurance quotes, so that you pay less while still receiving the best coverage possible for you and your family.

Life Insurers Use The Body Mass Index To Tighten The Belt On Fat People

Overweight people are in the firing line again. Life insurance companies are increasing premiums up to four fold for fat people. They’ve always charged more for those of us who over-eat, but during the last year the penalties have got worse.

In moves to tighten the belts further, the life insurers are lowering the weight limits they use to categorise people. This tougher move means that those who are merely overweight and would have previously qualified for a standard premium, are now penalised with higher premiums and the premium rapidly rises the more overweight they believe you are.

Height and weight are just two of the questions you have to answer when you apply for life insurance. From them, the life company calculates your Body Mass Index and if that exceeds the limits they define as acceptable, they might ask for a doctor’s report. In bigger cases they might ask you to have a medical examination. If this confirms that your weight is of concern, then you can expect your premium to be loaded by at least 50% and as much as 400% if you’re really obese. Recent research shows that around 25% of applicants will experience problems getting life cover due to their weight. In extreme cases the insurer will even refuse the application.

In an acknowledgement of normal middle age spread, the insurance companies do take your age into account when deciding your premium. They accept that people naturally tend to put weight on as they age. If you’re young and overweight, however, they’ll certainly hit you hard. So overweight and 38 will be hit much harder than overweight and 58.

For example, a non smoking healthy man aged 35 asking for 150,000 level cover over 25 years will currently be quoted 18.77 by Scottish Provident but this could easily jump to 35 if he is overweight and up to 47 if he’s obese.

And obesity is certainly a growing problem. Over the last 20 years obesity in adults has rocketed with more than 60% of men and 50% of women being judged as overweight or obese. And signs are that the problem won’t improve. In children aged between 2 and 15, 28% of girls and 22% of boys are overweight.

How do you rate on the Body Mass Index?

Calculate your own BMI.

Note your weight in pounds and multiply it by 703.

Divide the result by your height measured in inches

Again divide the resulting number by your height in inches

The result is your BMI

The typical insurance company considers a BMI of between 18.5 and 24.9 to as normal. Above 25 classifies you as overweight. Over 30 and you’re obese.

To give you more of a fix on what this means for you, here are the BMI’s for twelve famous people:

Under weight

Paula Radcliffe Marathon Runner – 18.0

Victoria Beckham Footballers Wife – 17.0

Jennifer Aniston Actress – 17.5

Normal weight

Alan Shearer Newcastle Footballer – 24.4

Davina McCall TV Presenter – 20.8

Cilla Black Presenter – 20.7

Overweight

Russell Crowe Hollywood Actor – 25.6

Ann Widdecombe MP – 25.1

Charlie Dimmock Gardening Presenter – 26.0

Obese

Norman Schwarzkopf US General – 30.5

Michelle McManus Presenter – 34.4

Dawn French Comedienne – 43.8

Health Insurance It’s Important To Know What’s Not Insured!

Around 7 million people in the UK are covered by health insurance, the majority being covered through their employers. The problem is that few have really studied their policy documents and many misunderstand what is covered. And perhaps just as important, what isn’t. If you expect health insurance to pay all your health costs, you’re mistaken.

Health insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you’ll know what to look out for!

Sorry it’s a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it’s a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic – and no, you won’t be covered.

But drawing a firm line between what is acute and what is chronic is fraught with problems, and leads to the biggest area of conflict between insurer and policyholder.

Everyone agrees that diabetes and asthma are chronic conditions as you’re likely to suffer from them for the rest of your life. So those sorts of condition are not covered.

Problems arise when the medical team initially considers a patients’ illness to be curable, but the condition subsequently deteriorates and the doctors change their mind, it’s now become incurable. This can happen especially in the treatment of some types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic – and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry – it’s too long term
The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define long-term. You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry it’s preventative
Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and Standard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry the drug is not approved
Two of the main attractions for taking out health insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there’s a rider.

Unless the drug has been approved for use by the NHS in England and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute’s brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief – and one that has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if a health policy won’t pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry it’s a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition pre-exists the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you injured your knee playing football. It appeared to recover but now it turns out that you have a torn cartilage and need an operation. The insurer could argue that this is a pre-existing condition and you have to pay for its’ treatment.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you’ve suffered from within the last 5 years, then they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry its not covered

Health Insurance is an annual contract just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it’s possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers’ pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there’s also a trend for new treatments to cost more Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So when you are considering Health Insurance, be aware that everything is not always black and white. And if you’ve got insurance and need treatment, always contact your insurer without delay and get them to confirm that your treatment is indeed covered

Whole Life Insurance, Trends, and Staying Power

Whole life insurance provides customers with a life insurance policy that will help their loved ones in the future, and with an investment component that will help customers and their families right away. This mixture of delayed and instant gratification has been attractive to life insurance shoppers for decades, but todays trend in life insurance is moving away from whole life insurance packages. Once, whole life insurance policies were the standard, but today they are the exception.

As the economy changes and the American public become increasingly savvy about money management, the full service that a whole life insurance policy provides just isnt as necessary as it used to be. People who want a more hands on approach to investing are likely to find a whole life insurance policy too limiting. And, the amount of money that one of these policies requires each month can make it difficult to pursue other investment options, especially for middle and lower class families who are living on a budget. A lot of financial experts today feel the investment portions of whole life insurance policies do not offer customers the best return rate on their money. This provides an incentive for people to purchase term life insurance policies which do not include any investment components, and then invest their money elsewhere.

However, there are still some advantages to purchasing a whole life insurance policy. Although the investments that an insurance company will make on your behalf may not be the most lucrative, they will almost certainly be among the most stable. Many people prefer a lower rate of return with a lower chance of loss rather than a riskier gamble. There is plenty to be said in favor of this perspective, especially when it comes to planning for the future. In addition, people who do not have the discipline or inclination to save money on their own often find the structured saving a whole life insurance policy requires to be a boon.

If the idea of budgeting your own savings plans and spending time researching hot stock tips appeals to you, a whole life insurance policy probably wont be to your personal taste. Of course, even if you dont opt for this tried and true kind of policy, you can be certain that someone else will. Although todays trends seem to foretell the end of the whole life insurance policy, there are still enough customers interested in this kind of traditional and conservative policy that insurance companies will be likely to offer this kind of coverage for many years to come.

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.

How To File A Report In Case Of A Car Accident

If you have been in a car accident, you must immediately file a report to your insurance company. Accidents have been increasing but some people do not have enough knowledge on how to deal with these cases the right way. You may have encountered an accident or you may just be part of the accident. Either way, you should know what to do after the accident has happened.

If you witnessed a car accident, the first thing you should do is to seek aid for the injured. After the ambulance has arrived or first aid has been provided, you should call the police and state what happened. You should answer all questions given by the police officer. Make sure that your answers are correct because the details given are written on a report, which will be used for assessing the case. All information given to the police officer must be accurate so that the fault will not be used against you.

In making a report, make sure that you dont change your statements after every court proceeding or investigation. The police officer may ask you questions about the case repeatedly. Make sure that you dont change your statements because it will not match with the previous story. You can do this simply by telling the truth.

Also make sure that you dont leave out any information.

If a police officer is not present, you can take down important details yourself so you will not forget it later. When the police officer is present, you can present your notes and report and he will further investigate. In making your report, you should include the specific time, location, area, position and you can also ask for witnesses to back up the accident scene.

People in the accident area may be very curious about what happened. If they ask for information, you should not share it with them especially your notes. You must first present it to the police so that the information is safe. If you spread the information, there might be inaccurate reports and some people might disseminate wrong information which will make the case puzzling.

Make sure that you stay on the scene after the accident has happened. If you leave the scene, there might be complications that will make the case very confusing. If you have been involved in a hit and run, try and get down the license number of the other vehicle.

If you have a camera with you or a camera cell phone, take some photos of the accident. This can provide strong proof and evidence which can be very helpful.

If you have a car accident, you need to know how to deal with it so you can make a report completely and have all required information for both the police and your insurance company.

Insurance Tips which type of insurance is best for you?

While shopping for insurance, it is necessary to follow all steps so that you can select the best insurance that will provide you better opportunities at cheap rates. Select your insurance plan according to the changing environment.

Too much insurance means wastage of money and too little insurance can result into financial disaster for you and your family. In this article you will find insurance tips that will help you in making proper selection of insurance policy.

The first step is to decide that how much insurance is needed. You can either do this yourself or take help of an insurance expert having full knowledge of insurance policies and procedures. You can also follow self-help books & software programs to find out your insurance needs.

The second step is to decide upon the type of insurance policy you want; life, auto, health, dental, travel, home etc. For e.g. if you are in need of life insurance and what type of life insurance you need like term life, whole life, universal life.

After deciding the insurance level and its type, the next step is to choose the best price for your insurance plan. There are different companies providing various types of insurance plans at different rates. The price you have to pay mostly depends upon your age, gender and medical condition. Before buying insurance policy, gather information about the financial condition of the company. The different rating scales of an insurance company are A.M. Best Company, Duff & Phelps, Moody’s Investors Service etc.

After receiving your insurance policy document, study it thoroughly and make sure that the policy is exactly what you demanded. Read all the policy terms and conditions written on the document. If you are satisfied or in any case you want your money back, you are also allowed to return the policy & get a full refund within 20 days.

The last step is filling the form and you must be careful when the agent is filling your application form. After completion read it cautiously and then sign it.