09th February 2011
The field of Long Term Care, i.e. the providing of care (skilled, intermediate and custodial) for individuals who require such care, and furnished by Nursing Home, Community Care Retirement Centers, Adult Living Facilities, Home Health Care, and other suc...
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09th February 2011
Obviously, the first step in this plan would be to verify that the employee receives first-aid and other immediate treatment for their illness or injury. Needless to say, the proper first-aid treatment often saves the life of the patient, and at the very...
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04th February 2011
Treatment review can be either Prospective, Concurrent, or Retrospectively, as explained earlier. Review can be at any or all of these points in treatment.
Prospective Review. Pre-certification or pre-admission certification is probably the most reco...
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04th February 2011
In any type of health insurance, the determining factor regarding pricing, plan development, forecasting and eventually, controlling costs, is utilization, i.e. how much and how often the system is used. The more health insurance is “utilized", the more ...
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03rd February 2011
The 3 areas that the typical auto premium dollar are allocated to would be: Bodily Injury Coverage, Collision and Property Damage Coverage. We will discuss these 3 first.
Bodily Injury Liability - This is the coverage which most protects against fi...
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03rd February 2011
Bob and Mary Gordon are both employed. Bob is a supervisor for a large automobile repair firm. Marie is a social worker for the State Welfare Department. Bob and Marie have two children. Karen, aged 20, is attending college 200 miles from home. Ken,...
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03rd February 2011
The Tort Liability System Based on Fault is the traditional method for compensating injured automobile accident victims in the United States. As noted before, a “tort" is a legal wrong for which the law allows a remedy in the form of money damages.
N...
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15th December 2010
The cancellation or nullification of Flood Insurance Policy procedures can be found in detail at http://www.fema.gov/business/nfp/manual.shtm - and it contains some10 pages of detail. This discussion does not cover all of the intricacies and details co...
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15th December 2010
The APPLICATION for flood insurance is, understandably, a little more complicated than some of the other property and casualty policy applications as it covers a specific risk on property that must be identified although the range of buildings and propert...
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15th December 2010
BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
The responsibility of providing a number of elevations based on the building type selected is that of the surveyor, engineer, or architect. From these elevations gathered, the agent is required to deter...
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15th December 2010
An Elevation Certificate (EC) is mandatory on Post-FIRM construction, but is optional on Pre-FIRM construction. It is required by the NFIP so that it can be certified by the NFIP as to the lowest floor of a building so that the policy can be properly rat...
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20th October 2010
Wording regarding the PPO Providers (when applicable) are the same as with individual Major Medical plans. As a rule, Provider-type plans are established the same for Group and Individual plans. Note the illustrated Schedule of Benefits on the first page...
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20th October 2010
The Group Policy is a document between the employer and the insurance company, mostly of an administrative nature. The individual employee’s coverages are provided in a Certificate of Coverage and details of coverage, benefits and provisions are provided...
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20th October 2010
The following text is typical of the language and provisions used on the first page of the Major Medical policy. Much of this information is required by state regulations and may vary by state.
IMPORTANT NOTICE
(NOTE: In most, if not all, jurisd...
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15th October 2010
In the absence of fraud, all statements made by applicants or Insureds will be deemed to be representations and not warranties. No statement made for the purpose of affecting coverage will avoid coverage or reduce benefits unless contained in a written a...
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