Different from our Agenda Magazine, which contains original articles and commentary on the insurance industry, our "El Blog" is the place to visit for current news and information. We search publications from across the country to bring you the latest articles impacting your business. You are encouraged to post your comments on the news stories presented here.

Monday, April 30, 2007

AZ Bill Challenges Use of Mexican Consular IDs

By Mike Sunnucks
Business Journal of Phoenix

A Republican-backed measure at the Arizona Legislature would bar state and city governments from accepting Mexican consular identification cards as valid IDs.

A bill to prohibit Arizona governments from accepting such IDs -- often used by illegal immigrants who do not have U.S. IDs -- has passed the Arizona House of Representatives and soon could be considered by the Arizona Senate.

The Mexican consular IDs also are accepted by some major banks -- including Bank of America -- as well as car dealers.

Arizona is a top entry point into the U.S. for illegal immigrants -- many of whom are looking for work and others who are involved in criminal activities including gangs and drug smuggling.

From: Business Journal of Phoenix (www.bizjournals.com)

Travelers Quarterly Net Up 8%

Travelers Insurance reported first-quarter net income increased 8 percent to $1.09 billion, or $1.56 per share, compared with $1.01 billion, or $1.41 per share in the same period last year.

Net earned premiums for the quarter for the St. Paul, Minn.-based company, formerly known as St. Paul Travelers, rose 6 percent to $5.3 billion, primarily driven by strong retention rates, lower ceded premiums and growth in new business volume, the company said in an earnings statement.

Bear Stearns analyst David Small said the company beat his estimate by 6 cents and consensus by 10 cents per share.

Mr. Small noted that the carrier continues to post surprisingly strong top-line growth.

“Even in this quarter, as other market participants such as brokers and underwriters lamented about the rate of softening, Travelers was able to post net written premium growth of 7.8 percent compared with negative growth of 2.8 percent at Chubb, arguably one of Travelers closest peers,” he commented.

Investors must now look to see whether such growth is based on improved products and distribution or aggressive pricing, he advised.

“Interestingly, on renewal business, Travelers seems to be holding the line on price better than its peers,” Mr. Small wrote.

That would indicate from other market observations that the overall spread between new and current business is expanding, he added.

In addition, Travelers is appearing to be holding the line on auto pricing, in contrast to complaints previously from competitors, Mr. Small said.

From: NU Online News Service (www.nationalunderwriter.com)

Hartford: We May Be Sued In Bid Rig Scandal

By Daniel Hays
NU Online News Service

The Hartford said it is trying to negotiate a settlement of bid-rigging allegations, but “it is likely” that the New York Attorney General or another agency will sue the company.

In its 10-Q filing with the Securities and Exchange Commission, the company noted the price-fixing lawsuit filed Oct. 14, 2004 by then New York Attorney General Eliot Spitzer against Marsh & McLennan and its Marsh Inc. brokerage subsidiary.

That suit alleged that big name insurers including the Hartford, Conn.-based Hartford made arrangements with the brokerage to submit inflated bids for commercial insurance and paid contingent commissions to ensure Marsh would send business their way.

In a settlement, Marsh agreed to stop accepting contingent commissions on such business and repay clients $850 million. Criminal charges were brought against eight Marsh executives, two of whom are currently undergoing trial.

The Hartford’s filing said that while no regulatory action had been initiated against the company in connection with the Marsh lawsuit “it is likely that the New York Attorney General’s Office or one or more other regulatory agencies will pursue action against the company or one or more of its employees in the future.”

Currently, the company said it is “engaged in discussions regarding the potential resolution of the inquiry by the New York Attorney General’s Office and other regulatory agencies into broker compensation. The potential timing of any such resolution or the initiation of any formal action is difficult to predict.”

From: NU Online News Service (www.nationalunderwriter.com)

Hartford Net Jumps 20 Percent

The Hartford Insurance Group said today that first-quarter net income rose 20 percent compared to the period last year.

The Hartford-based multiline insurer reported net income of $876 million, or $2.71 per share, compared with $728 million, or $2.34 per share, in the same year-ago period.

Chairman Ramani Ayer said a 17 percent return on equity came as a result of “navigating in a diverse set of markets and competitive environments.”

Written premiums for business insurance remained flat at $1.3 billion. Small commercial written premiums, which Mr. Ayer termed the “sweet spot” for the company, grew 3 percent. A 4 percent decline in middle market premiums offset that gain.

The company posted a business combined ratio of 89.1, excluding catastrophes, compared with 87.4 in the same 2006 period.

Overall, personal lines written premiums were $939 million, a 4 percent increase the prior year.

Excluding catastrophe losses, personal lines posted an 84.1 combined ratio, virtually unchanged from the 84.4 of the prior year period.

From: NU Online News Service (www.nationalunderwriter.com)

Ariz. Governor Napolitano Signs Captive Insurance Law

Arizona Governor Janet Napolitano has signed HB2294, Captive Insurer Amendments, updating Arizona's captive insurance law. The amendments will be effective 90 days after the legislative session adjourns.

The new amendments implement:

* New provisions allowing the establishment of branch captives to provide employee benefits.

* New provisions defining "deductible reimbursement" business, and clarifying that deductible reimbursement business is permitted on a direct basis.

* Re-defines "industry group captive insurer" to eliminate group member eligibility requirements of a third party insurance consultant and a threshold amount of annual premium expenditure, and substitutes a simple homogenous risk standard.

* Allows group captives (except RRGs) to cover "controlled unaffiliated business".

* Eliminates remaining restrictions against writing commercial motor vehicle business on a direct basis.

* Eliminates an Arizona residency requirement for captive managers, and requires that captive managers do business at location in Arizona.

* Reduces the minimum capital requirement for a protected cell captive from $1MM to $500K.

* Allows any surplus note interest rate approved by the Director.

* Specifically allows a reinsurance captive to securitize its risk portfolio through contracts that allow the purchase of interests on a nonrecourse basis.

* Allows pure captives to be formed as a LLC.

* Allows group captives to have as few as 3 directors, and up to as many directors as it has members (in addition to outside directors).

* Coordinates the effective date of corporate re-domestication to Arizona and the effective date of the new Arizona certificate of authority.

* Clarifies that audit reports are due within 6 months after the end of the captive's fiscal year.

* Clarifies the requirement for prior approval of changes to captive business plans.

* Clarifies the confidential treatment of all information related to captive insurers, except for name, type, date licensed, license status, and business of owners (does not apply to RRGs)

* Specifically authorizes the Director to expend monies in the captive insurance regulatory and supervision fund to pay the costs of administering the captive insurance law and to promote the state's captive insurance industry pursuant to guidelines that she adopts.

Sources: Arizona Captive Association (www.azcia.org), Arizona Legislature (www.azleg.state.az.us)

From: Claims Guides (www.claimsguides.com)

Friday, April 27, 2007

LAAA Pays Respects to Insurance Personality George Viso

The Latin American Agents Association regrets to announce the passing of one of its valued members, George Viso. The owner of George Viso Insurance Agency in West Hollywood for over 25 years, he was a fixture at LAAA meetings and events and contributed innumerably to the direction and success of the association.

Waging what was ultimately a losing battle with mouth cancer, George was a businessman to the end, strategizing how to promote a new financial product at a recent LAAA meeting with association founder Andre Urena. “The first thing he said to me was, don't mind the voice, my mouth cancer is flaring up but we are fighting aggressively and he moved onto the business at hand,” recalls Urena. “I remember George since starting in this business. He attended and participated in all the meetings, and made an important contribution every time. I remember after my presentations, he would pull me aside and gave me his take on current issues.” Urena added that Viso would “always encourage me to take the high ground when our group was attacked. He became a staple of our L.A. meeting and he will be missed.”

LAAA President Gustavo Contreras commented that Viso was one of the first members to approach him with support and advice after he took office early this year. “I really want to represent the rank and file LAAA agents as president, and actively sought input. George provided me with guidance and insight that has helped make my first six months in office very productive. His passing has definitely left a void in our association.”

Viso passed away on Sunday, April 23rd, and services were held Wednesday, April 25th at 10:00 am at Mt. Sinai Cemetery in Burbank. For more info, contact the LAAA office at (626) 444-0999.

Ohio's New Teen Driving Law Leads Some Companies to Lower Rates

Ohio's new law restricting young drivers is saving some people money on car insurance bills because the companies believe the regulations will lower accident rates.

Some insurance companies lowered teen driver rates after the law that restricts the hours teens may drive and their number of passengers went into effect April 6.

Teen drivers with Grange Insurance will get up to a 5 percent discount when the company cuts its rates in June. Allstate Insurance Co. lowered fees last summer in anticipation of the law, and teen drivers can further cut their rates by taking an online safety program, spokeswoman Lisa Finney said.

In the last 18 months, State Auto Insurance dropped rates for teen drivers by 5 to 10 percent, said Joel Brown, vice president of personal insurance.

"Insurance companies are starting to see lower losses from teen drivers, and are turning around and passing those savings on to customers,'' said Mary Bonelli, spokeswoman for the Ohio Insurance Institute.

Nationwide Mutual Insurance Co. and State Farm Insurance Cos. say they'll wait to see if the law lowers the accident rate for young drivers. A study by the Ohio Department of Public Safety suggested states with similar laws saw a 23 percent drop in teenage accidents.

Ohio's law bars drivers under the age of 17 from carrying more than one non-relative as a passenger. It also blocks drivers under 17 from driving from midnight to 6 a.m., and 17-year-old drivers can't be on the road between 1 a.m. and 5 a.m. Exceptions can be made if the teen is driving to and from work, and the hours or number of passengers don't matter if a parent or guardian is in the car.

When the law took effect, some teens grumbled that it was unfair and that parents should have the right to determine who and when their kids drove.

Proponents argued the restrictions meant less distractions for teen drivers, and as of February, 43 other states had passed laws similar to Ohio's covering teen drivers.

The relaxed fees could help parents, whose insurance bill can double when they add a teenage driver to their policies, Bonelli said, although the actual cost is affected by many factors including the driver's age, driving record and the type of car covered in the policy.

Source: Associated Press (www.ap.org)

From: Insurance Journal (www.insurancejournal.com)

Calif. Pre-Paid Funeral Insurance Scam Targets Elderly

California Insurance Commissioner Steve Poizner is alerting senior citizens and their families to make certain they or their loved ones are not victims of a pre-paid funeral scam which targeted the elderly in Southern California. A California Department of Insurance (CDI) investigation found that the former owner of Valley Funeral Home in Murrieta sold "pre-need" burial insurance plans to senior citizens, including residents of area nursing homes, then pocketed the premiums and left her elderly clients without funeral coverage.

Lee Ann Wyskiver, 55, was arrested at her home on April 5, 2007, by CDI investigators and the Escondido, Calif., Police Department. Wyskiver is charged with six felony counts including grand theft and financial elder abuse. She was booked into the Escondido jail, and bail was set at $50,000. The Riverside County District Attorney's office is prosecuting the case.

According to investigators, between 1998 and 2004, Wyskiver collected nearly $20,000 from numerous elderly clients that thought they were purchasing a pre-need burial insurance policy. Pre-need or pre-paid burial insurance is a specialized form of life insurance or annuity used to fund the predetermined expenses of a funeral, cremation or burial. In some instances, the consumer was charged an additional fee to add an offered travel benefit.

Wyskiver allegedly had her elderly clients complete the appropriate life insurance applications for the requested coverage and collected the quoted insurance premium. She then led each client to believe that their policies had been placed with either Forethought Life Insurance Co. or Homesteader Life Insurance Co.

After receiving numerous complaints against Wyskiver's funeral home, the California Department of Consumers Affairs, Cemetery and Funeral Bureau initiated an investigation in 2005 and concluded that Wyskiver had committed gross acts of negligence and fraud, and revoked her license to operate a funeral home. Valley Funeral Home went out of business but failed to notify the clients.

In Nov. 2005, the same establishment opened as Murrieta Valley Funeral and currently operates under new ownership and management. It was through the new owner that the clients discovered they did not have the previously purchased insurance policy.

In addition to having a funeral home director's license, Wyskiver also had a license to sell life insurance during the time covered by the investigation. Potential victims are being urged to call CDI.

Source: California Department of Insurance (www.insurance.ca.gov)

Thursday, April 26, 2007

Bank of America Buying Seattle Mortgage

By Justin Matlick
Sacramento Business Journal

Bank of America Corp. is buying Seattle Mortgage Co.'s reverse mortgage operation.

The nation's third-largest reverse mortgage lender, Seattle's Reverse Mortgage of America division has roughly 400 employees and a loan portfolio totaling $4 billion.

Charlotte, N.C.-based BofA (NYSE: BAC) said it plans to absorb these workers, and to leave Seattle executives John Nixon and Charlie Jones in place to oversee the division. Financial details were not disclosed.

For BofA, the deal means a chance to make inroads into one of the mortgage industry's fastest-growing segments. Reverse mortgages are designed to help senior citizens borrow against their home equity. With millions of Americans expected to retire soon, banks and mortgage companies have been racing to establish a foothold in the area.

The deal is expected to close in the second quarter of 2007.

From: Sacramento Business Journal (www.bizjournals.com)

Calif. Assembly Insurance Committee Passes Fraud Measure

California's Assembly Insurance Committee has passed Assembly Bill (AB) 1401 on a bi-partisan 8-0 vote.

According to the California Department of Insurance, the measure would provide the DOI with additional investigators to fight insurance fraud. AB 1401 would also require the CDI to post investigative program performance outcomes on its Web site.

AB 1401, as amended, would increase the per-company fraud assessment from $1,300 to $5,100 but would not change existing law with regard to the $1.80 per-vehicle fraud assessment.

CDI estimates that insurance fraud totals $15 billion per year in a $118 billion per year industry.

This essentially imposes a "fraud tax" of nearly $500 per year on every man, woman and child in California, Commissioner Steve Poizner said.

Since 1973 insurers have been required by law to pay an annual fee to help California combat insurance fraud. AB 1401 would increase this assessment to $5,100 per insurer. CDI said the assessment has seen virtually no raises in the past 34 years, with the exception of a $300 increase in 2000.

AB 1401 would adjust the assessment for inflation, CDI said, helping it to fill approximately 22 vacant positions in the fraud division.

Source: California Department of Insurance (www.insurance.ca.gov)

From: Clailms Guides (www.claimsguides.com)

Wednesday, April 25, 2007

New Teen Driving Law Leads To Lower Insurance Rates in OH

Ohio's new law restricting young drivers is saving some people money on car insurance bills because the companies believe the regulations will lower accident rates.

Some insurance companies lowered teen driver rates after the law that restricts the hours teens may drive and their number of passengers went into effect April 6.

Teen drivers with Grange Insurance will get up to a 5 percent discount when the company cuts its rates in June. Allstate Insurance Co. lowered fees last summer in anticipation of the law, and teen drivers can further cut their rates by taking an online safety program, spokeswoman Lisa Finney said.

In the last 18 months, State Auto Insurance dropped rates for teen drivers by 5 to 10 percent, said Joel Brown, vice president of personal insurance.

"Insurance companies are starting to see lower losses from teen drivers, and are turning around and passing those savings on to customers," said Mary Bonelli, spokeswoman for the Ohio Insurance Institute.

Nationwide Mutual Insurance Co. and State Farm Insurance Cos. say they'll wait to see if the law lowers the accident rate for young drivers. A study by the Ohio Department of Public Safety suggested states with similar laws saw a 23 percent drop in teenage accidents.

Ohio's law bars drivers under the age of 17 from carrying more than one non-relative as a passenger. It also blocks drivers under 17 from driving from midnight to 6 a.m., and 17-year-old drivers can't be on the road between 1 a.m. and 5 a.m. Exceptions can be made if the teen is driving to and from work, and the hours or number of passengers don't matter if a parent or guardian is in the car.

When the law took effect, some teens grumbled that it was unfair and that parents should have the right to determine who and when their kids drove.

Proponents argued the restrictions meant less distractions for teen drivers, and as of February, 43 other states had passed laws similar to Ohio's covering teen drivers.

The relaxed fees could help parents, whose insurance bill can double when they add a teenage driver to their policies, Bonelli said, although the actual cost is affected by many factors including the driver's age, driving record and the type of car covered in the policy.

Information from: Columbus Dispatch (www.dispatch.com)

Source: Associated Press (www.ap.org)

From: Insurance News Net (www.insurancenewsnet.com)

U.S. Property-Casualty Insurers Pay Out $1.22 Billion For First Quarter Catastrophes

U.S. property and casualty insurers are expected to pay some $1.22 billion (€890 million) for catastrophic events during the first quarter, including severe tornadoes in several southern states, according to a company that tracks insurance data.

The ISO Property Claim Services unit said the total was down from $1.48 billion (€1.08 billion) in the first quarter of 2006 and the lowest since $1.04 billion in the first quarter of 2004.

The group said insurance payments stemmed from seven catastrophic events that damaged homes and businesses in 18 states. The costliest were tornadoes that hit Alabama and Georgia in March, the ISO said.

The states with the largest insured property loss were Georgia, $285 million; Alabama, $175 million; Texas, $167 million; Missouri, $140 million; and Florida, $100 million.

The company defines a catastrophe as an event that causes $25 million or more in insured property losses and affects a larger number of policyholders and insurers.

Source: Associated Press (www.ap.org)

From: Insurance News Net (www.insurancenewsnet.com)

Tuesday, April 24, 2007

Las Vegas Number One Hotspot for Vehicle Theft

The National Insurance Crime Bureau (NICB) reported today that after three consecutive years as the area with the worst per capita vehicle theft rate in the nation, Modesto, CA has fallen into the number five position-a dramatic improvement. Taking over the "Number One Hot Spot" is Las Vegas, NV.

As in 2005, the western United States still ranks as the area of the country with the highest auto theft rates. All of the nation's top ten areas are in the west with five of them in California.
For 2006, the ten metropolitan statistical areas with the highest vehicle theft rates are:

1. Las Vegas/Paradise, NV
2. Stockton, CA
3. Visalia/Porterville, CA
4. Phoenix/Mesa/Scottsdale, AZ
5. Modesto, CA
6. Seattle/Tacoma/Bellevue, WA
7. Sacramento/Arden-Arcade/Roseville, CA
8. Fresno, CA
9. Yakima, WA
10. Tucson, AZ

According to Hot Spots, its annual report on auto theft rates, NICB reviewed data supplied by the National Crime Information Center (NCIC) for each of the nation's 361 Metropolitan Statistical Areas (MSAs). MSAs are designated by the Office of Management and Budget and may include areas surrounding a specific city.

The rate is determined by the number of vehicle theft offenses per 100,000 inhabitants using the 2005 U.S. Census Population Estimates, the most current figures available.

Preliminary FBI data shows a 2.3% decrease in motor vehicle thefts during January-June, 2006, when compared with the same period in 2005. Nationally, this is the third straight year of decreases in vehicle theft.

"People can take any number of precautions to protect themselves from vehicle theft and, in most cases, those are sufficient to prevent a theft," said NICB President and Chief Executive Officer Robert M. Bryant. "But a determined thief, a serial vehicle thief, is someone for whom there is no absolute deterrent-except prison.

"NICB, through the support of its member companies, has pursued an aggressive "Bait Vehicle" and License Plate Reader Program around the nation. These cutting-edge enforcement tools offer law enforcement the latest in high- tech crime fighting, and are partly responsible for the absolutely outstanding results achieved in Modesto. When used in conjunction with comprehensive legislation and aggressive prosecution, police on the street can have a tremendous impact on vehicle theft and other crimes," added Bryant.

NICB recommends the following actions under its "layered approach" to protection that automobile owners can take to minimize their risk and prevent their car from becoming the next statistic:

Common Sense -- An unlocked vehicle with a key in the ignition is an open invitation to any thief, regardless of which anti-theft device you use. The common sense approach to protection is the simplest and most cost-effective way to thwart would-be thieves. Secure your vehicle even if parking for brief periods. You should always:

-- Remove your keys from the ignition
-- Lock your doors/close your windows
-- Park in a well-lit area

Warning Device

--The second layer of protection is a visible or audible device which alerts thieves that your vehicle is protected. Popular second layer devices include:

-- Audible alarms
-- Steering column collars
-- Steering wheel/brake pedal lock
-- Brake locks
-- Wheel locks
-- Tire locks/tire deflators
-- Theft deterrent decals
-- Identification markers in or on vehicle
-- VIN etching
-- Micro dot marking

Immobilizing Device

--The third layer of protection is a device which prevents thieves from bypassing your ignition and hot-wiring the vehicle. Some electronic devices have computer chips in ignition keys. Other devices inhibit the flow of electricity or fuel to the engine until a hidden switch or button is activated. Popular third layer devices include:

-- Smart keys
-- Fuse cut-offs
-- Kill switches
-- Starter, ignition, and fuel pump disablers
-- Wireless ignition authentication

Tracking Device

--The final layer of protection is a tracking device which emits a signal to police or a monitoring station when the vehicle is stolen. Tracking devices are very effective in helping authorities recover stolen vehicles. Some systems employ "telematics" which combine GPS and wireless technologies to allow remote monitoring of a vehicle. If the vehicle is moved the system will alert the owner and the vehicle can be tracked via computer.

The National Insurance Crime Bureau is the nation's leading non-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through information analysis, investigations, training and public awareness.

Anyone with information concerning auto theft and insurance fraud can report it anonymously by calling toll-free 1-800-TEL-NICB (1-800-835-6422) or by visiting our web site.

For the complete information on Hot Spots 2006, please visit www.nicb.org.

Source: National Insurance Crime Bureau (www.nicb.org)

From: PR Newswire (www.prnewswire.com)

NAIC Launches Insure U for Small Business

The National Association of Insurance Commissioners (NAIC) today launched a comprehensive public education program to assist small businesses with information about business risks and insurance options. Under the banner of Insure U for Small Business, the campaign includes an online education site, public service announcements in English and Spanish, and community outreach by public information officers of state insurance departments.

The Insure U for Small Business curriculum, available at www.InsureUonline.org/smallbusiness, includes six categories of vital information to small businesses: workers' compensation; group health and disability; business property and liability; commercial auto; group life and key person life; and home-based business insurance. After reviewing the curriculum's helpful explanations, tips and considerations, small business owners and managers can test their knowledge about insurance issues by taking an online quiz. Upon successful completion, they can download an Insure U for Small Business diploma.

"Small businesses are a major engine for our national economy, employing millions of Americans and generating immense economic activity," said Walter Bell, NAIC President and Commissioner of the Alabama Department of Insurance. "Small business owners need to understand the array of business risks they face, as well as how to protect themselves with the right insurance coverage. Insure U for Small Business - supported by state insurance departments across the U.S. - will help small business owners and managers make smarter insurance decisions."

Research conducted by the NAIC in March revealed that many small businesses - defined as those with fewer than 100 employees - are exposed to serious risks that could be mitigated by a better understanding of insurance options, according to Catherine J. Weatherford, NAIC Executive Vice President and CEO. Key findings of the research show:

-- Only 47 percent of small businesses offer heath insurance to their employees. Of those, 24 percent report changing the fee structure, deductibles or other components in the past year to offset the rising cost of premiums.
-- Only 59 percent of small businesses with fewer than 20 employees have workers' compensation insurance, which state law requires for most companies. Workers' compensation insurance protects business owners from claims by employees who experience a work-related injury or illness.
-- Only 35 percent of small businesses have business interruption insurance, which covers expenses like payroll and utility bills that often continue after a major event (e.g., a fire or storm) shuts down a company. Because rebounding from a disaster can take a considerable amount of time, small businesses need to understand this risk and the available insurance options.
-- Only 48 percent of small businesses carry commercial auto insurance. The others apparently rely on personal auto insurance. However, personal auto insurance policies typically have lower liability limits and may even exclude business-related liability.
-- While 71 percent of small businesses say they are very dependent on one or two key people for their success and viability, only 22 percent have Key Person life insurance, a type of policy that enables a business to weather the death of a key employee or buy out the key person's heirs if ownership rights are involved.
-- Among home-based businesses - 22 percent of the NAIC survey - 48 percent depend on their homeowners insurance to protect their businesses. However, most homeowners insurance policies severely limit coverage of business property and may totally exclude business-related liability claims.

"Insure U for Small Business represents a major commitment by the NAIC and its members - the chief insurance regulatory officials of the 50 states, the District of Columbia and five U.S. territories - to help small business owners," Weatherford said. "It builds on the momentum of the NAIC's highly successful Insure U consumer education program introduced a year ago."

The U.S. Treasury's Financial Literacy and Education Commission has embraced Insure U and made the program part of its National Financial Education Network.

In addition to launching Insure U for Small Business, the NAIC is expanding its efforts to help insurance consumers avoid being taken advantage of by insurance scams. Fighting fake insurance is the focus of newly updated English- and Spanish-language television public service announcements (PSAs) encouraging individuals to call their state insurance department prior to purchasing an insurance policy to confirm that they are dealing with a company or agent authorized to do business in their state.

Individuals may also call the NAIC's toll-free telephone number to find consumer representatives in their home state insurance departments. The number is 866-470-NAIC (6242). For more information about insurance, consumers can visit http://www.insureuonline.org/ or, for the Spanish-language version, www.InsureUonline.org/espanol.

Source: National Association of Insurance Comissioners (www.naic.org)

From: PR Newswire (www.prnewswire.com)

Montana Driver History Records, Vehicle Records Available Online

Officials with the Montana's Motor Vehicle Division announced two online search services that will allow access to vehicle and driver history information online.

With the Driver History Records Service, people can search information recorded with the MVD to get individual driver history record information, including:

* Any driving restrictions placed on the driver license like corrective lenses or driving at night;

* All reported vehicle accidents including date and time of the accident and the number of reported injuries due to the accident, and

* Some personal information including legal name, date-of-birth and type of driver license, including commercial licenses.

"This online search is much more convenient for Montanans," said Motor Vehicle Division Administrator Dean Roberts. "Prior to the public having access to this online service, the
process took several days."

The Vehicle Search Service allows people to research the history of a pre-owned vehicle and get immediate results before purchasing the vehicle. Searchers can verify the legal owner, title history and registration information on each vehicle. Right now, the vehicle search is only available to registered users of Montana e-government services. Registered users pay an annual fee to have round-the-clock access to online services.

"This is a valuable service for buyers of used cars," Roberts said. "We believe it results in a more informed buyer, and it may protect the buyer from scams, like unknowingly buying a stolen vehicle. Previously, this service was only available to authorized users like vehicle dealerships, insurance companies and banks."

Roberts said both search services are secure, and do not include sensitive information like a home address, Social Security number or previous driver license number. Prior to starting an online search, users will be asked to certify that they have a valid reason to request the information. Each search costs $7. There is no fee for registered users of Montana e-government services.

For information, visit www.doj.mt.gov/driving, under "online services."

Source: Montana Attorney General's Office (www.doj.mt.gov)

From: Claims Guides (www.claimsguides.com)

Colorado Offers Identity Theft Repair "Kit"

Colorado Attorney General John Suthers has released an Identity Theft Repair Kit to help combat the growing threat of identity theft in the state. The 21-page booklet will provide useful information on how to prevent identity theft and what to do if you become a victim.

"Identity theft is the fastest growing crime in America," commented Attorney General Suthers. "I, myself, have been a victim, and no Coloradan is immune. We hope to have these repair kits in the hands of Colorado citizens as soon as possible. The detailed checklist for victims will be invaluable."

The Attorney General has partnered with Lakewood-based FirstBank Holding Co. to ensure the booklet can be provided cost-free to Coloradans. FirstBank will distribute more than 20,000 of the repair kits through its 118 Colorado branch locations. The company will also pay the printing costs for the booklet, estimated at more than $14,000.

"As Colorado's largest locally-owned banking organization, FirstBank was a logical partner for the Attorney General's Office in this endeavor," said FirstBank Chief Operating Officer David Baker. "We are excited to be a part of this effort, and look forward to helping Attorney General Suthers spread the word about preventing this crippling crime."

The booklet was produced by the Attorney General's Office over the course of several months. Among the booklet's tips for preventing identity theft:

*Never provide personal identifying information during a telephone call you did not initiate. Banks and credit card companies do not call to "verify" account information.

* Do not carry your social security card in your purse or wallet, and never have the number printed on your checks, driver's license, or other financial documents.

* If any organization uses your social security number for identification purposes, call or write and ask that a different number be used.

* Never respond to pop-up messages on your computer claiming a problem with your credit card or other account.

* Use a cross-cut shredder to dispose of any personal documents you no longer need.

* Password protect all credit card accounts that allow it.

* Control access to your credit history by calling 888-5-OPT-OUT.

* Never leave outgoing mail in an unsecured mailbox overnight.

* Arrange to pick up new checks at your bank instead of having them delivered.

* Take all credit card and ATM receipts with you after any transaction.

* Write a letter to any financial institution you do business with and ask that they not share your information with third parties.

The repair kit also contains a 10-step checklist for victims of identity theft. It includes credit bureau phone numbers and online contacts, information on how to file a report with the FTC, and other relevant instruction.

"Education is our greatest weapon in the fight against identity theft," the Attorney General said. "No single measure can end the ID theft epidemic, but these repair kits will give Coloradans the tools they need to strike a blow against this dangerous breed of white-collar criminal."

For more information on preventing identity theft, or to procure an electronic copy of the ID Theft Repair Kit, visit http://www.ago.state.co.us/idtheft/IDTheft.cfm.

Source: Colorado Attorney General's Office (www.ago.state.co.us)

From: Claims Guides (www.claimsguides.com)

Regulators Scrutinize State Fund

By Chris Rauber
San Francisco Business Times

State officials are pursuing a multi-pronged investigation into the State Compensation Insurance Fund, including a fraud probe that has the potential to turn into a criminal investigation.

"Hard drives and documents from all relevant people at State Fund have been seized" by state investigators, said Jennifer Kerns, a spokeswoman for the Department of Insurance, noting that the department's fraud division "has law enforcement powers and will go wherever the investigation leads."

Kerns said fraud investigators are on site at San Francisco-based State Fund, as is a team of auditors and a financial examiner, who she described as one of the first to raise questions about potential problems involving group sales and administrative fees at the giant quasi-public workers' compensation insurer.

The audit was ordered by California Insurance Commissioner Steve Poizner last month after State Fund removed two top officials. President James Tudor and Vice President Renee Koren were fired March 20, following an internal investigation into allegations of potential conflicts of interest in the selling of group policies to members of trade associations. Both were abruptly removed from office by the organization's board of directors.

State Fund, the state's largest workers' compensation insurer, also is continuing an internal investigation into potential conflicts of interest with the help of the San Francisco law firm Clarence & Dyer LLP.

Reforms under way

Meanwhile, State Fund is moving to implement a number of reforms that Poizner demanded last month, including bringing on consultant Stephen Kolakowski as interim CFO to help put the organization's financial house in order.

It has also appointed management consultant Marjorie Berte to review its "management controls, procedures, authorizations and practices," State Fund officials said in an April 10 letter to Poizner. The commissioner gave State Fund two weeks to respond or face disciplinary action.

"It's our understanding that State Fund is moving forward to meet those directives," said Kerns, while stressing that insurance regulators will watch the organization carefully in coming weeks and months to ensure that progress continues.

Late last month, Poizner required State Fund to make a number of structural changes and to immediately fire or place on administrative leave any officials who knew about, or should have known about, "improper payments made by the organization."

The April 10 letter to Poizner was signed by Jeanne Cain, the organization's chairman, and Lawrence Mulryan, who was named to head State Fund on an interim basis late last month after Tudor and Koren were abruptly terminated by the board.

"As urgent priorities, we agree that the fund needs a chief financial officer, an expanded board, an audit committee and an enhanced internal audit function that reports directly to the board's audit committee," Cain and Mulryan said in their letter. In other changes, they said State Fund:

- Has transferred oversight of internal audit function to the board and the interim president.
- Plans to have regular internal audit reports sent directly to the board.
- Will create a standing audit committee of the board "as soon as that is possible."
- Has "refocused" the responsibilities of the organization's general counsel to be restricted to purely legal matters.
- Has drafted an "up-to-date code of ethics" that will be distributed to employees "very shortly."

Cain and Mulryan said other changes suggested by Poizner "will require further discussion and additional information that we expect to obtain from our ongoing review," noting that staff members from State Fund and the department are meeting regularly. Some changes will require authorization by the state Legislature.

The organization provides insurance to 230,000 employers in California, and wrote more than $6 billion in business last year.

State Fund spokeswoman Julie Jenkinson said the organization hired financial veteran Kolakowski, who has worked for Swiss Re, Underwriters Re and Ernst & Young, on a consulting basis to serve as interim CFO and make recommendations about setting up a permanent CFO function.

Outside experts tapped

State Fund historically has not had a chief financial officer or a chief investment officer and is legally restricted in the number of senior executives it can hire. That's a restriction that senior state and State Fund officials hope can be removed legislatively.

State Fund has also contracted with Berte, an insurance adviser to former Gov. Pete Wilson and a California Public Employees' Retirement System trustee, to review its internal policies and procedures, a review that's expected to take several weeks.

Berte "is examining our governance, structure and authority levels and making sure that appropriate controls and authorities are in place," Jenkinson said.

From: San Francisco Business Times (www.bizjournals.com)

Insurance Brokers Win Round Over Regulation

By Chris Rauber
San Francisco Business Times

California's insurance brokers have won a victory over the state Department of Insurance regarding so-called "underground regulations," in an administrative law case that could have far-reaching ramifications.

The California Office of Administrative Law ruled April 16 that the Department, under former Insurance Commissioner John Garamendi, overstepped its authority by inserting regulatory language into an out-of-court settlement and then designating it as legally precedent-setting.

The OAL barred not just the Department of Insurance but more than 200 state agencies from taking that approach which it said would "allow state agencies to circumvent the rulemaking process with impunity."

The decision "reaffirms the very important principle that regulatory agencies must comply with the rule of law," said Steve Young, general counsel for the Insurance Brokers and Agents of the West. "They cannot circumvent the Legislature or ignore due process protections." IBA West led a coalition of trade groups fighting to limit the state's powers.

Steve Hirsch, a partner at San Francisco's Keker & Van Nest LLP, represented IBA West. He said permitting such "precedential" settlements "would allow an agency to target a weak or small regulated entity, accuse it of some infraction, bully it into a settlement, and then insert into that settlement new laws that purport to govern the entire state."

IBA West filed in late September to stop the DOI from redefining the state's independent insurance brokers as de facto agents of insurance companies.

At the time, then-department spokesman Norman Williams argued that the DOI had followed state law in its actions. Former insurance commissioner Garamendi, now lieutenant governor, had been pushing for tougher brokerage regulations in the wake of the insurance brokerage bid rigging/contingent commission scandal uncovered two years ago by then-New York Attorney General Eliot Spitzer.

Linda Brown, the OAL's deputy director, said such a decision can be appealed to the courts, requesting that it be modified or set aside. A DOI spokeswoman said the agency is considering its options.

From: San Francisco Business Times (www.bizjournals.com)

Workers' Comp Fraud by Bosses Rising

By Kathy Robertson
Sacramento Business Journal

Workers' compensation fraud by employers appears to be up significantly in California, potentially cheating insurers out of millions and raising rates for businesses statewide.

The number of suspected fraudulent claims by California employers increased to 2,056 in the fiscal year ended June 30, 2006, almost five times as many as the 417 in fiscal year 2003, according to the state Department of Insurance.

Fraud by medical and legal providers also is on the upswing, with 872 cases of suspected fraud in fiscal 2005, more than double the 429 identified in fiscal 2003.

It's unclear whether more fraud is happening or more is simply being reported and prosecuted, but the trends align with growth in workers' compensation premium fraud by employers and medical/ legal providers nationwide, according to a study released this month by the Coalition Against Insurance Fraud in Washington, D.C.

The coalition is a nonprofit alliance of consumer groups, insurers and government agencies combating insurance fraud. The study is considered a barometer of the nation's annual progress against insurance fraud, which costs up to $80 billion annually. It concludes that a handful of fraud bureaus appear to be particularly effective in detecting and rooting out illegal behavior, and California tops the list.

Most action, most money

California convicts more insurance swindlers than any other state -- one of every three insurance fraud convictions in the nation, according to the study. The state fraud bureau logged a record 1,546 convictions in 2005, ahead of runners-up Florida at 493 and New York at 450.

California reported the most referrals of suspected fraud at 27,687, followed by New Jersey at 26,000. The referrals come from a variety of sources such as insurance companies, local law enforcement and calls to the fraud hotline.

The state also brings the most resources to the table to fight fraud, both in dollars and employees. California's $36.8 million fraud division budget is the richest in the country, followed by New Jersey at $29.7 million. The California fraud division is also the largest, with 298 staffers, followed by New Jersey at 270.

"It's fair to say the California Department of Insurance is one of the more active state agencies in terms of criminal enforcement," said Matt Jacobs, a former U.S. Attorney who is now a partner in the Sacramento office of DLA Piper. "It's an agency that has an enforcement staff that does cases. Some agencies don't have enforcement staff. Some have staff and don't do cases."

Not a victimless crime

Insurance is a $115 billion industry in California with a direct impact on the economy, said Dale Banda, deputy commissioner of the enforcement division at the insurance department.

"When you add up car, life, long-term disability and workers' comp insurance, it's a significant amount of your budget in business and personal life," Banda said. "Insurance fraud is not a victimless crime. It increases costs for everybody."

Workers' compensation fraud by employers falls into three categories:

Those who do not have workers' comp insurance
Those who deny benefits rightfully owed to employees and
Premium fraud, which can mean underreporting payroll or misclassifying employees.

One local example of some of the gray areas in the law is Sacramento business owner Stephanie Nishikawa's citation for not providing workers' comp insurance for some relatives who work at her store, The Paper Garden.

Benefit denials run the gamut from employers telling undocumented immigrants they'll be reported to immigration authorities if they file a claim to situations where "injured workers are being rolled up and dropped off at an emergency room while the employer speeds away," said Rick Plein, fraud bureau chief for regional offices in Sacramento, Benicia and Morgan Hill.

Premium fraud takes lots of forms and adds up fast. The five cases filed statewide during the current fiscal year total more than $60 million.

"We are seeing some pretty major dollars," Plein said.

In one Sacramento case last year involving North Pointe Enterprises Inc., a large residential framing contractor, three Elverta residents were arrested and charged with underreporting employees' wages by $1.9 million. An audit indicated the business owed $2.7 million in additional premiums.

Work-related injuries are a big cost driver in the construction industry, Banda said, so there are cases where employers under-report injuries to reduce the "experience modification," or the formula to determine rates based on a company's history of payroll and insurance claims, that cranks up rates.

The underground economy is a big issue, too, with employers paying cash under the table and under-reporting wages.

"It's tough to know how much fraud is out there when we only know what's reported to us," Banda said. Once identified, investigators still have to prove there was specific intent to defraud in order to make charges stick.

From: Sacramento Business Journal (www.bizjournals.com)

Monday, April 23, 2007

Kaiser Permanente Becomes Avivia Health

Kaiser Permanente Healthy Solutions is now Avivia Health from Kaiser Permanente. The name change is part of a complete rebranding, unveiled for the first time at the World Health Care Congress in Washington, D.C. on April 22, 2007.

The new name, logo and brand look are part of the continuing evolution of the company. As the business gathered momentum over the past two years it became clear that the company needed a new name and brand positioning to better reflect its core strengths and distinctiveness.

"Avivia (pronounced ah-VIV-ee-ah) is built from two Latin roots meaning 'the path to life'," says Chris Stenzel, CEO of Avivia Health. "The path shown on our new logo represents the journey toward improved health and wellness. Built upon Kaiser Permanente's strong clinical foundation, we distinguish ourselves from traditional disease management providers. We utilize a whole person approach to chronic disease management, wellness and productivity management. Our approach helps participants take a much more active role in improving and maintaining their own health." Avivia Health is an endorsed brand of Kaiser Permanente.

New graphics will complement the Avivia Health name and logo. Those graphics emphasize the balance between the scientific side of the programs and the human side - the concern employers have for their workforce and the desire to keep those people healthy and productive.

Stenzel says, "Just as we are continuously innovating and improving our service offering, we are repositioning our brand in the marketplace. Our ability to quickly and effectively respond to change is one of the ways we stand head and shoulders above our competitors."

Avivia Health will continue to provide Intelligently Tailored(TM) population care management and wellness services, including customized services. No corporate changes will result from the new name and branding. Our strategic relationships with Health Dialog and the world-renowned Kaiser Permanente will remain intact.

The new Web site address is www.aviviahealth.com. The phone number is 888-4AVIVIA (888-428-4842).

Avivia Health from Kaiser Permanente provides total population care management and wellness services to medium and large-sized employers, and community health plans. Avivia Health is wholly-owned by Kaiser Permanente entities. The company has headquarters in Oakland, California and offices in Atlanta, Georgia and Chicago, Illinois.

From: Insurance News Net (www.insurancenewsnet.com)

Friday, April 20, 2007

Court Dismissal Of Anti-Trust Lawsuit Against Insurers and Brokers Is Good News To Industry

The National Association of Professional Insurance Agents (PIA) praised District Judge Garrett E. Brown Jr.’s dismissal of antitrust and racketeering case accusing 105 insurers and brokers of conniving to fix bids, maneuver customers, and pay or accept inappropriate bonus commissions.
The case was a consolidation of lawsuits filed by businesses, public agencies, and individual across the country initiated by former New York Attorney General Eliot Spitzer.

The judge ruled in favor of the defendants, including the Hartford Financial Services Group, The Travelers Cos. Inc. and Aetna, because the plaintiff’s argument failed to prove any wrongdoings.

On the charges of antitrust violation Brown found no common plan or scheme to illegally divide the market among the alleged conspirators.

The judge wrote, “While there was an exchange of information about these contingent commission agreements, which plaintiffs allege were a method by which the market or customers were allocated among the insurers, plaintiffs have not shown that the insurers colluded to allocate business.”

Brown’s decision was in agreement with the ruling of federal Judge Faith S. Hochberg who denied the same plaintiffs’ request in this action in October 2006. Hochberg said the mere existence of a contingency compensation available and earned by a producer is not an evidence of any illegal activities.

The earlier court opinion declared the compensations, or the right or ability of producers to earn them, is perfectly legal. PIA praised both rulings as “very good news” for its members. PIA is highly critical of moves to curtail the industry’s compensation system.

In an open letter to the insurance industry PIA decried attempts of certain Attorneys General to use the courts to determine how insurers will compensate their producers.

“That’s not fair to producers, and it is not fair to carriers,” PIA wrote. “Adding to the unfairness… some settlement agreements contain a provision requiring them to support laws and regulations to ban contingent commissions…they are being required to sign away their First Amendment rights and support political positions as dictated by the Attorneys General!”

According to PIA insurance carriers, just as any business, must have the freedom to configure their compensation system for optimum growth and profitability. The organization called any move to ban contingent commissions, yearly bonuses, or any form of incentive compensation as “anti-competitive attacks on how our American Free Enterprise System operates.”

PIA vowed to fight for the right of insurance companies to reward their independent agent producers with contingent commissions as part of their compensation and for the right of independent agents to receive such compensation. “We will continue this fight in the courts, through the state legislatures and in the court of public opinion…because that’s the right thing to do.”

Bryan L. Clobes, one of the lead plaintiff attorneys and a partner at Cafferty Faucher is equally determined to continue the fight with “full confidence” in the strength and merit of their complaints. Although Brown gave the plaintiffs 30 days to file an amended complaint, Clobes did not disclose if they were taking Brown’s offer or take their case to the Third Circuit for a possible reversal.

Connecticut Attorney General Richard Blumenthal also expressed his intention to pursue the case. He called Brown’s dismissal as a setback and not a final defeat. Blumenthal declared the unfavorable decision will not prevent or slow down his department’s investigations and actions against illegal and abusive tactics practiced in insurance industry.

From: Insurance News Net (www.insurancenewsnet.com)

Travelers Opens Claim University

Travelers announced the opening of its claim training facility in Windsor, Conn., Travelers Claim University. This new, state-of-the-art training facility is aimed at providing customers with highly-trained, expert claim professionals.

The 108,000 sq.ft. educational facility is designed to give Travelers' claim professionals the in-depth training and expertise they need to provide knowledgeable, accurate and efficient claim service for customers and agents.

Travelers Claim University houses a heavy-equipment lab featuring cranes, backhoes, bulldozers, and other heavy-duty vehicles and received a Chief Automotive Fuzion Vehicle Repair and Sectioning System as part of the auto appraisal lab. This equipment helps teach auto appraisers how to properly read vehicle diagnostics, measure for damage and how structural repairs on vehicles can be accomplished with precision accuracy.

Approximately 8,500 front-line employees can attend the university each year for hands-on training in auto, property, heavy equipment or liability claim appraisal. Another 8,500 plus will be trained each year through virtual learning and distance learning. It replaces Travelers' decentralized training program and aims help the company attract and retain highly trained, talented and motivated claim professionals.

In the property lab, two full-scale furnished homes and a full-size convenience store complete with all mechanical systems (electric, plumbing, heating/air conditioning) help demonstrate a wide variety of building materials and construction methods. They can be strategically damaged and used to estimate repairs or replacement costs for property claims.

The facility additionally includes eight classrooms able to accommodate nearly 300 students, a 400-seat auditorium, virtual training rooms, distance learning capabilities, study rooms, media center, reference library, in-house workshop and numerous smaller-scale mock-up demonstrations to support material identification, damage reparability, and installation procedures.

Travelers Claim University enrolled its first class of adjusters March 12. A grand opening event will be held April 24, 2007.

Source: Travelers Insurance (www.travelers.com)

From: Claims Guides (www.claimsguides.com)

Physician, Hospital Groups Join Lawsuit Against Blue Cross

By Lisa Girion
Los Angeles Times

The largest organizations representing California physicians and hospitals joined a lawsuit against Blue Cross of California on Thursday, accusing the state's largest health plan of illegally and routinely refusing to pay them millions of dollars for medical care provided to enrollees whose policies were later canceled.

The move puts the doctors and hospitals on the side of patients, regulators and consumer advocates who have criticized Blue Cross and its competitors for canceling individuals' policies after they incur costly treatment. Such cancellations have left some patients with significant financial or medical hardships.

Blue Cross, owned by Indianapolis-based WellPoint Inc., defends the practice, saying it cancels policies only after determining that individuals submitted incomplete or inaccurate applications for coverage. In such cases, the insurer contends, the patients are responsible for paying the doctors and hospitals.

At issue are individual insurance policies, the kind needed by consumers who can't get group coverage from an employer. Unlike group coverage, where all applicants must be accepted, insurers are allowed to reject individual-policy applicants with preexisting conditions or other medical risks.

Disgruntled former policyholders have filed hundreds of lawsuits against Blue Cross and other carriers in California, accusing them of digging up application flaws after the fact so they can shirk their promise to cover medical bills. They allege insurers are violating state law by failing to determine whether policyholders intended to lie on applications, or merely made mistakes.

Now, the California Hospital Assn., representing about 430 institutions, and the California Medical Assn., representing more than 35,000 physicians, are joining a lawsuit against Blue Cross filed in Los Angeles in October by Coast Plaza Doctors Hospital and Methodist Hospital of Southern California. They say state law requires insurers to pay doctors and hospitals for authorized treatment even if the insurer later decides the patient should not have been covered at the time.

"The hospitals are saying, 'Just pay us for what you authorized us to do,' " said Jan Emerson, a spokeswoman for the California Hospital Assn. "Hospitals have done the right thing. The doctor referred them to the hospital for a procedure. The hospital called and got authorization for the procedure. We provided the care. And, after the fact, Blue Cross decides to rescind coverage. And the hospitals and the doctors are left holding the bag."

WellPoint spokeswoman Shannon Troughton said it was not that simple. Blue Cross contends that California law bars insurers from revoking authorizations for care, and Troughton said the company complied with that.

"Blue Cross' pre-authorization for healthcare services is an advance determination of the medical necessity of a proposed procedure only; it is not a guarantee of payment," she said, adding that the caveat is "stated expressly" when the pre-authorization request is made."Our authorizations for care, based on medical necessity, include express statements that they are not guarantees of payment," she said. "We do not revoke these authorizations. When we rescind coverage due to fraud, we are rescinding the member's contract."

Although Blue Cross also contends that rescinded patients are responsible for the bills, the consumers often are unable to pay because the medical debt dwarfs their income and they are caught up in a struggle to obtain new coverage — or come up with the cash for their continuing care.

California Medical Assn. President Anmol S. Mahal, a Fremont gastroenterologist, said Blue Cross' refusal to pay in such cases was unfair.

"We're talking about elective services that are provided by physicians in good faith after getting authorization," he said. "The physicians are not the ones who should be punished."The suit alleges that such unpaid bills are straining the state's healthcare network. As the state's largest healthcare insurer, Blue Cross does business with most hospitals and physicians. California hospitals reported shouldering $7.7 billion in bad debt last year. It is too early to know just how much of that is due to retroactive cancellations, hospital group spokeswoman Emerson said. But, she said, "it's fair to say it's potentially millions and millions."

The doctor and hospital groups reiterated allegations of former policyholders that, in many cases, the rescissions were improper in the first place.

"Now the largest representative of hospitals in California and the largest representative of doctors in California have concluded there is a problem here," said Glenn Solomon, a lawyer representing the groups.

William Shernoff, a Claremont lawyer representing hundreds of rescinded policyholders, said the groups brought "a lot more clout" to the issue.

The groups' decision to join the suit comes about a year after the controversy over retroactive cancellations emerged. The litigation snowballed, pulling in more consumers and tagging nearly every insurer, including Blue Shield of California, Kaiser Permanente and HealthNet.

The California Department of Managed Health Care is drafting regulations aimed at curbing rescissions and, since September, has sanctioned insurers in a handful of cases.

From: Los Angeles Times (www.latimes.com)

Bad Faith Bills Mark Many Legislative Sessions in 2007

Saturday Washington’s legal climate grew more hostile as the state Legislature agreed on legislation that lowers the threshold for allowing lawsuits against insurers, making even a violation of the Washington Administrative Code an act of bad faith, according to the Property Casualty Insurers Association of America (PCI).

Over the weekend, the Senate approved House amendments to SB 5726, which allows for first-party bad faith lawsuits and will be sending the legislation to the governor’s office. The bill increases allowable monetary damages, requires payment of costs and attorneys’ fees, and permits the courts to award triple damages as a punitive measure.

“This so-called Insurance Fair Conduct Act could make Washington among the worst states in the nation for settling insurance claims,” said John Eager, senior director, claims for PCI. “Washington statutes provide broader remedies and damages than most states and under SB 5726, virtually every insurance claim holds the potential to become a “bad faith” lawsuit. Insurers are already required by law to act in good faith in the interest of their policyholders, and severe penalties exist for those who do not. Consumers benefit from the reasonable resolution of disputes - not from windfall recoveries, higher insurance costs and higher fees for attorneys.”

However Washington is not alone in grappling with insurance claims issues. This year the trial bar has aggressively pushed an agenda that would encourage more lawsuits and ultimately increase insurance rates for consumers and businesses. The trial bar is supporting bills across the country that would make it easier to bring suits, recover damages and collect more attorneys’ fees. Of particular note this year has been the activity surrounding bad faith legislation. The trial lawyers associations have sought to expand their ability to bring both first- and third-party bad faith suits. PCI has been actively involved in fighting against bad faith legislative activity in Maryland, Minnesota, Montana, Oregon and Washington. Other states such as Connecticut, Maine and Vermont also defeated bad faith legislation this year.

During the recently adjourned Maryland legislative session, lawmakers passed bad faith legislation (HB 425 and SB 389) that allows policyholders to recover actual damages which may not exceed policy limits, expenses and litigation costs, including reasonable attorneys’ fees, and interest. Attorneys’ fees may not exceed one-third of actual damages recovered. During the session, lawmakers rejected one bill that would have created a first party bad faith tort of failing to act in good faith for all property/casualty insurers and two other bills that targeted only homeowners insurance companies.

In Minnesota, House File 1251 and Senate File 1152 have been dubbed the “double lawsuit bills.” These bills would enable personal injury lawyers to file two lawsuits for the same incident – one against the individual they think is responsible for the accident and that person’s insurance company. While the SF 1152 failed in its Senate committee, HF 1251 is still alive and may become part of the Public Safety Finance Division omnibus bill. PCI is working in partnership with a broad based coalition to fight these bills.

As the Montana legislative session draws to a close, legislation that would require insurers to pay attorney’s fees in first- and third- parties bad faith cases has died. However, the bill (HB 464) which was at the top of the Montana trial lawyers association’s legislative agenda did not die without a fight. The bill nearly died in a Senate committee with tied vote. Upon a second vote, it passed out of committee to be defeated on the Senate floor. However, the bill still had some life left and had to undergo two more votes before it ultimately died. Insurers and others worked to defeat this legislation testifying that this type of legislation would actually encourage more lawsuits in a state that allows more litigation against insurers than other states. PCI’s Regional Manager Kelly Campbell told lawmakers about the potential costly impact to average Montana families if this legislation were to pass.

The Oregon House Committee on Consumer Protection recently heard but took no action on HB 3075, which would allow both first- and third-party lawsuits against insurers for alleged violation of an unfair claims settlement practices standard. The bill allows personal injury lawyers to sue people who are liable for injuries and accidents, but also to file a second lawsuit against their insurance company for "bad faith."

“This ‘second lawsuit’ bill would be a disaster for Oregon - just as it was in California for nearly a decade until it was overturned by the courts,” said Kenton Brine PCI’s northwest regional manager. “During those 10 years, personal injury lawsuits nearly doubled, insurance fraud skyrocketed and consumers' insurance premiums rose dramatically. Oregon doesn’t need this type of legislation that forces most people to pay more for insurance so a few have the opportunity to bring a second lawsuit.”

From: Insurance News Net (www.insurancenewsnet.com)

Senate Panel Hears Complaints About Claims Practices

By Mark A. Hofmann
Business Insurance

A sometimes passionate Senate hearing on insurance regulation before the Senate Commerce, Science and Transportation Committee is unlikely to be the last word on the subject, industry observers say.

The last word concerning insurance regulatory issues-including possible repeal of the insurance industry's limited exemption from federal antitrust law-likely will be uttered in another venue because the Commerce Committee's jurisdiction over insurance matters is limited, they say.

Instead, last week's Commerce Committee hearing provided lawmakers and others dissatisfied with insurance industry practices with a public forum.

And witnesses before the committee aired their complaints, particularly regarding claims-handling practices in the wake of Hurricane Katrina.

States are unable "to properly regulate" the insurance industry, said Mississippi Attorney General Jim Hood. Insurers have tried to intimidate state governments, and should be subject to federal regulation, he said. "Take away their antitrust exemption and license them at the federal level," said Mr. Hood, who has sued insurers for their claims-handling practices.

Insurers should be stripped of the limited exemption from federal antitrust laws that they have under the McCarran-Ferguson Act, agreed Robert Hunter, director-insurance for the Washington-based Consumer Federation of America. He also called on the committee to allow the Federal Trade Commission to examine insurers' allegedly unfair claims practices.

"Consumer groups do not care who regulates insurance," he said. They simply want "excellent" regulation, whether at the state or federal level.

Sen. Trent Lott, R-Miss., called insurer behavior "outrageous" as well as "arrogant and mean-spirited." Sen. Lott, who is co-sponsoring legislation that would repeal the McCarran-Ferguson exemption, added that insurers "may have a surprise coming."

Sen. Mark Pryor, D-Ark., who presided over the hearing, noted that insurance trade groups had been invited to testify. None, however, accepted the invitation, in part because of scheduling conflicts and "some felt this might be an unfriendly venue for them-which is unfortunate," he said.

The committee also heard testimony in favor of a measure that would require insurers to provide consumer access to data on severely damaged, stolen or flooded vehicles that had been written off as total losses but that have, nonetheless, been refurbished and resold to unsuspecting buyers by unscrupulous dealers. That bill also was introduced by Sen. Lott.

The practical impact of last week's hearing remains unclear because of jurisdictional issues, industry observers said.

"I think the Banking Committee really has jurisdiction over virtually all insurance issues, but there may be some fringe areas where the Commerce Committee can legislate, such as the used car dealers issue we saw," said Ben McKay, senior vp in the Property Casualty Insurers Assn. of America's Washington office. "They could legislate another layer of bureaucracy on top of the private sector, but they don't have jurisdiction to fix the current system, which is what really needs to be done."

"While there have been murky issues in the past about jurisdiction, everyone in our community has acknowledged the primacy of the Senate Banking Committee as the principal venue for insurance regulatory issues," said Joel Wood, senior vp of the Council of Insurance Agents & Brokers in Washington. "No one's going to argue that that means that the Commerce Committee can't hold a hearing such as they did."

"They do have jurisdiction over one of the bills Sen. Lott has sponsored," said Melissa Shelk, vp with the American Insurance Assn. in Washington in reference to the auto identification bill. "It provides the opportunity to look at other issues that Sen. Lott and others have interest in with regard to the industry," she said.

"This was clearly an attempt to allow Sen. Lott and the other members who are concerned to express frustration with the insurance industry," said Julie Gackenbach, a Washington-based consultant for the National Assn. of Mutual Insurance Cos. "I expect to see continued discussions and hearings, but any legislative action I think will probably occur in other committees."

"To the extent that this issue is worked out, it will primarily be a Banking Committee and Judiciary Committee issue," Ms. Gackenbach said.

Source: Business Insurance (www.businessinsurance.com)

From: Insurance News Net (www.insurancenewsnet.com)

Workers' Comp Officials Sweep (CA) High Desert Businesses

By Mitch Deacon
Victorville Daily Press

With state labor officials conducting unannounced visits to High Desert businesses, employers are being asked to pay careful attention to laws relating to the proper payment of wages.

“Ignorance is no excuse: It’s your responsibility to know the law when you have employees,” said Robert Sweet, senior deputy labor commissioner in the San Bernardino office of the Division of Labor Standards Enforcement.

Sweet offered a review of labor regulations to area employers at a seminar sponsored by the High Desert Employer Advisory Council.

“The violations we commonly see are for not paying minimum wages and overtime that is not properly paid,” he said.

The minimum wage was just raised to $7.50, and it will rise again on the first of January 2008 to $8. If an employee receives a commission and a wage, the combined amount must equal or exceed the minimum wage.

The law stipulates special criteria for the paying workers an annual salary instead of an hourly wage.

Generally, only supervisors, managers who determine company policy or professionals with specialized education can receive a salary, which must equal or exceed twice the minimum wage. “To us, a salary is just a way of paying wages, and an employee receiving a salary is not exempt from the requirement of overtime,” Sweet said.

Workers’ compensation is another area that is closely monitored by state labor officials.

“Failure to provide workers’ compensation insurance results in a fine of $1,000 for each employee that is not covered,” said Renee Bacchini, a spokeswoman for the California Department of Industrial Relations in San Francisco.

“It’s the first thing we look for during an on-site investigation,” Bacchini added.

According to the Department of Industrial Relations, workers who are most vulnerable to labor law violations include farm workers, janitors, construction laborers, restaurant, car wash employees and workers in the garment industry.

“Many of the workers in these industries do not speak English and earn minimum wage, which raises concerns over minimum wage laws, workplace discrimination and the payment of overtime,” Bacchini said.

For any firm operating in any particular industry, doing business in California requires adherence to some of the most restrictive labor regulations in the United States.

“California leads the nation in employee protection rights, and many of the laws adopted here become the basis for national labor standards,” said Robert Lovingood, president of ICR Staffing Services in Victorville.

“The difference between labor conditions in California and Texas is vast,” Lovingood added.

Despite the progressive character of labor standards in California, employers are not legally required to provide workers with many of the benefits that are commonly taken for granted.

“There is no law in the state of California that requires an employer to provide medical insurance, paid vacations or sick time,” Sweet said.

“However, if your company provides benefits, we’ll enforce your policy,” he said.

Source: Victorville Daily Press (www.vvdailypress.com)

From: Workers Comp Executive (www.wcexec.com)

Thursday, April 19, 2007

Garamendi Ruling On Brokers Overturned

By Mark E. Ruquet
NU Online News Service

A California administrator has ruled that a change in the definition of an insurance broker instituted by the former insurance commissioner is illegal.

California ’s Office of Administrative Law ruled Monday that former Insurance Commissioner John Garamendi’s attempt to use a settlement as a precedent-setting rule was illegal and violated the state’s statutes on creating such rules.

In October of last year, the Insurance Brokers & Agents of the West filed a petition with the OAL objecting to Mr. Garamendi’s attempts to use a settlement reached with American Reliable as a precedent-setting agreement.

Under the agreement brokers were redefined as agents and the commissioner used the agreement to change the definition of brokers to agent-in-fact.

In the OAL’s 17-page opinion, it did not rule on the merits of the American Reliable agreement, but did find that defining the agreement as precedent-setting violated the state’s laws on this issue.

In a statement, Steve Young, IBA West General Counsel, said: “This is a hugely important decision for all Californians because it reaffirms the very important principle that regulatory agencies must comply with the rule of law. They cannot circumvent the legislature or ignore the due process protections that are the essence of the state Administrative Procedures Act.”

He added that if the OAL had ruled in favor of the department, then the “commissioner could have exercised near dictatorial powers to create and enforce new regulatory requirements.”
Byron Tucker, deputy commissioner of communications for Insurance Commissioner Steve Poizner said the department is currently evaluating the OAL’s decision before deciding if it will appeal the ruling or initiate a formal rule making process.

He pointed out that the OAL’s decision in no way addressed “the underwriting correctness of the department to distinguish between an agent and broker.”

Mr. Tucker declined to say when the department would make a decision, but noted that an appeal would have to be filed within 30 days, but the rule making process could take up to a year or more.

From: National Underwriter (www.nationalunderwriter.com)

InsWeb gains on Q1 profit

Shares of InsWeb Corp. increased more than 8 percent in midday trading Wednesday, but was up only 2 percent after market closure in the second consecutive day of significant gains for the stock.

InsWeb (Nasdaq: INSW) has detailed aggressive cost-cutting efforts and a focus on higher-growth revenue sources in recent months, helping the Gold River-based company to improve its operations and report its first-ever quarterly profit. The company on Monday reported a first-quarter profit of $400,000, or 10 cents per share, compared to a loss of $1.7 million, or 41 cents per share, for the same three-month period last year.

Shares increased 14 cents to $7.25 after close, with more than 2.5 million shares trading, compared to the average trading daily volume of 56,920 shares during the past three months.

InsWeb shares have gained more than $5.50 since Monday, and are much closer to its 52-week high of $8.30.

InsWeb stock also benefited from comments in a daily Motley Fool column on Tuesday, detailing its turnaround. Motley Fool has one of the most popular personal investment columns on the Web.

From: Sacramento Business Journal (www.bizjournals.com)

Tuesday, April 17, 2007

California Mortgage Defaults at 10-Year High

The number California homeowners getting default notices last quarter reached its highest level in almost 10 years, the result of flat appreciation, slow sales, and post teaser-rate mortgage resets, a real estate information service reported Monday.

Lending institutions filed 46,760 Notices of Default (NoDs) during the January-to-March period. That was up by 23.1 percent from a revised 37,994 for the previous quarter, and up 148.0 percent from 18,856 for first-quarter 2006, according to DataQuick Information Systems.

In Santa Clara County there were 1,058 NoDs in the first quarter, compared to the year-ago's 537 notices.

In San Mateo County there were 382 notices, more than double the 186 for the same period last year.

In Santa Cruz County there were 171, up from 108 in the year-ago period.

And in Monterey County there were 458, more than tripling the 129 notices a year-ago.

Last quarter's default level was the highest since 47,912 NoDs were recorded statewide in the second quarter of 1997. Defaults peaked in first quarter 1996 at 61,541. An average of 33,847 NoDs have been filed quarterly since 1992, when DataQuick's NOD statistics begin.

"Defaults tend to happen after a certain length of time and today's activity reflects a peak in the number of home loans made back in the summer of 2005. Additionally, the loans being made back then were riskier because of the subprime activity, as well as higher appreciation rates. It's easier to make a loan when the security for that loan is going up in value than when values are flat," said Marshall Prentice, DataQuick's president.

Most of the loans that went into default last quarter were originated between April 2005 and May 2006. The median age was 15 months. Loan originations peaked in August 2005, and adjustable-rate mortgage use for primary purchase home loans peaked at 77.8 percent in May 2005 and has come down since.

On primary mortgages, homeowners were a median five months behind on their payments when the lender started the default process. The borrowers owed a median $10,784 on a median $331,200 mortgage.

On lines of credit, homeowners were a median six months behind on their payments. Borrowers owed a median $3,580 on a median $60,000 credit line. However the amount of the credit line that was actually in use cannot be determined from public records.

From: Silicon Valley / San Jose Business Journal (www.bizjournals.com)

Allstate Loses $2.8 M Katrina Verdict In Louisiana

By Daniel Hays
NU Online News Service

Allstate said today it will appeal the $2.8 million award that a federal jury in New Orleans said it should pay to a policyholder whose home was destroyed by Hurricane Katrina.

Reacting to the U.S. District Court verdict yesterday, which included $1.5 million in punitive damages, company spokesman Mike Siemienas said the insurer “is shocked with the jury’s verdict in favor of the plaintiff.”

The case that was decided was brought by Robert and Merryl Weiss, whose home on the north side of Lake Pontchartrain in Slidell, La., was demolished by the 2005 hurricane.

Jurors decided that Allstate’s payment for wind damage was insufficient. The couple had received $350,000 under a federal flood insurance policy, and Allstate paid about $50,000 in structural damage in living expenses under a homeowners policy with a $343,000 limit for damage to the dwelling and $240,000 for personal property.

The insurer argued that its engineering findings did not support a claim for a higher amount, but the family contended their home was situated above the 14 feet of storm surge waters coming off the lake.

“Allstate believes that it acted in good faith throughout the entire claims process with Weiss. and we are disappointed that the jury ruled differently. We will appeal this ruling,” said Mr. Siemienas.

He said that Allstate has settled about 90 percent of its Hurricane Katrina claims, and “we are continuing to work to resolve claims every day.”

The Weiss case is the latest Hurricane Katrina claims dispute in federal court to end with a heavy punitive damage award against an insurer.

In January, a Mississippi jury brought in a $2.7 million verdict against State Farm--of which $2.5 million was punitive damages.

From: National Underwriter (www.nationalunderwriter.com)

Monday, April 16, 2007

Utah Court: Agents Should Take Care When Making Verbal Promises

The Utah Supreme Court has found that a "party may recover under the doctrine of estoppel when an insurance agent makes material misrepresentations as to the policy provisions, the party reasonably relies on those misrepresentations in buying the coverage, and that reliance results in legal injury to the party."

In Youngblood v. Auto-Owners Insurance Co., Robert L. Youngblood was struck by a vehicle when he was walking through a parking lot. The driver carried $50,000 in available liability insurance and the claim for the policy limit. However, Youngblood claimed that his damages exceeded $50,000, and thus sought additional coverage from his company's insurer, Auto-Owners Insurance Co.

Youngblood had purchased underinsured motorist coverage, in the name of his corporation, Youngblood Home Improvement Inc., rather than in his individual name.

According to Youngblood, his insurance agent told him his underinsured motorist coverage would cover him if he was struck by a vehicle as a pedestrian. However, the policy, as written, actually limited his coverage to bodily injury sustained only while he was "occupying" an automobile. Or, coverage would be provided if he had sustained bodily injury as a pedestrian or while occupying another person's automobile that is not insured under the UIM policy and the first named insured in the policy was an individual, according to court documents.

Youngblood acknowledged that the language of his policy did not extend coverage. However, he argued that coverage should be expanded to cover his claim, under the principles of estoppel.
For the purposes of the case, estoppel generally means when an insurance agent promises that things, knowing at the time of the promise all of the material facts, but is ultimately wrong, and reasonable reliance on that promise leads to loss or injury.

The Supreme Court said the "law holds insurance agents to accuratelyrepresenting policy provisions and honestly answering consumerquestions. Agents who are not trained to act with completehonesty and integrity in their interactions with consumers, orwho simply refuse to do so, place themselves and their principals at risk. The law will hold both principal and agent liable formisrepresentations upon which consumers reasonably rely."

Thus, the high court ruled that estoppel may apply under some factual circumstances. It said: "Estoppel may be applied to modify terms of an insurance policy when (1) an agent makes material misrepresentations to the prospective insured as to the scope of coverage or other important policy benefits, (2) the insured acts with prudence and in reasonable reliance on those misrepresentations, and (3) that reliance results in injury to the insured.

Thus, an insurance agent's verbal representations of a policy to an insured may provide insurance coverage beyond the express terms of the insurance policy, it indicated.

Source: Utah Supreme Court (www.utcourts.gov)

From: Claims Guides (www.claimsguides.com)

Auto Insurance Premiums Expected to Dip in '07: Drivers to Save a Few Bucks

By Marilyn Miller
The Akron (OH) Beacon Journal

U.S. drivers are expected to pay less for auto insurance this year compared with 2006, the first decrease since 1999. According to the Insurance Information Institute, the average premium rate should drop by half a percent.

The national average premium rate is estimated at $847 per policy, which translates to a savings of $4 compared to the national average of $851 paid in 2006.

Mitch Wilson, vice president of public information for the Ohio Insurance Institute, said auto premiums in Ohio are about $150 less than the national average. "Ohio is one of the states with the lowest auto insurance premiums," he said.

According to the most recent figures from the National Association of Insurance Commissioners (NAIC), Ohio has the 14th-lowest auto insurance premiums in the United States.

In 2004, the last figures available for the average expenditures for auto insurance throughout the United States, Ohio's average was $680.14 per year.

State Farm Mutual Automobile Insurance Co., which calls itself the largest insurer of autos in Ohio, reported it is lowering its overall rate level in Ohio an average of 8.8 percent.

Decreases also were made by Progressive, Westfield, Cincinnati Financial, Erie Insurance, American Family Insurance and GEICO.

Premiums for collision and comprehensive coverages are decreasing the most. The comprehensive coverage pays for losses such as theft, storm damage, fire, vandalism and glass breakage. Cost for liability coverage is also going down.

Changes in auto insurance rates are associated with medical costs, weather-related claims, the number of cars on Ohio roads and repair costs, officials said.

Savings vary by driver, based on where they live, the kind of car insured, who drives it, how much it is driven and the number of accident claims.

The Insurance Institute attributes the reductions to fewer claims reported, down 3 percent to 5 percent in 2006 compared with 2005.

The institute is a nonprofit, communications organization supported by the industry.

Ohio Department of Insurance Director Mary Jo Hudson urged consumers to shop around, suggesting savings might be realized by having multiple policies with one company.

"As the weather gets warmer, many Ohioans may turn their attention to buying a home or driving their car more," Hudson said. "They should also think about reviewing their auto and homeowners insurance policies and making sure the coverage they have fits their needs. Doing so could result in lower premiums."

The Insurance Information Institute offers some tips for consumers to lower premiums on their policies:

--Consider how you use your vehicle. Some companies base insurance rates on the number of miles that you drive to and from work.

--Raise your deductible. Increase the deductible on physical damage, it could produce savings of 15 percent to 30 percent or more, but make sure you have enough money to readily pay the higher deductible if something happens to your vehicle.

--Maintain good credit -- Insurers are using credit-based insurance scores to determine auto coverage premiums. This is because people with good credit tend to file fewer claims.

--Reduce coverage on older cars. An older vehicle might not require comprehensive and collision coverage. Consider the age and value of your auto and whether or not you can afford to fix it yourself if you have an accident. Also consider your overall liability limits. Consumers must make sure they have enough coverage.

--Compare insurance costs before buying a car. Your premium is based in part on the car's sticker price, the cost to repair it, its overall safety record and the likelihood of theft.

Many insurers offer discounts for features that reduce the risk of injury or theft. These include air bags, anti-lock brakes, daytime running lights and anti-theft devices.

Cars that are favorite targets for thieves cost more to insure.

Information that can help you decide what car to buy is available from the Insurance Institute for Highway Safety: www.iihs.org.

Source: The Akron (OH) Beacon Journal (www.thebeaconjournal.com)

From: Insurance News Net (www.insurancenewsnet.com)

J.D. Power Releases Results From First-ever Health Plan Satisfaction Survey

When J.D. Power and Associates bestows its coveted high consumer-satisfaction ranking on a car, automakers and consumers alike take note. Now, health insurers, benefit managers and employees will be paying similar attention to results from the first-ever J.D. Power and Associates National Health Insurance Plan Satisfaction Study, which surveyed 10,552 consumers on their satisfaction with their health plans.

The inaugural study examines seven performance factors in member satisfaction with major commercial health insurance plans. The factors - listed in order of importance as ranked by consumers are:

1. Coverage and benefits.
2. Choice of doctors, hospitals and pharmacies.
3. Information and communication.
4. Approval processes.
5. Insurance statements
6. Customer service.
7. Claims processing.

Other critical areas examined include preventive care and factors that lead to loyalty, shopping, switching, and positive and negative referrals by members.

However, the study excluded those areas that were shared or outside of the plan's control, such as benefit design, wait times at individual physician practices and - most notably for employers - cost.

Cost as a factor or attribute was purposefully excluded, researchers say, because:

* Costs tend to be driven far more by richness of the benefit design, which is dictated by the employer.

* Costs are inconsistently applied to consumers from plan to plan and employer to employer.

* Inclusion for ranking purposes obscures important issues of plan performance.

Likes and dislikes

Overall, 56% of consumers surveyed are satisfied with the level of service being provided by their plan.

As noted above, consumers weighted coverage and benefits as the most important factor (28%) in gauging satisfaction - including the type and variety of prescription drugs covered, nonemergency doctor visits and wellness exams.

In addition, two attributes in particular - ability to access needed care and treatment, and variety of preventive services offered, such as smoking cessation and health screenings - account for slightly more than half of the impact of the coverage and benefits factor (52%).

Variety of preventive care services provided accounts for just less than one-fourth of the importance weight.

Not only do consumers want preventive care offered, they also want to be encouraged to use it - although such encouragement does not appear to have a high impact on utilization.

For example, the highest level of encouragement for preventive care services reported by HMO members was for flu vaccinations. Even so, about 39% of HMO members did not receive this most-frequent preventive benefit.

Even hallmark services, such as mammograms, colon cancer screening and prostate screening, reflect low levels of encouragement and even lower levels of utilization among the members.

Just more than half of women (51%) were encouraged to get a mammogram, 32% of men were encouraged to receive a prostate screening and 35% of members over 50 were urged to get colon cancer screenings.

Underscoring the importance of preventive services encouragement, members' utilization of these key services can almost double or better than triple with encouragement from their plan).

On a positive note, members who are employees of large and "jumbo" companies (500 to 5,000, and 5,001 or more employees, respectively) reported notably higher levels of prevention encouragement.

Information and communication also mean a great deal to consumers - accounting for 17% of the weight for overall satisfaction.

The highest satisfaction rates are related to a contact with a live customer service representative. Web-based and e-mail interaction also rate highly. Lower satisfaction results from the use of automated phone system contacts.

The patients who received the plan information and communications centered around personal health issues tended to experience the highest levels of satisfaction.

Blues'-ribbon winners

Privately held plans, especially BlueCross BlueShield plans, outperform public and non-lue plans overall and on all seven factors. BlueCross BlueShield plans receive the highest ratings when regarding choices members have for doctors, hospitals and pharmacies. Private plans also receive their highest rating for this factor.

Additionally, the Blues plans outperform their counterparts by a satisfaction gap of 48 points in claims processing.

(Not-so) Best Western

In addition, the study finds that respondents in the Western U.S. Census region rated their plans notably lower overall (and on all seven factors) when compared to respondents in the other regions.

Health plans in the West received the lowest scores for claims processing and information and communication. The largest satisfaction gap between regions is in regards to claims processing - South (731) and West (687). (See sidebar to read overall how the plans fared regionally on a 1,000-point scale.)

The full, detailed study results are available at www.jdpower.com.

Source: Employee Benefit News (www.benefitnews.com)

From: Insurance News Net (www.insurancenewsnet.com)

Arizona Appeals Court Rules Pain Not Equal to Injury

The Arizona Court of Appeals has ruled that subjective pain does not fall under Arizona's definition of an injury for which an employee is entitled to workers' compensation benefits.

According to court documents, in Polanco vs. Industrial Commission and Pima County, Mont Polanco, an employee of Pima County, injured his back during the scope of his employment while lifting a rock out of a manhole in 2001. His subsequent workers' compensation claim was accepted for benefits, and he had diskectomy surgery. Polanco's claim was closed in Feb. 2003, but he continued to receive treatment for his back injury, "including caudal epidural injections" that "markedly improved [his] pain and allowed him to work full-time."

He suffered an industrial motor vehicle accident in Aug. 2004, at which time the injections became less effective. In late 2005, Polanco's physician recommended he have a spinal cord stimulator implant to control his pain. Consequently, Polanco filed in Nov. 2005 a petition to reopen his initial claim, which the insurer denied.

"The ALJ denied benefits, finding the employee had not shown his inability to return to work was related to his injury and, in the alternative, determining his injury was not compensable because residual pain did not "constitute a ratable permanent impairment under the [American Medical Assocation] Guides," according to court documents.

In writing for the appeals court, Judge William Brammer Jr. said a claim could not be reopened based on a worker's "increased subjective pain if the pain is not accompanied by a change in objective physical findings." To qualify for benefits, the court of appeals said the employee must prove from both a legal and medical perspective that the injury is work-related.

"Section 23-1061(H) governs the reopening of workers' compensation claims and requires an employee to prove the existence of 'a new, additional or previously undiscovered temporary or permanent condition' to reopen a claim. And the employee must show a causal relationship between the new condition and a prior industrial injury," courts documents note.

Thus, the court acknowledged that "because subjective pain is not an injury within the meaning of article XVIII, Section 8 of the Arizona Constitution, paragraph 23-1061(H) does not unconstitutionally eliminate it as a type compensable injury. And the objective physical findings requirement of paragraph 23-1061(H) does not address either legal or medical causation. That requirement instead makes clear that subjective pain alone cannot support a petition to reopen a claim. Rather, subjective pain must be directly related to the degree of impairment resulting from an objective physical change."

Source: Arizona Court of Appeals (www.supreme.state.az.us)

From: Insurance Journal (www.insurancejournal.com)

Georgia House Panel OKs Uninsured Motorist Change Despite Warnings

By Greg Bluestein
Associated Press

The Georgia House Judiciary Committee gave the green light last week to a measure that would overhaul the way insurance companies pay for accidents involving underinsured drivers, despite warnings from Georgia's top insurance official that it could hike insurance premiums by up to 20 percent.

The measure would allow some car crash victims to tap into their uninsured motorist plan if the wrongdoer's policy doesn't cover the entire cost of the car crash. State Sen. Cecil Staton, the bill's sponsor, said allowing insurance companies to "stack'' the policy brings more fairness to the system.

But Insurance Commissioner John Oxendine warned committee members it could cost Georgia drivers an estimated $400 million more in monthly premiums each year, and argued that the state should continue to allow drivers to decide whether to pay extra for the option.

"I don't think it's appropriate to put the burden on citizens without weighing all these options,'' he said.

Under current Georgia law, if a driver with $50,000 in liability coverage causes more than that amount in damages, then the insurance of the victim's car is kicked in. But the "uninsured motorist'' policy would only pay the difference between the policy's limit and the figure paid by the insurance of the driver who caused the wreck.

Staton said that means if both policyholders have the same amount of coverage and the accident costs thousands of dollars more, then the innocent driver could be left holding the bag. His proposal requires the victim's insurance company to cover the rest.

"We at least owe them the decency of allowing them to get what they pay for,'' said Staton, R-Macon. "To get all of what they pay for.''
___
On the Net:
Senate Bill 276: http://www.legis.state.ga.us

Source: Associated Press (www.ap.org)

From: Insurance Journal (www.insurancejournal.com)

Online Auto Insurance Purchases Increase 58 Percent

Auto insurance policies purchased online increased 58 percent in 2006 compared to 2005, according to comScore Inc., which tracks activity in the digital world. In its "2007 comScore Online Automobile Insurance Report," comScore also noted that the total number of auto insurance quotes submitted online increased 15 percent.

According to the company, price-conscious consumers consider the Internet critical to their research. They submitted more than 70 million auto insurance online rate quotes from 2004 to 2006, the report noted.

"Consumers continue to migrate toward conducting complex financial transactions online," said Kevin Levitt, vice president of comScore Financial Solutions. "The automobile insurers are supporting this shift with more efficient Web sites and clearer communication of the value proposition for purchasing policies online. The substantial growth rate in online policy purchases reflects an important transformation in the dynamics of the online auto insurance market."

This year also shows signs of increasing Internet use. During January and February, the number of auto insurance quotes submitted online increased 29 percent, and the number of policies purchased online increased 45 percent compared to the same period in 2006.

Reasons for not purchasing or researching auto insurance online included preference for speaking with an actual person, and not wanting to submit confidential information over the Internet. The report noted more than percent of consumers said that guaranteed site security would increase their likelihood of purchasing online.

The 2007 comScore Online Automobile Insurance Report uses comScore's proprietary panel of 2 million-plus online consumers. Additional information was gathered through a survey conducted among 2,043 U.S. online consumers from March 1-8, 2007. For more information about the report, visit www.comscore.com/auto_insurance_report.

Source: comScore (www.comscore.com)

From: Insurance Journal (www.insurancejournal.com)

Saturday, April 14, 2007

Five Percent Slump In Young People Taking Out Life Insurance

The number of young people buying life cover has fallen by 5 per cent in the past year, according to Lifesearch.

The protection company released its new business figures, which showed that people aged 35 years and under buying some form of life cover had fallen by 5 per cent to 31 per cent in the 12 months from January 2006 to 2007.

Lifesearch says research suggests younger people make poor product choices, with those aged 18 to 29 almost six times more likely to insurance their life than their income, even though they have no dependants.

Only 12 per cent of the 18 to 29 age group felt they had purchased the product which best suited their needs and 37 per cent of this group bought on price alone.

Lifesearch head of protection strategy Kevin Carr says: "More work needs to be done to reach the 35 and under age group, so they understand why protection is important and which type of cover is best for their individual circumstances.

"Many are buying no financial protection, or are relying on the internet to get the best deal, which might work in car insurance, but not with financial protection."

CBK principal Peter Chadborn says: "It proves that protection is becoming commoditised and is delivered and sold like a commodity which down-values it. People are having families later and getting on the property ladder later too which explains why fewer younger people are perhaps taking out protection."

Source: Money Marketing (www.moneymarketing.com)

From: Insurance News Net (www.insurancenewsnet.com)

Antitrust Commission Calls for Insurer Exemption Review

By Mark A. Hofmann
Business Insurance

A bipartisan panel's recommendation that Congress should rarely, if ever, grant industries immunity from federal antitrust laws could aid lawmakers who wish to repeal the McCarran-Ferguson Act.

That's so even though the majority of the Antitrust Modernization Commission's 12 members stopped short of calling for repeal of the limited antitrust exemption granted to insurers by the act. Instead, the group in its April 3 report called for congressional review of insurers' exemption as well as exemptions granted to other industries, and recommended that exemptions be granted only under very limited circumstances.

Four members advocated repealing the McCarran-Ferguson exemption.

The report came only weeks after lawmakers, displeased with some insurers' claims-handling practices in the wake of Hurricane Katrina, introduced legislation in both houses of Congress that would repeal insurers' limited antitrust immunity.

"It certainly can be used by those who would like to repeal the exemption," said Bob Detlefsen, vp-public policy for the National Assn. of Mutual Insurance Cos. in Indianapolis. "Nothing in the report offers support for those of us who would prefer that Congress not tinker with the McCarran Ferguson Act."

"I think there are some problems with the report," he said. "It says that insurers really have nothing to fear from antitrust laws." The report said that issues such as data-sharing among insurers would be assessed by "the courts under a rule of reason analysis that would fully consider the potential pro-competitive effects of such conduct and condemn it only if, on balance, it was anticompetitive."

"But it assumes that courts applying this rule of reason analysis will actually make reasonable decisions," Mr. Detlefsen said. "It also discounts the impact that costly antitrust litigation would have on companies and consumers. It ignores the extent to which the threat of litigation would inhibit insurers from acting cooperatively, even if they thought eventually their actions would survive antitrust scrutiny by the courts."

"I think taken in a different environment, it would not raise much concern," said Ben McKay, senior vp in the Property Casualty Insurers Assn. of America's Washington office. "It basically tells Congress once again to look at antitrust exemptions, which they've done in terms of McCarran-Ferguson in every decade since the 1960s. For a report to suggest that they do it once again would not normally raise many concerns-we would expect the same results, which is leave it alone, the industry works."

But "in the current post-Katrina environment, we worry that repeal is being pushed as a cure for other problems," Mr. McKay said. "It's a little bit more fuel to the tinderbox that we have to worry is going to ignite."

"The report contains some good news," said a spokesman for the American Insurance Assn. in Washington. "It does not specifically call for repeal of the McCarran-Ferguson antitrust exemption." He also noted that "one of the report's bedrock conclusions is that free market principles are at the foundation of the U.S. economy and that neither the government nor private actors should undermine free market competition."

But he added that "the big deal is in its discussion of the McCarran-Ferguson exemption, the report fails to make the connection between government regulation and antitrust enforcement. With property/casualty insurers, states have imposed government price controls instead of allowing the free market to determine the range of insurance prices that competitors offer. This regulatory system developed out of McCarran-Ferguson. The report seems to condemn this sort of government economic regulation, but it fails to acknowledge that this is applied to property/casualty insurers."

The 540-page commission report is available at www.amc.gov.

Source: Business Insurance (www.businessinsurance.com)

From: Insurance News Net (www.insurancenewsnet.com)

Friday, April 13, 2007

Progressive Reports 1st-Quarter Decline

Mayfield, Ohio-based Progressive Insurance Company reported this year’s first-quarter net income dropped 17 percent compared with the 2006 period.

The company posted first-quarter net income of $363 million, compared with $436 million last year.

Bear Stearns analyst David Small said “the report should quell investor fears somewhat that the ‘sky is falling’ in the personal auto segment as accident-year profitability was solid.”

“Additionally, the flat year-over-year top line in March should be seen as an improvement following six consecutive quarters of declines,” he wrote.

Overall, Bear Stearns believes “the auto cycle will play out slower and less severely than many expect,” Mr. Small related.

Net written premiums declined 1 percent for the same period with a $3.5 billion figure compared with a $3.6 billion for the first quarter of 2006.

The combined ratio for the quarter rose to 89.5 from 85.2 last year.

In its monthly commentary, the company said there was an unfavorable prior accident development primarily related to the emergence of larger losses from prior years in commercial auto products.

While Mr. Small noted this “negative surprise,” he also said that the greater than expected share repurchase highlights the company’s solid capital position.

From: NU Online News Service (www.nationalunderwriter.com)

Lott Suggests An Antitrust Pass For Small Insurers

By Arthur D. Postal
NU Online News Service

Sen. Trent Lott, R-Miss., suggested at a committee hearing today that legislation he supports to repeal the anti-trust exemption for insurers could be modified to exempt small carriers.

The lawmaker, speaking at a session of the Senate Commerce Committee, said his bill to end insurers' limited anti-trust exemption under the McCarran-Ferguson Act could provide a “safe harbor” from anti-trust laws for small insurers with $2 billion or less of insurance in place.

Repeal of the insurance industry’s antitrust exemption under McCarran-Ferguson is among several bills Sen. Lott has proposed to “fix some of the problems” he finds with the insurance industry as a result of its handling of claims resulting from Hurricanes Katrina and Rita in 2005.

Another bill he talked about at the hearing is S. 545, legislation which would require VIN-based disclosure for all totaled vehicles by the industry through a database the industry would be forced to maintain.

Discussing the antitrust legislation, the senator accused large insurers of “hiding behind” small insurers in seeking to retain their current anti-trust exemption.

In Mr. Lott’s view, the “big insurers” are claiming that repeal of McCarran-Ferguson would inordinately affect smaller insurers who need to have access to pooled claims and other data.

In his comments, Sen. Lott termed the insurance industry’s conduct in handling hurricane claims “outrageous, arrogant and mean-spirited.” He is currently suing State Farm in a dispute over a claim he submitted for destruction of his Pascagoula, Miss., home by Katrina.

He said that Mississippi State Attorney General Jim Hood had “a lot of evidence of misconduct and fraud” by State Farm in considering criminal charges against the company, but decided instead on a more “practical solution.”

In his own testimony before the committee, Attorney General Hood said he reached a class settlement for homeowners with State Farm after curtailing a grand jury probe of the insurer because the company told him it would pull completely out of Mississippi if it was indicted.

Because the firm is by far Mississippi’s largest insurer, the state would be hurt because it would have been difficult to find alternative insurance capacity, he said.

Both Sen. Lott and Mr. Hood cited recent revelations by a North Carolina firm that State Farm had threatened to fire an engineering concern it hired to inspect storm-damaged homes in Mississippi and Louisiana.

The Associated Press reported today it had evidence that management of the engineering firm “suggested in e-mails that the insurer was dissatisfied with how it was reporting damage.”

Only a few members of the committee attended the hearing, chaired by Sen. Mark Pryor, D-Ark., who noted in his opening remarks that no insurer or insurance company trade group choose to testify. They were unwilling to sit still for a grilling by Sen. Lott, Sen. Pryor suggested.

A senior insurance trade group lobbyist said that was not the case. The lobbyist, who asked not to be named out of concern for retaliation, noted that a number of insurance trade groups testified at a companion hearing on the anti-trust issue being held at the same time by the Senate Banking Committee.

“Historically, the Senate Banking Committee has claimed primacy over insurance issues,” the lobbyist said, “and participating in a hearing being held at the same time by another committee would, the industry felt, be considered ‘insulting’ by Sen. Chris Dodd, D-Conn., the chairman, and Sen. Richard Shelby, R-Ala., the ranking minority member.”

Sen. Lott’s call for repeal of McCarran-Ferguson, which was urged by Attorney General Hood and Robert Hunter, director of insurance for the Consumer Federation of America, was not echoed by other members of the Commerce Committee.

During the hearing, Sen. Pryor asked David Regan, vice president for legislative affairs for the National Association of Automobile Dealers, if a simpler solution might be available for revealing to dealers and consumers that a vehicle had been totaled.

Sen. Pryor, a former state attorney general, suggested that putting a sticker on a junked vehicle when it is resold through auction might do.

But Mr. Regan said that suggestion had been rejected several times by the Federal Trade Commission, among others, during deliberations on the issue of an appropriate consumer protection.

In his testimony, Attorney General Hood called for repeal of McCarran-Ferguson, along with a federal mandate that insurers provide all perils home coverages in all states and bar use of “anti-concurrent causation clauses” that exclude windstorm claims if flooding is involved.
Julia Benafield Bowman, Arkansas insurance commissioner, testified on behalf of the National Association of Insurance Commissioners at the hearing.

She supported retention of McCarran-Ferguson provisions that leave regulation of insurers to the states and noted that her office fields 40,000 calls annually from consumers. Consumer protection is best left to the states, she said.

Moreover, the federal government already has an appropriate role in regulating insurers, she said, citing the Terrorism Risk Insurance Act, first enacted in 2002 and up for renewal again this year. “The more state regulation we can keep, the better,” she testified.

From: NU Online News Service (www.nationalunderwriter.com)

Safeco Rolls Out Package BOP

Seattle-based Safeco isoffering BOP Access, a new commercial insurance businessowner policy that is designed to disentangle the insurance buying process for small businesses -- such as restaurants and light manufacturers -- that have above-average insurance needs. The product is designed to remove the need for customizing individual policies, according to Mike Hughes, executive vice president of insurance operations.

For example, the policy should help restaurants with their coverage. Given "the growing emphasis on organic foods, premium wines and expensive bottled waters, these business owners need specialized protection against loss, contamination and damage due to spoilage," Hughes said.

BOP Access includes coverage for loss of business income up to 12 monthsand additional expenses, and identity theft recovery insurance for $12 per year. In the event of ID theft to a defined individual, the coverage provides reimbursement for eligible expenses and a personally assigned case manager who can act as a limited power of attorney to do most of legwork.

The policy also includes: - An updated "Liability Plus" endorsement with expanded coverage, such as employment practices liability;- A flex "blanket" limit for other losses such as computers, valuablepapers, and accounts receivable (eliminating the need to set separateindividual limits); and- Coverage for building demolition and the increased cost of construction because of ordinance or law.

BOP Access is available for eligible classes with up to $15 million in total insured values, and $15 million in sales per location (for manufacturers, eligibility is up to $20 million in sales for all locations). Coverage is available in California, Connecticut, Georgia, Illinois, Michigan, Minnesota, Oregon, Texas and Washington. Additional states will be added throughout the year.

Source: Safeco Insurance (www.safeco.com)

From: Insurance Journal (www.insurancejournal.com)

Bank Insurance Brokerage Revenue Surges Over 10%

The nation’s bank holding companies reported their insurance brokerage fee income grew more than 10 percent in 2006, while total insurance revenue decreased 1.3 percent--a drop attributed to a reduction in the number of firms reporting.

The Michael White Associates consulting firm in Radnor, Pa., and the Washington-based American Bankers Insurance Association released the findings today based on data reported to the Federal Reserve Board by top-tier bank holding companies.

The organizations said total insurance revenue went from $44.1 billion in 2005 to $43.5 billion in 2006.

The White firm and ABIA analysis measures the banking industry’s insurance business and provides some benchmarks that gauge bank insurance performance.

“While the industry’s insurance underwriting activities registered a decline of 5.2 percent, its insurance brokerage fee income continued growing, increasing 10.6 percent in 2006,” said Michael D. White, president of MWA.

“Among the top-50 in insurance revenue, the mean ratio of insurance revenue to noninterest income was 14.8 percent in 2006, so insurance activities continue to make increasingly meaningful contributions to banking revenues,” he added.

Brokerage income went from $10.98 billion in 2005 to a record $12.14 billion in 2006, as 656 bank holding companies--67 percent of all top-level BHCs reporting--engaged in sales activities producing insurance brokerage fee income, compared to 1,428 in 2005, the report said.

It was explained that fewer bank holding companies reported total insurance revenues in 2006 because the Federal Reserve redefined “small” BHCs as those with less than $500 million, instead of $150 million, in consolidated assets.

The total number of BHCs that must report detailed fee income information was reduced by 1,317, while the number of BHCs that reported total insurance fee income in 2006 fell by 791.
“While insurance underwriting income has grown at a compound annual rate of 3.1 percent since 2001, insurance brokerage fee income has been racing upward at a compound yearly average of nearly 20 percent during that same period,” according to ABIA Executive Director Valerie Barton.

She said that while brokerage income growth was slowed in 2006 by softening of property-casualty premiums and declines in some agencies’ contingent commissions, “insurance brokerage remains healthy, and the prospects for continued growth in bank insurance revenues are very positive."

The top-five BHCs for insurance income were:

• Citigroup Inc., New York--$3.2 billion.
• Wells Fargo & Company, San Francisco--$1.34 billion.
• Countrywide Financial, Calabasas, Calif.--$1.21 Billion.
• HSBC North America Holdings, Prospect Heights, Ill.--$1.07 billion.
• BB&T Corp., Winston Salem, N.C.--$812 million.

Copies of MWA’s reports can be obtained from MWA by calling 610-254-0440, or by visiting www.BankInsurance.com.

From: NU Online News Service (www.nationalunderwriter.com)

NAIC To Aid Hispanic Event

The National Association of Insurance Commissioners will help sponsor the National Association of Hispanic Publications Inc.’s 2007 Convention and 25th Anniversary.

The event kicks off tomorrow and runs through Saturday at the Scottsdale Hilton Resort & Villas in Scottsdale, Ariz.

Arizona Insurance Director Christina Urias will speak with Hispanic journalists from 11:00 a.m. to 4:00 p.m. Friday, at the NAIC exhibit booth at the NAHP Exhibit Hall, NAIC said.

As a sponsor of the annual Hispanic media convention, the NAIC also will co-host an editorial workshop, titled “Attracting Readers to Consumer Education Issues,” from 2:30 p.m. to 3:45 p.m. Friday.

NAIC Communications Director Scott Holeman will moderate the workshop with Hispanic journalists from La Opinion, wire service EFE and AARP’s Segunda Juventud.

From: NU Online News Service (www.nationalunderwriter.com)

Insurance Industry Added Jobs

The Bureau of Labor Statistics reported that seasonally adjusted data for insurance carriers and related activities showed the number of employees for the sector increased by 800 last month.

Some 2,333,400 were employed in March by insurers compared with 2,332,600 in February.

February’s number represented a surge of 3,000 workers who were put on the payroll, up from 2,329,600 the previous month.

From: NU Online News Service (www.nationalunderwriter.com)

Tuesday, April 10, 2007

Phoenix BBB hires liaison for Hispanic community

In its efforts to reach out to the Hispanic community, the Business Bureau of Central/Northern Arizona has hired a Hispanic outreach liaison.

Ayana Meraz will work directly with the Hispanic media as well as participate in community events, task forces and trade shows, officials said in an announcement Tuesday. "The BBB has long recognized the need to help and educate the Hispanic community, and Ms. Meraz will aid in continuing their efforts," the organization said.

Meraz received a master's degree in mass communication from Arizona State's Walter Cronkite School of Journalism and Mass Communication in May 2006.

From: Business Journal of Phoenix (www.bizjournals.com)

AIG Auto to Test Drive Tracking System for Teen Drivers

Direct marketer AIG Auto Insurance announced it will pilot a Teen GPS Program for policyholders with teen drivers. The program uses Global Positioning System, or GPS, technology to allow parents of teen drivers to monitor the location of the teen's car and driving.

The program will initially be piloted in Arizona, Illinois, New Jersey, Pennsylvania, South Carolina and Washington.

According to the National Highway Safety Administration, auto accidents are the leading cause of death for 16 to 20 year olds,with roughly 6,000 young lives lost annually.

After installing a small GPS unit, parents can instantly determine the exact location of the teen's car via the Web or any phone. Additionally,the AIG Teen GPS Program will automatically send the parent an email and/or text message if the teen's car exceeds pre-defined speed limits or is driven too far from a pre-defined location (home, school, work, etc.).

AIG Auto Insurance has teamed with MobileTeenGPS (www.mobileteengps.com) as its technology partner for the AIG Teen GPS Program.

Source: AIG Auto Insurance (www.aigauto.com)

From: Claims Guides (www.claimsguides.com)

Improving Safety for Latino Workers Gains Attention

EDITORIAL

The Northern California Engineering Contractors Association and Matsen Insurance Brokers deserve to be commended for tackling the difficult issue of safety in the workplace for Latino workers.The ECA and Mike Lopez, a vice president of the Matsen construction division, spearheaded the second-annual half-day conference last week, How to Improve the Safety of your Latino Workforce.As they so ably articulated, improving safety in the workplace for Latinos isn't just about higher productivity and lower workers' compensation rates.

It's the right thing to do as companies and as a community.

The statistics on Latino injuries and deaths in the workplace, particularly in the construction and agriculture fields, are disturbing. Consider:

• Workplace accidents involving Latinos are 20 percent above those involving non-Latinos.
• Latino fatalities rose 11 percent in 2004 after declining for two years.
• Latino workplace fatalities were up 102 percent from 1994 to 1999.
• An unsettling 12 percent of injuries occur on the first day of work.

Experts cite many reasons for why this is occurring. They say it's because of the strong Latino work ethnic, putting the job before oneself. High respect for authority causes some workers to push themselves too hard and discourages speaking up about a potential hazard.

What's required to turn the statistics around is an all-out effort to confront the issues and to do so in a sustainable fashion. Training is excellent. But it does not change behavior. Management and consistent reinforcement does.

Especially critical in the summer months ahead is prevention of heat exhaustion on construction sites, in the vineyards and elsewhere.

An effective and enforced injury and illness prevention program is the best way for North Bay companies to put safety first.

The ECA's Lorena Fisher and Matsen's Mr. Lopez are to be congratulated for helping spread that message.

Source: North Bay Business Journal (www.northbaybusinessjournal.com)

From: Workers' Comp Executive (www.wcexec.com)

Monday, April 09, 2007

Blue Cross Receives State Reprimand, Fine

A recent investigation revealed just how low a health insurer can go, even the biggest one in California. The Department of Managed Health Care exposed the fact that Blue Cross of California committed scores of state law violations.

Health insurance policyholders were dumped by Blue Cross and subjected to severe hardship because they made the mistake of getting pregnant or becoming chronically ill, according to state regulators. Yet, there was no indication that these policyholders did anything to merit such treatment. There were no indications that they lied on their applications to cover pre-existing medical conditions, which would be legal grounds for cancellation, or other offenses.

In fact, regulators examined 90 randomly selected cases of policy cancellations and found Blue Cross violations in each one. Going 90-for-90 is a dream for someone such as Warriors guard Jason Richardson, but it's a nightmare for Blue Cross policyholders. Those numbers make you wonder how far this abuse really goes?

Blue Cross was fined $1 million. It probably should've been higher. Blue Cross' parent company, WellPoint, had revenues of nearly $57 billion last year — somehow the punishment doesn't seem to fit the crime. "Blue Cross is reaping millions in savings by not paying for care," said Jerry Flanagan, a patient advocate with the Foundation for Consumer and Taxpayer Rights, responding to Blue Cross' fine.

The ones punished were those who lost their policies and wound up paying considerable amounts of money for treatments they thought were covered by Blue Cross. And what about those whose health was placed at risk due to arbitrary decisions made by the health insurer? Other health insurers will see similar investigations; we can imagine what those results will be.
Many of the victims have turned to the courts. A group of former policyholders is pressing a class-action lawsuit against Blue Cross, but that could get tied up for years. Don't believe, however, that this is the only course available.

Perhaps Blue Cross has done severe damage to itself. Think about it. Thanks to the exposure from the Department of Managed Health Care, a different light has been shed on Blue Cross. If you are leery, you can unload Blue Cross if you are a policyholder, or avoid this agency if you are not.

The health care system is not the greatest free market system in the world, safe to say, but there are choices. If you've been treated poorly, go somewhere else. Believe this — enough bad publicity will change the way health insurers conduct business. And we encourage the Department of Managed Health Care to keep going — we will be fascinated to learn what comes next.

Source: Alameda Times Star (www.timesstar.com)

From: Insurance News Net (www.insurancenewsnet.com)

Insurance Industry Adds 800 Jobs in March

By John Williams
A.M. Best Company

Insurance industry payrolls rose by 800 in March to 2.333 million, following a revised 3,000 jobs gain in February. February's increase previously had been reported at 2,100. The Bureau of Labor Statistics released the seasonally adjusted data April 6.

Total March nonfarm payrolls increased by a seasonally adjusted 180,000 to 137.622 million, after February's revised gain of 113,000 (previously 97,000). On a year-to-year basis, growth in March held at 1.5% versus February. The 1.0% annual growth in March insurance payrolls, however, was down from 1.4% the month before.

Total insurance industry payrolls are reported on a seasonally adjusted basis, along with the current month's nonfarm payrolls. Separately, data by industry segment?broken out by various insurance carrier and non-carrier categories?are available only on an unadjusted basis for the prior month.

The just-released February detail showed an annual gain of 1.6% in insurance carrier employment, down from 2.0% in January. The overall annual growth of 1.4% in February's insurance industry payrolls reflected the gain in carrier employment combined with a 1.1% annual increase in jobs among insurance brokerages, agencies and related services.

The annual rates of change in February insurance carrier payrolls were gains of 2.4% for life, health and medical insurers; 1.3% for property/casualty insurers; 5.0% for reinsurers; and an annual contraction of 3.9% for title insurers.

In the non-carrier sector, February employment rose at an annual rate of 2.2% for agencies and brokerages, but it fell by 0.6% for third party administration and by 6.0% for claims adjusting.

Source: A.M. Best Company (www.ambest.com)

From: Insurance News Net (www.insurancenewsnet.com)

Washington Passes ID Theft Law

The Washington legislature has passed a law designed to help reidents protect themselves from potential identity theft and financial destruction. Substitute Senate Bill 5826 passed unanimously in both sides of the Legislature and is scheduled to be delivered to Governor Chris Gregoire for signing.

"Legislators united in their support of an important bill that gives all Washington residents the opportunity to freeze unauthorized access to their credit reports," said Attorney General Rob McKenna. "This crucial law allows individuals to reduce their risk of becoming identity theft victims. At the same time, it provides a quick, convenient method for consumers to thaw a freeze for the purpose of buying a car, obtaining a mortgage or applying for a new credit card."

McKenna has made identity theft prevention a top priority for the Attorney General's Office and has crusaded for a preventative freeze bill since 2005. Earlier this session, he joined legislators and leaders from AARP and the Washington Credit Union League in encouraging the Legislature to help Washington residents protect themselves from the snowballing threat of identity theft.

SSB 5826 amends Washington's Fair Credit Reporting Act to allow the availability of a credit freeze to all Washington consumers. Unlike a fraud alert, which places a statement on your credit report, a security freeze means that your credit file cannot be shared with potential creditors. A freeze can prevent identity theft since most businesses will not open credit accounts without checking a consumer's credit history first.

The new includes an easy 'thaw' mechanism to give consumers the option to allow temporary, restricted access to their credit files.

Washington's existing statute, RCW 19.182.170, was passed in July 2005 and went into effect last year. It allows only identity theft victims and people whose information was stolen in a data breach to request a freeze. McKenna said the law doesn't protect consumers whose personal information has been stolen until that information is actually used to commit fraud.

Under the new law, identity theft victims and seniors ages 65 and older will be able to place a freeze for free. Other consumers would pay to up $10 to each bureau for placement of a freeze, a temporary lift or removal. Consumers who aren't entitled to a free freeze would therefore pay a total of $30 to freeze their reports with the three major credit reporting agencies, Equifax, Experian and Trans Union.

Source: Washington Atorney General's Office (www.atg.wa.gov)

From: Claims Guides (www.claimsguides.com)

San Francisco Attorney Launches Insurance Reform Website

By Chris Rauber
San Francisco Business Times

Plaintiffs' attorney, insurance gadfly and author Ray Bourhis has started a web site designed both as a profit-making enterprise and to "mobilize" consumers to push for insurance industry reform.

The site, www.insuranceconsumers.com, has multiple purposes, said Bourhis, a partner at San Francisco's Bourhis & Mann law firm. Those include informing consumers about the "absence of federal regulation and the weakness of state laws governing the industry," helping them avoid problems when buying insurance or filing claims, and "galvanizing" insurance buyers into a new political force, according to the company.

Bourhis said he's initially funding the site's development and operation with his own money, but hopes to attract venture funding. In the near future, he plans to place advertisements about the site in major newspapers, "and at that point go to the venture people for funding."

His law firm represents consumers on all types of insurance disputes, its web site said, primarily focusing on disability, long term care, medical, homeowners, property and casualty, and life insurance. Its specialty is bad faith litigation -- making it the type of plaintiffs' law firm insurance companies love to hate. The firm says it's worked with New York Gov. and former state attorney general Eliot Spitzer, Lt. Governor and former California Insurance Commissioner John Garamendi and others on investigative and regulatory matters, and is working nationally on insurance reform.

Despite its reformist perspective, the site "is definitely intended to make money," Bourhis said. "People spend $1 trillion per year on insurance premiums. Most people don't have the foggiest idea what they're buying or paying for, and there's no one out there doing something significant about it."

So far, though, there's little indication the site is gaining much traction. As of April 2, only a handful of people had posted comments on its blog, and several appeared to be connected to the site. Although content is free, Bourhis is asking consumers to chip in $9.95 per year, using a PayPal button, to become members and help get the project moving forward.

From: San Francisco Business Times (www.bizjournals.com)

Friday, April 06, 2007

A.M. Best Launches New Online Consumer Insurance Information Center

A.M. Best Co. has launched Best’s Consumer Insurance Information Center, an online resource designed to inform consumers about the various insurance options available to them, and to demonstrate the importance of an insurer’s Best’s Financial Strength Rating in determining how likely the company is to fulfill its financial obligations to policyholders.

Overview information on life insurance and annuities, health and accident insurance, and auto, home and personal property insurance is currently available in this Center. Visitors can also expect to find answers to basic questions that may arise when deciding on the line of coverage that would best suit their needs, such as: “What does it protect against?” “Who needs it?” and “When should I buy it?”

This Center features a convenient tool that lets users search for an insurer and view its Best’s Rating, basic contact information and its top five lines and states of business (by direct premiums written). A user-friendly glossary defining basic insurance terms is available to help consumers more fully understand the terms and conditions of their insurance policies.

Additionally, visitors can access contact and background information on their commissioners and link directly to their state's Department of Insurance Web page.

The valuable information featured in Best’s Consumer Insurance Information Center is currently available to all A.M. Best Web site visitors free of charge at www.ambest.com/consumers.

Source: A.M. Best Company (www.ambest.com)

From: Business Wire (www.businesswire.com)

A.M. Best Affirms Ratings of Unitrin Inc. and Its Subsidiaries

A.M. Best Co. has affirmed the financial strength rating (FSR) of A (Excellent) and the issuer credit ratings (ICR) of “a” of Unitrin Property and Casualty Insurance Group (Unitrin) and its members.

A.M. Best has also affirmed the FSR of A (Excellent) and the ICRs of “a” of United Insurance Company of America (UICA) (Chicago, IL), Union National Life Insurance Company (Baton Rouge, LA) and The Reliable Life Insurance Company (St. Louis, MO), the three career agent life/health insurance subsidiaries of Unitrin’s publicly-traded parent, Unitrin, Inc. (Chicago, IL) [NYSE: UTR].

Additionally, A.M. Best has affirmed the FSR of A- (Excellent) and ICR of “a-” of Reserve National Insurance Company (RNIC) (Oklahoma City, OK), Unitrin, Inc.’s independent agent life/health insurance subsidiary.

Concurrently, A.M. Best has affirmed the ICR of “bbb” and the debt ratings of Unitrin, Inc.’s outstanding senior notes and its $300 million shelf registration. The outlook for all ratings is stable. (Please see link below for a detailed listing of the companies and ratings.)

Unitrin’s ratings reflect its strong capitalization, improved underwriting performance and geographic and product spread of risk. The group’s outlook is based on its improved operating performance in recent years and the successful assimilation of the book of business acquired from Kemper.

Unitrin’s positive rating factors are derived from a diversified product offering, strong market presence, long-standing independent agency relationships and prudent catastrophe exposure management. The underwriting focus remains centered on providing private passenger automobile and homeowners coverages and commercial policies for “main street” businesses.

The ratings also acknowledge management’s commitment to improve profitability by implementing rate increases, geographically diversifying its business and re-underwriting select books of business. In addition, loss and loss adjustment expense reserves have developed favorably in recent years. As a result of these actions and firm market conditions, operating results improved in recent years. Also, Unitrin benefits from the financial flexibility and operational support from Unitrin Inc., which maintains moderate financial leverage and solid fixed-charge coverage.

Negative rating factors include Unitrin’s significant underwriting losses in the earlier years, which were attributable to inadequate rates and weather related losses, and exposure to market risk and potential volatility in surplus balances because of the group’s large, concentrated common stock portfolio. However, the group’s operating results improved in recent years, primarily due to corrective actions that were implemented by management and firm market conditions.

The ratings of the life/health career agent subsidiaries reflect their strategic role within the Unitrin, Inc. organization, strong niche presence in the home service life insurance market, well established career agency force and favorable operating performance. Furthermore, A.M. Best believes that the risk-adjusted capitalization of the three life/health subsidiaries, both on a combined and stand-alone basis, remains sufficient despite large dividend payments made to Unitrin, Inc. over the last several years.

Partially offsetting these positive rating factors is A.M. Best’s belief that the life/health subsidiaries may be challenged to sustain premium growth and operating performance given the limited growth potential in the mature home service market and to sustain historical levels of earnings given the reduced levels of invested assets and the continuing low interest rate environment.

The rating actions on RNIC reflect its improved accident and health premium trends, favorable operating performance and adequate stand-alone risk-adjusted capitalization. Partially offsetting these positive rating factors is the challenge for RNIC to sustain its operating performance given its limited business profile marketing accident and health insurance products and Medicare supplement insurance to individuals and small business owners living in rural areas.

For a complete list of Unitrin, Inc.’s FSRs, ICRs and debt ratings, visit www.ambest.com/press/040601unitrin.pdf.

Source: A.M. Best Company (www.ambest.com)

From: Business Wire (www.businesswire.com)

P-C Rates Continue Decline

By Mark E. Ruquet
NY Online News Service

Property-casualty rates continue spiraling downward, showing a decline of 12 percent over the previous month, according to an online insurance wholesale exchange.

In its latest Market Barometer, Dallas-based MarketScout said on average March rates were down 12 percent with no lines of business showing any sign of upward momentum.

In a statement Richard Kerr, chief executive officer of MarketScout, said: “The softening of the market is due to seven drivers:

• Major insurance companies are reporting strong profits.

• Many admitted carriers are now writing business which was previously written in the nonadmitted market.

• There is an influx of new capacity via startup insurance companies.

• Florida has passed legislation which will result in billions of dollars of new property insurance capacity.

• The stock market remains strong.

• Corporate earnings are strong.

• There have been no major catastrophe losses in almost 18 months.

As a result, property and casualty rates are down 12 percent for March 2007.”

Of 13 coverage classes of business MarketScout broke down, general liability rates declined the most at 13 percent, closely followed by umbrella/excess and workers' compensation at 12 percent. Surety was down the least at 3 percent, with crime and fiduciary standing at negative-4 percent. The remainder ranged from negative-8 percent to negative-11 percent.

All size accounts showed downward trends. Small accounts were down 9 percent; medium accounts down 10 percent; large accounts down 12 percent; and jumbo accounts down 13 percent.

From: National Underwriter (www.nationalunderwriter.com)

Thursday, April 05, 2007

Study: Calif. Leads Nation in Fraud Convictions

California leads the nation in criminal insurance fraud convictions, according to a study by the Coalition Against Insurance Fraud. According to the study, the Golden State had more than one third of of all convictions generated by state insurance agenices across the United States and had the most resources to fight fraud than any other state.

"The high rate of successful prosecutions in California reflects the aggressive investigative prowess of the fraud bureau in the state's insurance department, and is a testament to having prosecutors in the district attorney's office who work exclusively on insurance cases," the coalition's study said.

The study tallied the following statistics:*Convictions: The Golden State's fraud bureau unit logged 1,546 criminal convictions in 2005, ahead of Florida's 493 convictions.

*Case leads received: California leads the nation with 27,687 case leads the fraud unit received in 2005. This is slightly ahead of New York, which received nearly 26,000 leads. Leads come from insurance companies, local law enforcement, calls to the fraud hotline, and leads the fraud unit's own investigators uncover.

*Cases presented for prosecution: California ranks second nationally in cases it presented for potential criminal prosecution. Its 754 cases stand slightly behind Florida with 773 for 2005.

*Open investigations: Whether the state's case pipeline � and downstream convictions � will remain at current levels remains a question. The fraud bureau stands only fifth in overall in open investigations. Its 1,250 cases rank well behind New Jersey's total of 2,977.

"Caseloads are key indicators of activity level and the level of fraud overall within the state," the study indicated. The lower ranking thus could suggest lower overall activity level, or possibly fewer but larger and more complex cases such as staged-accident rings.

*Resources: California's fraud bureau brings more resources to the fraud fight than any other state. The unit's top-ranked $36.8-million budget in 2006 was well ahead of New Jersey's $29.7 million. That enabled the fraud bureau to spend about $28,700 per fraud case in 2005, also the highest total in the nationa, the study said. The unit also reported a nation-leading 298 employees, ahead of runnerup New Jersey's 270.

"These resources reflects both the sheer size and persistence California's fraud problem, plus an aggressive response to the crime," says the Dennis Jay, the coalition's executive director.

The Coalition Against Insurance Fraud is a nonprofit alliance of consumer groups, insurers and government agencies combating all forms of insurance fraud. For more information, visit www.InsuranceFraud.org.

Source: Coalition Against Insurance Fraud (www.insurancefraud.org)

From: Insurance Journal (www.insurancejournal.com)

I.I.I. Launches Small Biz Insurance Web Site

A new Web site sponsored by the Insurance Information Institute in New York is offering tips to help small and medium-sized businesses understand their insurance needs, I.I.I. said.

With over seven million small businesses in the U.S., ranging from construction firms to grocery stores to home-based businesses, each one faces the possibility of being wiped out by either a disaster or a lawsuit, said Loretta Worters, I.I.I. vice president.

Moreover, almost all businesses are accountable for the safety of their workers and bear responsibility for injuries suffered on the job. “This resource was designed to help businessowners decide what kinds of insurance they need for their particular business,” she said.

The guide, which can be accessed at http://www.iii.org/smallbusiness, provides information on what coverages businesses should consider such as a businessowners policy, as well as what businessowners should know about risk management and loss control.

The Web site also features a section on insurance for specific businesses including artisans, contractors, business offices, construction, e-commerce, farm or ranch, and food service businesses.

“A business that is indifferent to loss control may have a higher than average number of insurance claims,” Ms. Worters said. “A really poor loss history can make it difficult to find insurance.”

Conversely, businesses that actively manage risks, and thereby control losses, will have fewer claims and will often see those efforts rewarded with lower insurance premiums, she said.

Ms. Worters noted that the new Web site also provides information on the insurance coverages available, including property insurance, liability insurance, business auto and workers’ compensation insurance. “Purchasing the right amount and the right type of insurance coverage is critical to long-term business success,” she said.

Source: Insurance Information Institute (www.iii.org)

From: National Underwriter (www.nationalunderwriter.com)

Anthem Blue Cross and Blue Shield in Nevada and Colorado to Participate In Unprecedented Data Sharing Program

In Nevada and Colorado, Anthem Blue Cross and Blue Shield announced that it is participating in an unprecedented data- sharing program developed by the Council for Affordable Quality Healthcare (CAQH). The program, based on rules drafted by CAQH's Committee on Operating Rules for Information Exchange (CORE), is designed to link the data collected by health plans, providers, and vendors so that doctors can electronically verify their patients' insurance information in twenty seconds or less, significantly improving communications between providers and insurers.

The CORE program is a voluntary, industry-wide collaboration facilitated by CAQH. Anthem has been certified as a CAQH CORE health plan and has already completed the Phase I implementation of the CORE rules, which allows for standardized data transfer and quicker response times. Physicians who link to the health plan through electronic data interchange (EDI) will be able to use EDI for this quick verification. EDI is a method for two organizations to confidentially exchange data from one computer to another using standard formats that are HIPAA compliant. Currently, Anthem's EDI is used for claims filing, claims status checks, eligibility verification, electronic remittance advices, and electronic fund transfers back to health care providers.

"Anthem is committed to employing the most advanced information technology solutions available to improve both our members' experience and their interactions with physicians," said Mike Murphy, president, Anthem Blue Cross and Blue Shield of Nevada. "CAQH has developed an excellent framework for simplifying the administrative side of the health care system, and Anthem has worked diligently to ensure that we are capable of bringing the benefits of CAQH's efforts to our members."

"These programs have the potential to transform the way that health care providers and health plans communicate," said Murphy. "But most importantly, they will take much of the confusion out of the health care system for our members."

Source: Anthem Blue Cross and Blue Shield (www.wellpoint.com)

From: Insurance News Net (www.insurancenewsnet.com)

Blue Cross Tried to Steal Customers, Alleges Competitor

By Carol Gentry
Tampa Tribune

As two possible buyers kicked the tires Tuesday at Universal Health Care Insurance Co. in St. Petersburg, the company's attorneys fought separate legal battles against the state and a competitor, accusing both of using illegal tactics to try to put the young company out of business.

Universal filed a complaint against Blue Cross and Blue Shield of Florida on Tuesday in Pinellas Circuit Court, saying that the state's largest insurer deliberately smeared Universal to steal its customers.

Universal said Blue Cross committed illegal acts, including forgery, which would entitle the Pinellas company to triple damages if it can prove its case.

Blue Cross "intentionally, maliciously and unjustifiably interfered with" Universal's relationships with its members and doctors, the complaint states, through "false, misleading, deceptive (and) defamatory conduct."

Blue Cross has acknowledged sending e-mail to 3,000 sales agents on March 26 that said Universal's Any, Any, Any plan had gone out of business and its members had been moved into a Blue Cross drug plan for Medicare beneficiaries. Blue Cross said the e-mail were sent by mistake and issued retractions.

The errant messages were part of a "contingency plan" drawn up in coordination with the Centers for Medicare & Medicaid Services (CMS), Blue Cross spokesman Mark Wright said Tuesday in an e-mail response to questions from The Tampa Tribune.

Blue Cross "has been working with CMS to remedy any confusion that may have been created with the release of this material," Wright said.

Universal's lawsuit claims that the false information went beyond the e-mail to agents. It says Blue Cross also sent letters on CMS stationery saying that as of March 31, Universal's Any, Any, Any plan "will no longer be part of the Medicare program."

Letter Says Contract Ended

The letter, dated March 27 and addressed to Medicare beneficiaries, said CMS "will end Universal's Medicare Advantage contract because Universal is experiencing financial problems so severe that we have decided Universal is not able to continue providing your health services in a safe and effective way."

Universal's complaint states that Blue Cross sent the letters to members of the Any, Any, Any plan and to doctors, causing members to drop out of the plan and doctors to stop accepting its members as patients.

Cynthia Moreno, director of a CMS branch in Baltimore, is printed at the end of the letter in the signature area.

It isn't clear whether the CMS letter is genuine, why CMS would have sent it to Blue Cross, or whether Moreno authorized the use of her name. CMS officials did not respond to requests for explanation.

In Tallahassee, a Leon Circuit Court judge ordered attorneys for the Office of Insurance Regulation to file papers by Friday as to why he should honor their request for a state takeover of Universal. He set April 20 to hear evidence.

Judge Thomas H. Bateman III told attorneys for the state and Universal to "stop trying the case in the press."

"I'm not going to stand for it," he said. "We need to get the case resolved in here."

Judge Blasts State Agency

Bateman lambasted the Department of Financial Services for filing petitions with a different judge last week after he had already begun handling the Universal case. Last week, the two judges combined the actions in Bateman's court.

You "got all these things balled up [and] made it more confusing than it needs to be," the judge told DFS Deputy Chief Attorney Robert V. Elias.

The insurer, the largest subsidiary of the Universal Health Care Group founded by St. Petersburg geriatric specialist Akshay Desai, is a new type of Medicare Advantage called a private fee-for-service plan. Its first enrollments in Any, Any, Any, went into effect Jan. 1, quickly rolling up 75,000 members by mid-February.

The rapid-fire growth was faster than the state felt was financially safe, so the Office of Insurance Regulation placed the plan under state supervision Feb. 21 and ultimately recommended receivership and liquidation. Universal blocked the action through court action March 22, putting everything on hold.

CMS sent Universal $60 million on Sunday to cover treatment for Any, Any, Any members through April.

Universal Health Care's other plans, including Medicare Masterpiece, are not affected by the state or court actions.

In St. Petersburg, Universal spokesman Bob O'Malley said representatives of two companies were on-site looking over the financials of the targeted subsidiary. While he declined to name them, O'Malley said the companies have "significant health care expertise" and were in "active discussions with the company about possible investment."

Source: Tampa Tribune (www.tampatrib.com)

From: Insurance News Net (www.insurancenewsnet.com)

Wednesday, April 04, 2007

Kaiser Permanente Identified as a Top Spot for Diversity

By Chris Rauber
San Francisco Business Times

Kaiser Permanente said Wednesday it's won a "coveted spot" on a national list recognizing employers committed to recruiting and retaining a diverse workforce.

The giant Oakland-based health-care system ranked 27th overall on DiversityInc's 2007 Top 50 Companies for Diversity list, which Kaiser identified as the largest competition of its kind nationally. This is the second time Kaiser's made the list, the health-care system's officials said April 4.

Overall, more than 300 large employers competed for a spot on this year's version, about twice as many as three years ago and 24 percent more than last year's total. The roster recognizes factors such as "excellence in CEO commitment," human capital, corporate communications and supplier diversity, according to Kaiser. Other top companies on the list comprise a virtual who's who of American corporate powerhouses, including Bank of America, AT&T, Ford Motor Co., Verizon, Xerox, Wachovia, Procter & Gamble, Johnson & Johnson, Wells Fargo, and Cox Communications, among others.

The list is based on answers to a survey sent to any company that requests it and has more than 1,000 employees, said officials at DiversityInc, a Newark, N.J.-based monthly business magazine and daily web site.

Kaiser said it won its place on the list for a number of accomplishments, most notably because 77 percent of its workers are women and 57 percent are members of ethnic minority groups. Systemwide, Kaiser has 156,000 non-physician employees and 13,000 doctors. In addition, Kaiser said, its board of directors is 36 percent female, and half of its board members are "people of color."

Kaiser also cited its Institute for Culturally Competent Care, various multicultural staff associations, nine centers of excellence focusing on improving health outcomes for targeted minority populations, annual community health fairs and an award-winning Health Care Interpreter Training Program.

"Our work force reflects the wonderful racial, ethnic, religious, gender, sexual orientation and disability diversity of our membership," George Halvorson, chairman and CEO of the system's nonprofit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals, said in the statement.

"We have been a leader for a very long time in creating excellent care for a very diverse set of people. Our workforce reflects our commitment to that agenda."

Luke Visconti, partner and co-founder of DiversityInc, a Newark, N.J.-based monthly business magazine and daily web site, agreed, describing Kaiser as a "true champion of diversity."

The DiversityInc Top 50 companies, expressed as a stock index, beat the Standard & Poor's 500, the Dow Jones Industrial Average and the Nasdaq on a 10-, five- and one-year basis, according to privately held DiversityInc, "documenting the connection between good diversity management, excellent corporate governance and return on equity for investors."

From: San Francisco Business Times (www.bizjournals.com)

U.S. Trust CEO to Step Down Amid Culture Clash with BofA

By Mark Calvey
San Francisco Business Journal

Bank of America's merger-integration style apparently isn't sitting well with U.S. Trust's CEO, who will step down this summer.

Peter Scaturro's imminent departure, first reported in a front-page story in Wednesday's Wall Street Journal, doesn't bode well for U.S. Trust's outlook after it's sold by Charles Schwab (NASDAQ: SCHW) to the Charlotte, N.C., bank.

BofA is purchasing the company for $3.3 billion in a transaction that's expected to close later this year.

"Something has gone very significantly wrong for Scaturro to leave," said John Conover, president and CEO of San Mateo-based Borel Private Bank and Trust, who was once a BofA senior executive. BofA CEO Ken Lewis was full of praise for Scaturro and his team when the deal was first announced, but that's water under the bridge now.

"It's a happy marriage until you get to the altar," Conover said of mergers involving big banks.
The culture clash between U.S. Trust and BofA is reminiscent of the rocky merger integration between San Francisco's BankAmerica and Charlotte's NationsBank almost a decade ago.

Scaturro apparently chafed at BofA's efforts to integrate U.S. Trust into the larger bank. At one point, Scaturro sought to report directly to Lewis, the CEO. That was probably a non-starter in BofA's world.

Other disputes centered around computer systems to be used, investment product offerings for U.S. Trust clients and whether the wealth management firm's rich clients should be charged for using non-BofA ATMs.

"This is a relationship business and these high-value clients dislike all these charges in their relationships," said Steve Buster, CEO of the Mechanics Bank in Richmond.

By some estimates, clients at a firm like U.S. Trust are already paying 1.2 percent of assets in a $2 million stock portfolio managed by the firm. The fee structure likely falls from there based on assets, services, and portfolio holdings.

Both Mechanics Bank, Borel and their many Bay Area rivals in wealth management anticipate picking up new clients for its services as BofA (NYSE: BAC) digests U.S. Trust and Merrill Lynch & Co. (NYSE: MER) integrates San Francisco-based First Republic Bank. (NYSE: FRC)

From: San Francisco Business Journal (www.bizjournals.com)

End Insurers’ Trust Exemption, U.S. Panel Says

By Arthur D. Postal
NU Online News Service

A federal commission recommended today that Congress consider eliminating insurers’ limited antitrust exemption, saying recent trends point to the benefit of ending such arrangements.

The recommendation was contained in the report of the Antitrust Modernization Commission. Four of the 12 members of the commission specifically called for repeal of McCarran-Ferguson and three other antitrust exemptions, including the Shipping Act, the Export Trading Company Act and the Webb-Pomerene exemption.

An insurance trade group reacted that the commission did not have a full understanding of the way the law worked.

One commission member, John Shenefield, a lawyer at Morgan Lewis Washington who was also in charge of antitrust enforcement in the Carter administration, said the repeal of those exemptions “should not be delayed.”

But, in addition, he said, Congress should create another commission to examine all the other exemptions “now on the books.”

The commission dismissed in its report the potential effect that eliminating the exemption from collecting loss data would have on small insurers. It said eliminating the exemption should have no effect on such industry practices.

“Like all potentially beneficial competitor collaboration generally,…such data sharing would be assessed by antitrust enforcers and the courts under a rule of reason analysis that would fully consider the potential pro-competitive effects of such conduct and condemn it only if, on balance, it was anticompetitive.”

The commission added, “Insurance companies would bear no greater risk than companies in other industries engaged in data sharing and other collaborative undertakings.” It also noted, “To the extent that insurance companies engage in anticompetitive collusion, however, then they appropriately would be subject to antitrust liability.”

The report said various factors have driven the movement toward deregulation, noting that technological progress has facilitated the growth of competition in “industries previously considered natural monopolies.”

In addition, the report said, “critiques of regulation have pointed out that federal regulatory agencies were sometimes ‘captured’ by firms they regulated, to the detriment of the public interest, and that the costs of regulation were significantly more than anticipated.”

The general conclusion is that, “in many instances, “regulation reflects successful rent-seeking by private economic interests and generally reduces consumer welfare by restricting output,” the commission concluded.

Jonathan Jacobson, a commission member from New York, added in additional remarks that, regarding exemptions enjoyed by the shipping and insurance industries, for example, “sufficient evidence was presented at those hearings, in my view, and sufficient independent analysis strongly confirms, that these exemptions have outlived any utility they may have had and should be repealed.”

The specific antitrust exemptions he cited were the McCarran-Ferguson insurance exemption, the Shipping Act, the Export Trading Act and the Webb-Pomerene Act.

Mr. Jacobson, an antitrust partner at Wilson Sonsini Goodrich & Rosati, was joined by two other members of the panel in his additional comments, Debra Valentine and John Warden.

“At each hearing, the commission was presented with substantial evidence of anticompetitive activities the exemptions do or can permit.” Mr. Jacobson said.

“And, in each case, the response was basically the same—that ‘our industry does many good things, does not restrain competition, and needs the exemption to avoid potential treble damage litigation.’”

Mr. Jacobson added, “This litany provides no basis for an exemption. Virtually every industry does good things. Conduct that does not restrain competition is not prohibited, with or without an exemption. And freedom from private litigation is something, again, that every industry would like.

“If these were valid bases for an exemption, there would be immunities from the antitrust laws everywhere,” he added. “The real question in each case is whether the application of normal antitrust rules will impair some important public goal, and whether an exemption is truly necessary to ensure that this goal is served.”

He concluded, “None of the industries we examined came close to meeting that standard of proof.

“In my view, the commission would have better served the country through a more focused review of these four and other widely applicable exemptions (such as the Capper-Volstead Act) than by relying purely on the generalist overview reflected in our official recommendations,” he concluded.

Among the first insurance groups to react, the Property Casualty Insurers Association of America (PCI) said in a statement that the commission findings reflected a misunderstanding insurers’ exemption and what it allows.

“The clamor over the limited exemption provided by McCarran-Ferguson is a misguided attempt to punish large insurers for their perceived mishandling of a small percentage of [2005] Hurricane Katrina claims,” said Ben McKay, PCI’s senior vice president, federal government relations. The commission was created in 2002.

Mr. McKay added that an antitrust repeal would “punish the millions of consumers who rely on small and medium-size companies to protect their homes, autos and businesses. Because repeal would significantly damage these insurers’ ability to compete effectively in the market,
consumers would pay higher prices and have fewer insurance choices.”

PCI pointed out that the AMC report simply calls for a review of McCarran-Ferguson, not necessarily repeal.

From: National Underwriter (www.nationalunderwriter.com)

Tuesday, April 03, 2007

Insurers Blast Florida Report on Education, Job Rating

Florida insurers are hammering a Florida Office of Insurance Regulation report on the use of occupation and education for rating of auto insurance policies, calling the report's claims that the use of these factors unfairly affects lower income and minority consumers "entirely bogus and unsubstantiated."

The Florida Insurance Council maintains that there is no unfair bias in the use of education and occupation by insurers.

"While critics argue that certain levels of educational attainment or occupation are associated with certain income levels, they fail to associate risk or cost with education or occupation," the FIC stated in a release. "Once risk is associated, insurers have found that occupation and education are not only actuarially valid predictors of risk, but that they are not unfairly discriminatory."

FIC cited a study last year by the Maryland Insurance Administration, which it says found that the use of education and occupation as underwriting factors is "reasonably objective; is a predictor of loss; meets actuarial standards of practice and principles related to risk classification; and is reasonable."

The insurers' group also noted that Florida's policymakers recognize that the practice is acceptable since under Florida law, it is legal to use education and occupation.

In further defense, the group pointed out that no insurer uses education or occupation as the only factors in determining rates. Instead, they use as many as 20 different characteristics including territory, gender, make of car, driving record, miles driven, location, driving experience and others.

To restrict insurers' ability to use such risk-based factors would harm consumers, insurers argue.

"Restrictions on actuarially predictive underwriting criteria would lead directly to more uncertainty and therefore less competition, higher prices and growth in auto insurance markets of last resort," the FIC said.

Source: Florida Insurance Council (www.flains.org)

From: Insurance Journal (www.insurancejournal.com)

Florida Officials: Education, Job in Rating 'Unintentionally' Harms Minorities

Results of a report on the factoring of occupation and education for underwriting and rating of auto insurance policies show that while the practices "unintentionally harm minorities and low-income individuals" in determining premiums and eligibility, they are nonetheless legal.

"Let me be perfectly clear -- this practice is legal under current Florida law," Insurance Commissioner Kevin McCarty said. "However, similar to insurance companies' past use of credit scoring, this practice creates unintended effects that policymakers may find unacceptable."
In 2003, the Florida Legislature passed Section 626.9741 severely limiting the use of credit scoring in insurance underwriting after this practice was also shown to disproportionately impact minorities and low-income individuals.

As early as 2004, the OIR informed the industry that utilizing the factors of occupation and education for underwriting and rating was questionable, and they advised the industry to cease within one year.

Florida Chief Financial Officer, Alex Sink said, "Just because something might be legal doesn't make it right. I don't see how someone's job reflects on how they drive or what rates they should pay. Rates should be fair and based only on actual risk."

The OIR issued subpoenas to several company groups including those representing GEICO, Liberty Mutual and AIG to evaluate their use of occupation and education for rating and underwriting decisions.

OIR's report is based on a Feb. 9 public hearing held in Tallahassee.

All three insurance company groups utilizing these practices claimed they were doing so on a "color-blind" basis as they do not collect race or income information. Yet these companies also acknowledged that they have not researched the potential impact of their practices on vulnerable classes of consumers.

According to state officials, another concern is this practice could proliferate, as companies not using these factors may be at a competitive disadvantage, and forced to adopt these practices to effectively compete.

Insurance Consumer Advocate Bob Milligan also weighed-in on the issue. "I will support the efforts of the Office of Insurance Regulation as they move to fix this egregious situation through quick legislative action and appropriate rulemaking," he said.

A copy of the report is available at http://www.floir.com/pdf/OCCRateRpt.pdf.

Source: Florida Office of Insurance Regulation (www.floir.com)

From: Insurance Journal (www.insurancejournal.com)

AIG Specialty Boosts Its Capacity for Public Entity Liability

AIG Specialty Excess, an umbrella and excess casualty underwriting unit of the AIG Companies, has increased its capacity of excess liability insurance for public entities to $25 million from $15 million.

AIG Specialty Excess will offer the increased capacity of $25 million on all commercial umbrella and excess casualty policies for public entities. The new capacity will be available for not only states, counties and cities, but also educational institutions, transit authorities, utilities and other public agencies.

The $25 million capacity will be available on a broad occurrence-based form.

Source: AIG Insurance (www.aig.com)

From: Insurance Journal (www.insurancejournal.com)

Anthem Blue Cross And Blue Shield Launches 'RightPlan PPO 40' a New Health Insurance Option For Nevadans Seeking Individual Coverage

Anthem Blue Cross and Blue Shield has announced the launch of RightPlan PPO 40 to the Nevada market. Designed for self-employed individuals, "empty nesters" and early retirees, children not covered by their parents' plan, and young adults losing dependent coverage, RightPlan expands Anthem's already robust individual product portfolio and complements the company's offerings for individuals."

RightPlan PPO 40 features a simple plan design with no medical deductible, a $40 copayment for doctor's office visits, and comprehensive coverage for prescription medications," said Nevada Plan President Mike Murphy. "Members can get even more value from this plan when they take advantage of programs and services - such as preventive care screenings, health and wellness programs, and healthy living resources at anthem.com - to help them stay healthy."

The plan includes: -- Benefits for preventive care to help members stay healthy -- Access to more than 3,900 providers and specialists and 32 acute care hospitals from one of the largest statewide PPO networks in Nevada - so members are covered just about anywhere -- Savings for members - because Anthem has negotiated lower rates with providers and hospitals, members pay a lower percentage of the fees -- Discounts for products and services through SpecialOffers@Anthem that promote health and well-being -- Out-of-state coverage through Anthem's BlueCard program.

"Even if you're healthy, you could be caught off-guard by an unexpected illness, injury, or serious accident," continued Murphy. "Health care expenses can quickly add up to a staggering financial loss. RightPlan PPO 40 can help limit your out-of-pocket costs, protect your assets, and safeguard your future earnings."

Nevadans seeking individual coverage can get more information about RightPlan PPO 40 by logging on to Anthem.com.

Source: Blue Cross and Blue Shield of Nevada (www.anthem.com)

From: PR Newswire (www.prnewswire.com)

Travelers Completes Sale of Mendota Insurance Company to Kingsway Financial Services, Inc.

The Travelers Companies, Inc. (NYSE:TRV) announced yesterday that it has completed the sale of Mendota Insurance Company, its non-standard auto insurance unit operating under the Mendota and Mendakota brands, to a subsidiary of Kingsway Financial Services Inc. (TSX:KFS)(NYSE:KFS). The impact of this transaction will not be material to Travelers' ongoing operations. Kingsway has determined to retain all of Mendota's employees in their current locations and the current Mendota management will continue to lead the organization.

Source: Travelers Insurance (www.travelers.com)

From: Business Wire (www.businesswire.com)

Monday, April 02, 2007

Sen. Lott Wants Insurance Gap Disclosure Enforced by Feds

U.S. Senator Trent Lott, R- Miss., wants to require insurers to disclose property insurance coverage and noncoverage in plain language on the front page of each homeowner's policy and has introduced a bill giving the Federal Trade Commission enforcement authority to see this is done.

"Insurance policies are notoriously hard to read and understand because they're primarily written in complex legalese," Lott said in introducing his bill. "While insurance is a legal contract, it also is a product purchased by consumers. That's why I believe every insurer should include a plain-English description of a homeowner's policy, prominently displayed on the policy's first page."

Lott's bill will require this basic description be contained in a "noncoverage disclosure" box stating in bold font, twice the size of the body of the policy's text, all conditions, exclusions and other limitations pertaining to the individual policy's coverage.

The bill further requires the Federal Trade Commission to enforce this disclosure requirement, and it establishes penalties for insurers who fail to comply through the FTC's existing laws governing unfair or deceptive practices.

Lott contends his bill, the Homeowners' Insurance Noncoverage Disclosure Act, would save money and time associated with insurance policy disputes.

"Consumer groups have estimated a provision like this could have saved consumers anywhere from $55 billion to $65 billion in Hurricane Katrina's aftermath," Lott said. "Having a clear, concise description of every policy serves the best interest of consumers, insurers and taxpayers."

But insurers oppose the bill, arguing that it duplicates state regulatory requirements involving "plain language" insurance terms and will in fact increase costs.

According to June Holmes, interim chief executive officer of Property Casualty Insurers Association of America (PCI), many states -- including Lott's home state of Mississippi -- "are already doing an excellent job in enacting and enforcing these 'plain language' requirement.'

Holmes said Lott's proposal "will do nothing to enhance the 'plain language' requirements already on the books in almost every state. But by calling for the FTC to enforce this redundant and unnecessary requirement, Senator Lott's proposal will add another layer of costly and duplicative federal oversight of a function best left to the states -- not to mention the confusion that dueling federal and state regulations would cause for consumers."

From: Insurance Journal (www.insurancejournal.com)

Insurance Industry Charitable Foundation Hosts 14th Annual Gala

The Insurance Industry Charitable Foundation will host its 14th Annual Gala on May 12, 2007, at the Ritz Carlton in San Francisco, to benefit charitable causes in California.

Steve Poizner, California Insurance Commissioner, will be the keynote speaker at the event. Also at the Gala, Frank Robitaille will be recognized as the 2007 Foundation Honoree.

Robitaille was one of five Chartered Property Casualty Underwriters that founded Insuring the Children in 1994, a nonprofit organization created to raise awareness of child abuse and neglect and to support prevention and care programs. He graduated from California State University Los Angeles with a Bachelors Degree in Business Education and attended Claremont Graduate School. He earned his CPCU designation in 1975 and Associate in Risk Management in 1976. He taught CPCU and Risk Management through Orange Coast College and the Insurance Education Association. Frank, along with Fred Armstrong, formed Armstrong/Robitaille in 1979 and expanded the business with offices in Pasadena, Larkspur, Portland and Michigan. In 2001 they sold the business to Union Bank.

The Foundation addresses the most intractable problems in California including hunger and children affected by abuse, by combining the collective strengths of the industry to provide grants, volunteer service and leadership.

Cost for a table of 10 at the Gala is $6,000. Individual tickets are $650.To participate or sponsor, call 925-280-8009 or visit www.iicf.org.

From: Claims Guides (www.claimsguides.com)