Insurance Claims & Disputes


Book Description




Delay, Deny, Defend


Book Description

An expose of insurance injustice and a plan for consumers and lawmakers to fight it Over the last two decades, insurance has become less of a safety net and more of a spider's web: sticky and complicated, designed to ensnare as much as to aid. Insurance companies now often try to delay payment of justified claims, deny payment altogether, and defend these actions by forcing claimants to enter litigation. Jay M. Feinman, a legal scholar and insurance expert, explains how these trends developed, how the government ought to fix the system, and what the rest of us can do to protect ourselves. He shows that the denial of valid claims is not occasional or accidental or the fault of a few bad employees. It's the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm. Citing dozens of stories of victims who were unfairly denied payment, Feinman explains how people can be more cautious when shopping for policies and what to do when pursuing a disputed claim. He also lays out a plan for the legal reforms needed to prevent future abuses. This exposé will help drive the discussion of this increasingly hot- button issue.




Insurance Claim Secrets Revealed!


Book Description

This is the best book you can own on the strategies YOU need to use to get the insurance companies to pay you ALL the money you are entitled to collect when you have a claim. Wouldn't you agree that nothing else matters about insurance other than getting the claim PAID IN FULL? In this book, you will learn: &ndash The games and scams insurance companies use to cut costs and keep claim payments at the lowest amounts possible &ndash When it's the right time to use an attorney &ndash How you can take control of your claim, and not allow the insurance company or claims adjuster to control YOU &ndash What a Public Adjuster is, and the valuable help you can get from Public Adjusters &ndash That the insurance adjuster is NOT there to help you &ndash and much more You will learn: &ndash What to do when you have a car accident...BEFORE you open the car door or talk to anyone &ndash How much MORE money I collected (thousands!) in the two little claims I had while writing this book &ndash About Diminished Value on automobiles, and how it can cost you THOUSANDS if you don't fight &ndash About cheap aftermarket auto parts that insurance companies LOVE, but leave you less safe &ndash And so much more Ask yourself these questions: Do you carry a spare tire and jumper cables in the trunk of your car? Do you have a toolbox at home? Have you ever bought a book or read an article that showed you how to fix something? Do you own a first aid kit? Do you have a fire extinguisher or smoke alarms in your home? Why would you do ANY of those things? Answer: So you are prepared BEFORE something bad happens. READ THIS BOOK BEFORE SOMETHING BAD HAPPENS TO YOU!!! READ THIS BOOK AFTER SOMETHING BAD HAPPENS TO YOU, TO KEEP IT FROM GETTING WORSE! This book should be on the shelf in EVERY HOME. This book should be in EVERY automobile glove box.




P&C Insurance Claim Management


Book Description

A reference guide for property & casualty insurance claim supervisors and managers. The book focuses on key claim operational issues and the fundamental responsibilities of claim supervisors and managers.




Medical Insurance Made Easy - E-Book


Book Description

This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement. 3 separate chapters offer coverage of the basic concepts of medical coding. A comprehensive overview of the CMS-1500 claim form with step-by-step guidelines and illustrations thoroughly covers reimbursement issues and explains the billing process. Includes detailed information on various insurance payers and plans including Medicare, government medical plans, disability plans, private indemnity plans, and managed care. Stop & Review sections illustrate how the concepts presented in each chapter relate to real-life billing situations. Sidebars and Examples highlight key concepts and information related to the core text lesson. A companion CD-ROM contains sample patient and insurance information that readers can use to practice completing the accompanying CMS-1500 claim form, as well as a demonstration of Altapoint practice management software. Features completely updated information that reflects the many changes in the insurance industry. Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.




Allocation of Losses in Complex Insurance Coverage Claims


Book Description

This treatise offers comprehensive treatment of many of the issues driving contemporary insurance claims and coverage litigation and reinsurance cessions and arbitrations.




Claims Reserving in General Insurance


Book Description

This is a single comprehensive reference source covering the key material on this subject, and describing both theoretical and practical aspects.




Stochastic Claims Reserving Methods in Insurance


Book Description

Claims reserving is central to the insurance industry. Insurance liabilities depend on a number of different risk factors which need to be predicted accurately. This prediction of risk factors and outstanding loss liabilities is the core for pricing insurance products, determining the profitability of an insurance company and for considering the financial strength (solvency) of the company. Following several high-profile company insolvencies, regulatory requirements have moved towards a risk-adjusted basis which has lead to the Solvency II developments. The key focus in the new regime is that financial companies need to analyze adverse developments in their portfolios. Reserving actuaries now have to not only estimate reserves for the outstanding loss liabilities but also to quantify possible shortfalls in these reserves that may lead to potential losses. Such an analysis requires stochastic modeling of loss liability cash flows and it can only be done within a stochastic framework. Therefore stochastic loss liability modeling and quantifying prediction uncertainties has become standard under the new legal framework for the financial industry. This book covers all the mathematical theory and practical guidance needed in order to adhere to these stochastic techniques. Starting with the basic mathematical methods, working right through to the latest developments relevant for practical applications; readers will find out how to estimate total claims reserves while at the same time predicting errors and uncertainty are quantified. Accompanying datasets demonstrate all the techniques, which are easily implemented in a spreadsheet. A practical and essential guide, this book is a must-read in the light of the new solvency requirements for the whole insurance industry.




The INSURTECH Book


Book Description

The definitive compendium for the Insurance Digital Revolution From slow beginnings in 2014, InsurTech has captured US$7billion in investment since 2010 — a 10% annual compound growth rate is predicted until at least 2020. Three in four insurance companies believe some part of their business is at risk of disruption and understanding the trends, drivers and emerging technologies behind Insurance’s Digital Revolution is a business-critical priority for all growth-minded firms. The InsurTech Book offers essential updates, critical thinking and actionable insight — globally — from start-ups, incumbents, investors, tech companies, advisors and other partners in this evolving ecosystem, in one volume. For some, Insurance is either facing an existential threat; for others, it is a sector on the brink of transforming itself. Either way, business models, value chains, customer understanding and engagement, organisational structures and even what Insurance is for, is never going to be the same. Be informed, be part of it. Learn from diverse experiences, mindsets and applications of technologies Discover new ways of defining and grasping growth opportunities Get the inside track from innovators, disruptors and incumbents Be updated on the evolution of InsurTech, why it is happening and how it will evolve Explore visions of the future of Insurance to help shape yours The InsurTech Book is your indispensable guide to a sector in transformation.




Adjuster Stories


Book Description

Insurance adjusters meet clients on the worst days of their lives, and they must be diplomatic, tactful, and ethical. The job is not only about returning phone calls and doing paperwork. Whether the case involves cargo damage, residential and business property damage, fire, fraud, burglary, or arson, its the job of the adjuster to get to the bottom of things. Author Jonathan L. Scott has spent more than thirty years as an adjuster. In a series of short stories, loosely based on actual insurance claims, he recalls navigating the human dimension of balancing a clients circumstances with policy requirements and the lawand its never easy. All adjusters investigate, evaluate, and settle claims, but the best ones are worth their weight in gold several times over. The bad ones, however, can cause huge problems for the public and their employers. If youve ever been curious about the work of an insurance adjuster, read on and find out how each claim becomes its own little adventure.