Care Without Coverage


Book Description

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.




General Liability Insurance Coverage


Book Description

Insurance coverage disputes raise issues in which laws and outcomes regularly vary from state to state. Whether a claim is covered can depend a great deal on whether the case arises on one side of the street or another. It is imperative that insurance claims professionals, lawyers, brokers, risk managers, risk consultants, regulators and judges have adequate access to comparative state-law research. This book is designed to give the stakeholders in the claims process ready access to the law of all 50 states on the most important liability insurance issues to quickly learn and assess state law relevant to coverage disputes. The Second Edition includes nearly 800 new cases covering all 50 states and the District of Columbia, and adds a new chapter addressing Coverage for Pre-Tender Defense Costs.




Coverage Matters


Book Description

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.




Insuring America's Health


Book Description

According to the Census Bureau, in 2003 more than 43 million Americans lacked health insurance. Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole. This report is the sixth and final report in a series by the Committee on the Consequences of Uninsurance, intended to synthesize what is known about these consequences and communicate the extent and urgency of the issue to the public. Insuring America's Health recommends principles related to universality, continuity of coverage, affordability to individuals and society, and quality of care to guide health insurance reform. These principles are based on the evidence reviewed in the committee's previous five reports and on new analyses of past and present federal, state, and local efforts to reduce uninsurance. The report also demonstrates how those principles can be used to assess policy options. The committee does not recommend a specific coverage strategy. Rather, it shows how various approaches could extend coverage and achieve certain of the committee's principles.




Health-Care Utilization as a Proxy in Disability Determination


Book Description

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.




Health Insurance is a Family Matter


Book Description

Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.




Modernizing Insurance Regulation


Book Description

The future of the insurance regulation begins now For those involved with the insurance industry, from investmentprofessionals to policy makers, and regulators to legislators,tremendous change is coming. With insurance premiums constitutingan ever-growing portion of annual U.S. GDP and provisions of theDodd-Frank Act specifically calling for modernization of insuranceregulations, the issues at hand are pervasive. In ModernizingInsurance Regulation, these issues are described against abackdrop of the political and industry discussions that surroundinsurance, regulation, and systemic risk. Experts Viral V. Acharyaand Matthew Richardson discuss a variety of issues with topthinkers in the fields of finance, derivatives, credit risk, andbanking to bring to light the most germane elements of this ongoingdiscussion. In Modernizing Insurance Regulation, Acharya andRichardson call on the expertise of all the relevant stakeholderswithin government, academia, and industry to offer a well-roundedand independent view of insurance regulation and how the evolutionof this key industry affects the U.S. economy now and in thefuture. Provides an overview of the feasibility of maintaining astate-level regulatory structure Offers a view of the issues from top academics, industryleaders, and state regulators Explores the debate surrounding the insurance industry andsystemic risk Provides an in-depth look at upcoming changes under theDodd-Frank Act Modernizing Insurance Regulation provides a look into thecrucial changes coming to insurance regulation and an overview ofhow those changes will affect almost everyone.




Solved! Curing Your Medical Insurance Problems


Book Description

Consumer protection advocate Ralph Nader praised Solved! Curing Your Medical Insurance Problems: "Who hasn't been bewildered and outraged by lengthy, inscrutable medical bills and the tricky ways of the health insurers? ....Learn what to watch out for in this volume by authors who know the inside ways of sellers who try to take you to the cleaners." Some say, "You get what you pay for." If only this were true! Too often, consumers find themselves paying much more than they expected, getting much less than they bargained for. Medical care is no exception. In their book, the authors show readers how to spot over-charges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. Furthermore, they presented steps to take to prevent being victimized by "the system." And what is the system? In America, it is a hybrid of private healthcare providers, massive insurance companies, and governments at the state and national levels. Unlike Britain with its single-payer National Health System, this public-private mixed-breed creates the need for patient advocate professionals, who take up the cudgels on behalf of the medically disadvantaged and the financially strapped.




Insurance Claims in New Zealand


Book Description

"Insurance claims are the reason for the existence of the insurance industry. In this comprehensive work, authors Paul Michalik and Chris Boys put claims at the heart of their analysis of insurance law in New Zealand. Insurance Claims in New Zealand is a rigorous and complete presentation of the law relating to how insurance claims are made and assessed in New Zealand. The authors examine issues arising at every level in the process -- from determining the validity of the policy and resolving issues of coverage and exclusion, to assessing the quantum of the loss or damage to be paid. Since 2015, when the first edition was published, there have been a number of developments in Insurance law: the concept of post claim good faith has developed; a number of outstanding unresolved issues have received judicial attention, including the assignment of claims rights, and the fraudulent claims rule; the issue of insurers' liability for defective repairs has been resolved; the Earthquake Commission/Toka Tū Ake's empowering legislation has been substantially overhauled; the Canterbury Earthquake Insurance Tribunal was established; and the Government has begun the work of meaningful insurance law reform"--Publisher information.




Unemployment Insurance in the United States


Book Description

Discusses the unemployment insurance system in which programmes are operated by each state within the minimum standards established by the federal government.