A Snohomish County woman who admitted to forging thousands of dollars in receipts for an insurance claim has paid $69,610 in restitution to her insurance company, State Farm. The case was investigated by the company and the Office of the Insurance Commissioner’s Special Investigations Unit.
Juli-Anna Rowe, 45, of Issaquah, has signed a diversion agreement with the Snohomish County Prosecutor’s Office. She agreed to pay full restitution of $66,610 – which she has done – and to attend a theft-awareness program and therapy. After three years, if Rowe completes the program as agreed, the insurance-fraud charge of “false claims or proof” will be dismissed.
The case stems from a 2005 insurance claim. On June 3, 2005, Rowe said, she loaded a rented U-Haul moving trailer with $85,370 in personal property and drove from her home in Washington toward her destination in California. In Oakland, Calif., she stopped to rest at a hotel. While there, she said the contents of the trailer were stolen.
State Farm paid Rowe $54,421 for the value of the property she said had been stolen. Her policy also allowed for nearly $31,000 in additional claims when she replaced some of the missing property.
In filing those additional claims, however, Rowe submitted numerous altered and forged receipts. In an interview with a detective from the state insurance commissioner’s special investigations unit, Rowe admitted to altering receipts by cutting and pasting increased amounts onto them, photocopying the forged papers and submitting those to State Farm. She also admitted that she did not replace all of the items she claimed she had.
Under the terms of her policy, intentionally concealing or misrepresenting any fact involved in a claim voids the entire claim. So Rowe paid back the $54,421 that State Farm had paid out, plus $15,189 in investigation expenses incurred by the insurer.
Special Investigations Unit Detective Sgt. Dan Sharp praised the work of State Farm on the case.
“They identified the fraud and did much of the initial investigation, making it easier for us to move ahead with this case,” he said.
Jumat, 30 Oktober 2009
Insurance news, the Halloween edition
Lots of scary stories in the news today.
First off, pay and benefits are rising at the slowest rate since 1982, according to the Associated Press.
And today brings a long list of stories expressing reservations about the federal health care reform debate in Congress. A sampling:
-Health Care Businesses at Risk in House Overhaul (AP),
-Will the Public Plan Have Higher Premiums than Private Insurance? (WA Post's Ezra Klein)
-and the Magic of Financing Health Care Reform (The New York Times Economix blog has a down-to-earth -- and worrisome -- explanation of the budget-savings assumptions in the health reform plan)
Also in the scary department is a New York Times column written by an economics professor, who argues that federal health reform "is due to explode." Why? He says that requiring everyone to buy coverage or get it through their employers would drive down wages: "In other words, millions of people would be compelled to spend lots of money on something they previously did not want, at least not at prevailing prices."
First off, pay and benefits are rising at the slowest rate since 1982, according to the Associated Press.
And today brings a long list of stories expressing reservations about the federal health care reform debate in Congress. A sampling:
-Health Care Businesses at Risk in House Overhaul (AP),
-Will the Public Plan Have Higher Premiums than Private Insurance? (WA Post's Ezra Klein)
-and the Magic of Financing Health Care Reform (The New York Times Economix blog has a down-to-earth -- and worrisome -- explanation of the budget-savings assumptions in the health reform plan)
Also in the scary department is a New York Times column written by an economics professor, who argues that federal health reform "is due to explode." Why? He says that requiring everyone to buy coverage or get it through their employers would drive down wages: "In other words, millions of people would be compelled to spend lots of money on something they previously did not want, at least not at prevailing prices."
National licensing group names OIC staffer "Regulator of the Year"
The Securities and Insurance Licensing Association (SILA) has named a Washington state insurance program manager “Regulator of the Year,” in recognition of his contribution to the state’s efforts to modernize and streamline licensing of insurance agents and brokers. (In Washington, agents and brokers are now known as “insurance producers.” )
Award winner Jeff Baughman, who works for Washington Insurance Commissioner Mike Kreidler as the Licensing and Education Program Manager, was named this week at a ceremony in Phoenix, Ariz.
SILA’s “Warren E. Spruill Regulator Recognition Award” is given annually to a regulator who works to better the relationship between insurance departments and the industry.
Washington’s Office of the Insurance Commissioner has been working hard to make it possible for all licensing transactions, including accepting new applications and renewals, to be performed over the Internet. The online system was completed earlier this year.
Baughman also served as the agency’s business lead in implementing statutory changes on July 1st that brought the state very close to full compliance with the national standards for uniformity and reciprocity in the licensing of agents and brokers. Kreidler is proposing legislation to complete that goal, including dropping a fingerprinting requirement for background checks for non-resident applicants.
“We couldn’t be more pleased to see the work of Jeff and the agency recognized at the national level,” said Deputy Insurance Commissioner John Hamje. “We’re very proud of Jeff, and are equally proud of the numerous other agency staff members who’ve worked to make these projects a reality since they were first initiated in 2004. Everyone involved in this process should take great pride in this award.”
Award winner Jeff Baughman, who works for Washington Insurance Commissioner Mike Kreidler as the Licensing and Education Program Manager, was named this week at a ceremony in Phoenix, Ariz.
SILA’s “Warren E. Spruill Regulator Recognition Award” is given annually to a regulator who works to better the relationship between insurance departments and the industry.
Washington’s Office of the Insurance Commissioner has been working hard to make it possible for all licensing transactions, including accepting new applications and renewals, to be performed over the Internet. The online system was completed earlier this year.
Baughman also served as the agency’s business lead in implementing statutory changes on July 1st that brought the state very close to full compliance with the national standards for uniformity and reciprocity in the licensing of agents and brokers. Kreidler is proposing legislation to complete that goal, including dropping a fingerprinting requirement for background checks for non-resident applicants.
“We couldn’t be more pleased to see the work of Jeff and the agency recognized at the national level,” said Deputy Insurance Commissioner John Hamje. “We’re very proud of Jeff, and are equally proud of the numerous other agency staff members who’ve worked to make these projects a reality since they were first initiated in 2004. Everyone involved in this process should take great pride in this award.”
Kamis, 29 Oktober 2009
On average, how much do workers pay for health insurance coverage?
For weeks, the Associated Press has been running a series of thumbnail sketches detailing different aspects of the health insurance reform debate going on in Congress.
Today's, published locally in the Seattle Times, answers one of the most frequent questions we get at the Washington state insurance commissioner's office: On average, how much do people pay for health coverage?
For the answer, the AP turned to the Kaiser Family Foundation's 2009 survey, which found that employer-provided coverage for one worker costs an average of $4,824 a year, with the worker paying an average of $779.
To cover a family, the cost is $13,375, with the worker paying $3,515.
But click on both links -- there's more data there about what those costs might look like in a few years, and some discussion about the potential effect of federal reform.
Today's, published locally in the Seattle Times, answers one of the most frequent questions we get at the Washington state insurance commissioner's office: On average, how much do people pay for health coverage?
For the answer, the AP turned to the Kaiser Family Foundation's 2009 survey, which found that employer-provided coverage for one worker costs an average of $4,824 a year, with the worker paying an average of $779.
To cover a family, the cost is $13,375, with the worker paying $3,515.
But click on both links -- there's more data there about what those costs might look like in a few years, and some discussion about the potential effect of federal reform.
Insurance news: Health insurance gift cards at the supermarket, "cowboys" underpricing coverage, and Aetna's financials...
The health insurance reform news today is dominated by House Democrats unveiling their legislation, including a public option. Here's the LA Times' take.
The Washington Post's Ezra Klein takes up the interesting question: Will Any States Actually Opt Out of the Public Plan?
And the Miami Herald discovers a surprising development at the local Winn-Dixie: Gift cards to help pay for health insurance.
Here in rainy Washington state, insurance commissioner Mike Kreidler's calling for legislation to help a flood-threatened area south of Seattle get coverage. An insurers' group argues that the proposal "comes too soon and goes too far," acording to this article in Insurance Journal.
There's an interesting story on the Bloomberg wire: Zurich-based Ace Ltd. CEO Evan Greenberg says that insurers are underpricing their policies, "with `cowboys' setting unreasonable rates for coverage." The article quotes another executive as saying that rates may not increase until 2011 as insurers compete for business in a shrinking market. The story also comes on the heels of this report (which, yes, I blogged about yesterday) which talks about the possibility of a long-term reduction in insurers' investment returns. (See page 57.)
At Aetna, meanwhile, 3Q profit grew 18 percent, with executives saying in an AP story that they "finally have a handle on rising medical costs" that hurt profits earlier.
The Washington Post's Ezra Klein takes up the interesting question: Will Any States Actually Opt Out of the Public Plan?
And the Miami Herald discovers a surprising development at the local Winn-Dixie: Gift cards to help pay for health insurance.
Here in rainy Washington state, insurance commissioner Mike Kreidler's calling for legislation to help a flood-threatened area south of Seattle get coverage. An insurers' group argues that the proposal "comes too soon and goes too far," acording to this article in Insurance Journal.
There's an interesting story on the Bloomberg wire: Zurich-based Ace Ltd. CEO Evan Greenberg says that insurers are underpricing their policies, "with `cowboys' setting unreasonable rates for coverage." The article quotes another executive as saying that rates may not increase until 2011 as insurers compete for business in a shrinking market. The story also comes on the heels of this report (which, yes, I blogged about yesterday) which talks about the possibility of a long-term reduction in insurers' investment returns. (See page 57.)
At Aetna, meanwhile, 3Q profit grew 18 percent, with executives saying in an AP story that they "finally have a handle on rising medical costs" that hurt profits earlier.
Insurance news: New report about climate and challenges for insurers
A new report from the Insurance Information Institute talks about the nation's financial crisis and how it's hit insurers. It includes an excellent overview of the recession compared to how far/quick the nation's bounced back from previous downturns.
Among the points in the 110-page report: that state and local government finances are in dire straits, with "large, long-term cuts necessary to align spending with shrinking tax revenues." And study author Robert Hartwig says the issues and threats facing insurers include larger-than-usual recent losses, long-term reductions in investment earnings, and the threat of inflation eating further into those earnings.
(Here's a PowerPoint link to the same presentation.)
Among the points in the 110-page report: that state and local government finances are in dire straits, with "large, long-term cuts necessary to align spending with shrinking tax revenues." And study author Robert Hartwig says the issues and threats facing insurers include larger-than-usual recent losses, long-term reductions in investment earnings, and the threat of inflation eating further into those earnings.
(Here's a PowerPoint link to the same presentation.)
Selasa, 27 Oktober 2009
White House report: Rural Americans face higher poverty, less health coverage, and little choice
The White House has put out a report about rural health care, trying to make the case that rural Americans -- with less insurance, higher poverty, fewer providers and fewer good-benefits jobs -- stand to benefit from the Obama administration's health reforms more than most. Among the findings:
Rural Americans pay for nearly half of their health care costs out of their own pocket, and one out of every five farmers is in medical debt.Click here to read the report.
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