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The National Council on Compensation Insurance (NCCI), a national insurance rating and data collection bureau, specializes in workers’ comp data. Annually, it collects statistics covering over four million workers compensation insurance claims and two million policies. It uses this information to provide, among other things, information on trends in workers’ compensation throughout various industries, which enables them to make insurance rate and loss cost recommendations.

A favorable outlook for workers’ compensation insurance rates

The results so far from this fiscal year’s rate filing cycle, which began in July 2015 and will continue through June 2016, indicate that there could be a good pattern for policyholders moving forward. Of the 32 filings from the NCCI, 23 have been for decreases, 8 have been for increases and one—Illinois—was amenable to a no filing. 

The Federal Reserve’s policies are contributing to lower insurance rates

Although these numbers have not been fully validated, many in the field of workers’ compensation believe that if these numbers hold, results similar to the 2015-2016 filing cycle can be expected for 2016-2017. According to a recent NCCI report, “The economic recovery in the United States remains on track, and continues to progress much as it has for the past several years. In our view, the Fed’s decision to stand pat on the federal funds rate was motivated first by the absence of observed inflation in the US economy, and, second, by a desire not to commit prematurely to interest rate tightening while there remains the possibility of international economic contraction instigated by China and while important sectors of the US economy remain soft, particularly the residential housing market.”

Workplace accidents have been less frequent and less severe

At its last annual meeting in 2015, NCCI offered its opinion that conditions have improved in the workers comp environment with premiums growing nationally in the workers’ compensation systems. Insurance executive Donna Urben says: “This is approximately the third-plus year of consecutive loss cost decrease, for a majority of the states,” and the accompanying lower rates “are driven by frequency and severity trends.” Overall, losses have been moderate and frequency trends have been in decline for several years.

The economy is aiding workers’ comp insurance pricing

Because payroll is used as the exposure base, the economy has a significant effect on workers’ comp pricing. As the economy continues to improve, more people are employed, resulting in more premiums for workers compensation carriers. Add to that an abundant capacity among these carriers to write workers’ comp policies, and it becomes evident that there is a competitive atmosphere, which will give options to consumers, policyholders and insured.

Low inflation, fewer and less severe work accidents, and a relatively strong economy, with falling unemployment and modest wage inflation, all point to a competitive workers’ compensation environment in 2016.

Contact Us For All Your Workers Comp Insurance Needs

It’s a buyer’s market for businesses shopping for workers’ compensation coverage—at least for the foreseeable future. For a competitive quote, contact us online or call (800) 947-1270 or (610) 775-3848.

Hearing loss may be a compensable work injury leading to increased workers compensation insurance costs. Taking steps to reduce the risk of hearing loss is easier than you might think.

Loud noises in the workplace can damage your employees’ hearing. It’s estimated that 22 million workers are exposed to potentially hazardous noise levels at work. The National Institute for Occupational Safety and Health (NIOSH) recommends that workers should not be exposed to noise at a level that amounts to more than 85 decibels for 8 hours. In an effort to create a safer workplace by reducing noise levels, NIOSH suggests an approach that implements controls based on a hierarchy of effectiveness.

Control Workers Comp Premiums by Adopting the Hierarchy of Hazard Controls

Occupational health and safety professionals apply the following actions, listed from most effective to least effective, to reduce or remove a noise hazard:

1. Elimination: Physically remove the hazard
2. Substitution: Replace the hazard
3. Engineering Controls: Isolate workers from the hazard
4. Administrative Controls: Change the way employees work
5. Personal Protective Equipment: Protect workers with special clothing and equipment

Low-Noise Tools

Purchasing low-noise tools and machinery, reducing vibration where possible, providing barriers to isolate workers or loud equipment, and maintaining machinery with proper lubrication are effective methods for reducing noise in the workplace.

In addition, the Occupational Safety and Health Administration (OSHA) requires employers in general industry to maintain a hearing conservation program whenever noise exposure meets or exceeds the eight hour time-weighted average of 85 decibels. Baseline and annual audiograms, employee training, and hearing protection must all be included in the program.

But even with controls and programs in place to eliminate or reduce noise hazard on the job, some employees will experience work-related hearing loss resulting in a compensable work injury resulting in a workers compensation insurance claim.

Hearing loss may be a compensable work injury

The Workers’ Compensation Act provides for benefits for loss of hearing related to exposure to noise while at work, and it’s estimated that $242 million is spent annually on workers’ compensation for hearing loss disabilities.

While most states recognize hearing loss as compensable, the specifics of the law may vary (for instance, in some states the employee must have hearing loss of at least ten percent in both ears in order to be entitled to benefits). The employee must be evaluated by a physician who specializes in hearing problems to determine the percentage of hearing loss, and the worker must show that there was exposure to hazardous noise in the workplace.

The difficulty for any workers’ compensation adjuster will be determining what portion of hearing loss is work-related and what part of the loss is age-related or is due to non-work related activities (shooting a gun for sport or using a chainsaw on weekends). Another issue that the adjuster may face is finding a previous audiogram from which to compare the present test to get a true measure of hearing loss.

Protect your business against hearing loss claims

There are steps that employers can take to eliminate or reduce the size of a hearing loss workers comp claim, and in the process lower your long-term workers compensation insurance costs:

• New employees who will be exposed to excessive noise should have an audiogram completed as part their hiring requirements. This will provide the baseline for any future hearing loss claim.
• Do a risk assessment by having the decibel level of your plant checked. Any noise level above 85 decibels can then be addressed.
• If a worker is constantly exposed to tools and machinery that reach more than 85 decibels, an audiogram should be completed annually.
• The mandatory use of hearing protection (earplugs or earmuffs) should apply to all employees who work in areas of excessive noise.
• All employees should be provided with safety materials that address the importance of hearing protection at work and in non-work related activities that create high noise levels.

Occupational hearing loss is one of the most common work-related illnesses. Safeguard your workers and minimize the costs to your business by effecting and maintaining these essential controls and programs.

Workers Comp Questions? Contact Us!

To learn more about Workers Compensation Insurance, contact us online or call (800) 947-1270 or (610) 775-3848.

Over 4,000 employees are injured, and another 325 die each year in workplace electrical accidents. Do not let this be one of your employees! Protect your employees and minimize your workers compensation insurance costs through proper safety procedures.

Downed electrical wires are one of the leading causes of electrical accidents, and most can be prevented. Being aware and well educated on how to handle these situations can be the difference between life and death!

Extreme Danger: Downed Power Lines

Workers involved in clean-up and recovery efforts are three times more likely, when compared to other occupations with electrical hazards, to be injured or killed by downed and low hanging electrical wires. These disaster scenes are usually very chaotic and uncontrolled, which can easily lead to mistakes and injuries. When first arriving at a scene, it is important to stop and look around, evaluate the situation and assess for any loose or low hanging electrical wires, quickly make a plan, and then proceed.

Safety Tips for Handling Downed Power Lines

Checking on equipment and electrical lines is the first step to ensuring safe working conditions for everyone involved in the effort. It should ALWAYS be assumed that all electrical wires are live and active!

• Downed and low hanging wires must always be considered active, regardless of whether or not they are touching the ground, because voltage may still be running through them and one touch could be deadly! Also keep in mind that all wires are designed differently and just because the wire is well insulated, coated, and weatherproofed does not automatically make it a television or cable wire. It could still be a high-voltage electrical wire.
  
  
• Always assume that all equipment, such as generators and conductors, are live even if they are not sparking or humming. Some of this equipment does not automatically turnoff when damaged, and a simple touch to the equipment or the ground around it could kill you instantly!

Energy that is provided through electrical wires is amazingly powerful! Therefore, its strength should never be tested.

• Never drive over power lines. You run the risk of becoming trapped in your vehicle or at the very least your vehicle could become entangled within the wire. This goes for any equipment vehicles you may be driving.
  
  
• If you are in a regular or equipment vehicle, and you were to come into contact with an electrical wire, ALWAYS assume it is live. Your best choice to resolve this situation is to remain inside your vehicle and place a call for help. If this is not possible, such as if your vehicle is on fire, you need to jump as far away as possible from the vehicle making sure NOT to touch the vehicle and the ground at the same time. Proper landing technique is with both feet together, maintaining good balance, and then continuing to shuffle away in small steps to eliminate the path of electric current, and ultimately electrical shock.

Backfeeding occurs when electrical conductors are unexpectedly energized by outside sources such as lightning, downstream events, generators, and circuit ties/switch points, which can result in additional injuries or death. Therefore, it is important to understand how voltages are spread and how to disable all electrical equipment properly and efficiently from the start.

• Proper lockout/tagout procedures ensure that all necessary energy sources have been properly disabled and do not pose a threat of being reignited due to unexpected circumstances such as lightning or generator reboots.
  
  
• Since electricity spreads outward, in a circular motion throughout the ground, when you move outside of the main point of contact, you can be creating larger, more dangerous voltages. This creates a hazardous situation for yourself and anyone else standing close to you.

Keeping Business Insurance Costs in Check

Safety should be your number one priority for the safety of your employees and as a means to keeping insurance costs – health insurance, workers compensation insurance, liability, and disability insurance – in check. Sharing this information with employees who respond to a clean-up or recovery effort could save a life and help your company’s bottom line.

Contact Us

For more information about saving on all your commercial insurance costs, please contact us online or give one of our experienced agents a call at (800) 947-1270 or (610) 775-3848.

Need something to jolt you awake faster than your morning espresso? Try these government statistics: About 70 percent of people over age 65 will need some type of long-term care during their lifetime, and more than 40 percent will need care in a nursing home at some point.

If you’re one of the many Americans who are not overly concerned about long term care insurance because you believe your kindly Uncle Sam will foot the bill, you should continue reading. 

What is Long-Term Health Care?

When someone requires help with physical or emotional needs over an extended period, this is long-term care. It involves a variety of services—from bathing and dressing to managing money--designed to meet these needs for a short time (several weeks or months) or a much longer period. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own.

Who Will Likely Need It?

While no one can predict how much or what type of long-term care insurance a person might require, there are several factors that can increase the chance of needing it:

• Age: The risk increases as people get older.
• Gender: Because women live longer, they are at a higher risk than men.
• Marital status: Single people are more likely than married people to need care.
• Lifestyle: Poor diet and lack of exercise can increase a person's risk.
• Health and family history: These factors also affect risk.

How to Pay for Long Term Care — the Myths

• Family members: Depending on a person's needs, long-term care can be provided at home by unpaid family members and friends. This option is becoming less reliable, however, as the ratio of available help for each aging family member continues to fall. Today there are about seven potential caregivers for one eighty-year-old requiring long-term care. By 2030 that ratio is expected to fall to 4-to-1 and by 2050 it could be as low as 3-to-1.
  
  
• Medicare: Many people mistakenly assume that Medicare will cover most long-term care costs. And while it does pay for some part-time services for people who are homebound and for short-term skilled nursing care, it does not cover ongoing personal care at home, like help with bathing, dressing, and eating. It may cover the first 100 days in a nursing home, but there will be some hefty co-payments, and nothing will be covered after that.
  
  
• Medicaid: This Federal and State health insurance program for people with limited income and resources can provide help only if you have less than $2000 in assets.
  
  
• Medicare supplement policies: These are not designed to meet long-term care needs, but some policies do cover co-payments for nursing home stays that qualify for Medicare coverage.
  
  
• Reverse mortgages: People who are considering tapping their home’s equity through a reverse mortgage in order to pay long-term care should be aware of the high closing costs, fees, and interest rates. This is not a viable solution for most people.

Long-Term Care Insurance—the Real Solution

Depending on the coverage options you select—from in-home help to nursing home care--long-term health care insurance can help you pay for the care you need. The insurance might also provide payment for adult day care, care coordination (helping you to find appropriate care services) and, in some policies, help pay costs associated with modifying your home so you can continue living in it safely.

Contact Us for Assistance with Long Term Care Insurance

Because the insurance can be set up many ways to pay for a wide range of services and support, it can be complicated. We recommend you spend time with one of our specialists to establish a policy based on your preferences, needs, and budget. Give us a call at (800) 947-1270 or (610) 775-3848.

Sobering Statistics on Business Interruption Insurance

A recent national survey of small businesses yielded some sobering statistics. It found that 66 percent of these businesses do not have business interruption insurance—even though an estimated 25 percent of them will not be able to reopen following a major loss, such as a fire, a break-in, or a storm.

That same survey also revealed that three out of four small business owners do not have a disaster recovery plan, yet more than half of them admit that it would take at least three months for them to recover from a disaster.

Most small business owners are at risk of disaster, but they are least likely to have disaster recovery insurance or a plan in place to help them recover. About a third of the owners say it is not important for their business to have a disaster recovery plan, and they give interruption insurance a low priority.

Business interruption insurance can be as vital as fire insurance

It’s unlikely that anyone would ever consider opening a business without buying insurance to cover damages from fire or windstorms. But many small business owners don’t give serious consideration to how they would survive if a fire or other disaster damaged their business premises and rendered them temporarily unusable. A business that has to close down completely while their buildings are being restored may lose out to competitors. A quick resumption of business after a disaster is essential.

A few key points about business interruption insurance

• Business interruption coverage is not sold separately but is added to a property insurance policy or included in a package policy. 
• It compensates you for lost income if your company has to vacate the premises due to disaster-related damage that is covered under your property insurance policy.
• Business interruption insurance covers the revenue you would have earned, based on your financial records, had the disaster not occurred.
• The policy also covers any operating expenses that continue even though your business activities have temporarily stopped.
• The price of the policy is related to the risk of a fire or other disaster damaging your premises.

A disaster could halt your business—even if your property remains undamaged

You have purchased a standard loss of business income policy, and you may think that you are totally protected from a disaster. Unfortunately, most policies do not cover utility interruptions—power, water, and communications--that originate away from your premises (for instance, the utility generating station may have been damaged or transmission lines could be down).

Losing these services for an extended period can be financially devastating. The first step is to evaluate the exposures facing your company. Will being out of power for hours or days adversely impact your operations and profits? If you come to the conclusion that it will, you should consider an endorsement that extends your coverage to include utility services interruptions.

Get back in business quickly with a Disaster Recovery Plan

In addition to the right insurance, a Disaster Recovery Plan (DRP) - a plan that describes how work can be resumed quickly and effectively after a disaster – is another element to ensure that a disaster doesn’t shut your business down. It consists of the precautions taken so that the effects of a disaster will be minimized and the organization will be able to either maintain or quickly resume critical functions. Typically, disaster recovery planning involves an analysis of business processes and continuity needs; it may also include a significant focus on disaster prevention.

Plans vary from one type of business to another, depending on the processes involved, and the level of security needed. Disaster recovery planning may be developed within an organization or purchased as a software application or a service. It is not unusual for an enterprise to spend 25% of its information technology budget on disaster recovery.

Contact Us for Help with Your Business Interruption Insurance Needs

A DRP, along with business interruption coverage, constitutes the business continuity planning that could rescue your business after a disaster. Depending on your particular business, properly planning for your business interruption insurance needs can be complex, but the well-trained staff at American Insuring Group can help. Click here to contact us or give us a call at (800) 947-1270 or (610) 775-3848.

Employees who are injured on the job may be entitled to compensation for medical care and wage replacement through their employer’s Workers Compensation insurance. The insurance provides medical care, lost wages, and any rehabilitation needed to return to work. Sometimes an employee is permanently and totally disabled or disabled to the point that the employee cannot return to meaningful employment. These cases are usually complex and can be difficult to settle. If a lump-sum cash settlement does not resolve a case, a structured settlement may offer a solution.

What is a Workers Compensation Structured Settlement?

A structured settlement is a financial or insurance arrangement whereby a claimant agrees to resolve a personal injury claim by receiving periodic payments on an agreed schedule rather than as a lump sum. Structured settlements are often used to resolve workers’ compensation insurance cases in which the negotiations between the plaintiff’s attorney and the insurance company have reached an impasse. The responsibility of future payments to the plaintiff falls on an independent third party—usually a life insurance company from which an annuity has been purchased by the workers’ compensation insurer.

Congress has encouraged the use of these settlements through the federal tax code since 1983. Internal Revenue Code section 104 specifies the amount of each payment, and the earnings on payments are excluded from the settlement recipient’s income.

Not all payout schedules from a structured settlement are alike. There are three main forms of periodic payments from a structured settlement:

• Deferred Lump-sum Payments: Payments are structured under a schedule of pre-determined dates. These payments are usually larger than regular periodic payments.
• Flexible Settlement Plan: Payments in this plan consider the needs of the injured worker—important future events at different stages of life—while maintaining control of the costs for the employer and insurer.
• Period Certain Annuity: The injured employee gets a larger settlement by agreeing to shorten the time period that the annuity will pay.

An initial lump-sum payment can be included in the settlement to cover such items as housing and transportation, and the settlement can also be structured to increase periodic payments at fixed dates in the future to account for inflation.

Advantages of Structured Workers Comp Insurance Settlements

Structured settlements are helpful for the injured worker in compensation cases. They can be set up to provide tax-free money for long-term and immediate needs, while eliminating the worry of managing a large amount of money. In most cases, a structured settlement will provide more money over the long term than the employee would realize from a cash settlement. The plan can be structured around age and life expectancy, thereby providing funds for maintaining medical treatment, future surgeries, and replacement of durable medical equipment.

The closure of the claim, expedited through a structured settlement, is a major benefit to the employer. It also avoids the uncertainty of litigation and all of the expenses that go with it. In the case of a disability that lasts a lifetime, all of the mortality and investment risk is transferred to the third-party insurer.

Insurers benefit because they free up money that would have been used for a lump-sum settlement and can now concentrate on other cases.

The employee’s lawyer has a satisfied client for whom he has provided financial stability.

A word of caution

A structured workers comp settlement is a flexible tool for resolving troublesome claims. Keep in mind, however, that each state has different laws with regard to settling workers’ compensation claims. Be sure to partner with a professional who can confirm the laws of your state.

Learn More About Workers Compensation Insurance

For more information and advice on workers compensation insurance, contact us online or give us a call at (800) 947-1270 or (610) 775-3848.

Avoidinging Workers Compensation Insurance Claims via Risk Awareness

For construction workers and others whose jobs require them to be outside, winter means a few months of extreme cold and challenging days, during which they will be susceptible to cold-related injuries.

In addition to injuries resulting from slips and falls as temperatures dip below freezing, there is also the risk of cold stress. Cold Stress is the result of skin temperature being lowered, ultimately resulting in a reduced core body temperature.

The human body’s natural reaction when exposed to cold environments is to maintain its core temperature. To do so, blood shifts away from less critical body parts--hands, feet, arms, legs and skin--to concentrate in the vital chest and abdomen areas. As a result of the blood shift, the body parts containing less blood face an increased risk of cold-related injuries. Under severe conditions, tissue damage and death may occur.

Cold stress and the risk of cold-related injury can be reduced by increasing management and worker awareness of the hazards. In order to ensure a safe working environment, mitigate risk and prevent workers' compensation insurance claims, it is important to understand the elements of cold stress. 

Types of cold stress facts you need to know

• Hypothermia involves a severe loss of body heat, resulting in shivering, confusion, and loss of motor skills to an extent where workers cannot replenish their warmth.
  
  
• Frostbite is the freezing of an area of the body, typically the nose, ears, cheeks, fingers or toes. Severe cases of frostbite may lead to amputation. Symptoms include numbness, hard skin, tingling or blisters.
  
  
• Trench foot occurs when a worker's feet remain damp for a prolonged period of time. Although not directly tied to extreme cold (wet feet can contribute to the condition in warmer temperatures), it is a threat in winter with symptoms of red skin, numbness swelling, or bleeding.

Workers can help prevent cold stress

Workers will be able to monitor their own health and identify problems with colleagues if they understand the symptoms of cold stress. Following some simple guidelines will also help them to prevent cold stress injuries:

• Dress in several loose-fitting layers and don’t forget boots, gloves, and a warm cap
• Have at least one layer of waterproof clothing to protect at least some of their other clothing from getting wet
• Take breaks to get warm. If possible, go indoors for a few minutes or at least get out of the elements
• Stay hydrated. This is every bit as important in winter as it is in hot weather
• Keep spare clothing nearby in case the clothing they’re wearing gets wet

What can employers do about cold stress?

A cooperative approach with employees is important. A cold stress prevention program, outlining steps to limit cold stress and reduce risk of injuries and illnesses, is a good start.

Another step you can take is a review of your scheduling. If at all possible, plan outdoor work, equipment repairs and other tasks when the weather is more favorable. While it is not always possible to prevent workers from operating outside at all times, especially in the construction industry with its deadline pressures, you can limit the length they have to spend in the coldest temperatures. 

Next, you must train your team. Review the symptoms of cold stress in a group meeting. Emphasize the safety measures that workers must take, and discuss the best emergency response methods and who to notify should an employee begin to show signs of cold stress.

Finally, you need to provide resources for your workers. These can include insulated clothing, a heated shelter, warm beverages or educational materials. Above all else, call attention to cold-weather safety this winter. These measures will help to keep your workers on the job and your workers compensation insurance costs low.

Control Your Workers Compensation Insurance Cost

Click here to contact us for more information about reducing the cost of workers compensation insurance, or give give us a call at (800) 947-1270 or (610) 775-3848.

Today’s businesses cannot operate without the aid of technology. Most companies do a significant portion of their business interactions online, and they are storing more sensitive information on their computers than ever before.

Even though technology has had a tremendously positive impact, it also comes with the inherent risk of data breaches.

As technology advances, these threats have become more difficult to resolve. Hence, the growing need for cyber liability insurance, also known as cyber insurance.

Data Breaches Affect Smaller Companies, Too

Data breaches at larger corporations-- Target and Neiman Marcus, for example—should not overshadow the more frequent security infringements that target smaller businesses. Many small business owners may not think they need cyber liability insurance; however, since half of all data breaches happen to small businesses, they are actually very vulnerable to security threats.

This should convince every enterprise, regardless of size, that cyber security and cyber insurance are worth considering. Whether it’s the theft of intellectual property or user data, a cyber breach can have unfavorable effects on your reputation, customer confidence and brand name.

The High Cost of Data Breaches

When criminals get access to your company’s databases, they become privy to a collection of information--Social Security and credit card numbers, addresses and other identifying data. Once they gain access to sensitive business data, they can use it to open and access accounts, steal money and destroy the affected individuals’ credit. And, of-course, a data breach can also cost the company that was breached thousands of dollars.

Some of these costs include:

• Lost profits and opportunities: When your company closes its doors while the data breach is investigated, sales and profits stop. And negative publicity and diminished customer confidence can decrease your sales significantly
  
  
• Updating or implementing your security system: New software, infrastructure and training in procedures and policies for your personnel can cost a great deal.
  
  
• Concessions to customers: Many businesses affected by data breaches offer free credit monitoring services, discounts, and promotions to help regain customers’ trust and loyalty.
  
  
• Bankruptcies and business closures: Stolen resources and the expense of responding to the breach can drain the limited resources of many small businesses.

Take Steps to Protect Your Business from Breaches

The best way to protect data is through a comprehensive cyber security policy. This will include keeping sensitive data on a "need to know" basis, employing network security and firewalls, and training employees on the proper care and control of customer data.

Employees need to understand the sensitivity and liability related to customers' financial and personally identifiable information. It is critical that you document your processes and conduct regular training sessions, as well as security audits, to ensure compliance.

Business owners should be aware that standard commercial insurance policies don’t offer the special protections afforded by cyber insurance, and in some cases, specifically exclude cyber threat coverage. Cyber insurance policies generally safeguard against viruses and hacking, and intervene if a breach does occur.

The Benefits of Cyber Insurance

If you run a small business, you may not have time to adequately manage your web security. Cyber threat policies can provide periodic reviews and assistance. Other benefits include:

• Reimbursement for Fees and Penalties. Insurance benefits could reimburse you for additional staff you hire to recover from a cyber-attack, paperwork or filing fees, or other related costs.
  
  
• Business Interruption Protection. The smaller your business, the more income you lose if you’re temporarily sidelined. Cyber insurance can offset losses.
  
  
• Legal Help. If a data breach results in legal action, your plan could help find expert counsel, as well as cover legal fees and judgments against you

Regardless of a company’s size or industry, business owners must take preemptive action to secure their customers’ valuable data against the possibility of a cyber-attack. In addition, investing in cyber liability insurance protects your assets should such an event occur.

Learn More About Your Cyber Insurance Options

To learn more about cyber liability insurance options and cost, and to find the cyber insurance policy that's right for your business, click here to contact us, or call us at (800) 947-1270 or (610) 775-3848.

Being denied life insurance can be scary...

Life insurance offers the peace of mind of knowing your family will have a financial safety net if you’re no longer there to provide one. While most people think obtaining coverage is as simple as filling out a few forms, that’s not always the case.

What should you do after you try to buy life insurance coverage but end up being denied? It can be a scary situation. You ask yourself why this happened and where you go from here. 

First of all, don’t get too upset. You’re not out of options. Begin by trying to find out why you weren’t approved. Next, take some steps toward a better outcome.

Reasons you may have been denied life insurance coverage

• You have a specific health condition: If you have elevated cholesterol or glucose levels, or previously had a heart attack or cancer, you may be denied coverage.
  
  
• You participate in high-risk activities: Sky diving, mountain climbing, and flying as a recreational pilot are considered risky hobbies that could get you turned down.
  
  
• You’ve been caught driving under the influence: Most companies won’t insure you if you’ve had multiple DUI’s. If it’s only been once, you might be able to shop around and get insurance coverage.
  
  
• You are overweight or obese: The red flag pops up for these conditions because they often lead to severe health complications, particularly cardiovascular issues.
  
  
• You use drugs: Life insurance companies will want to know about any kind of drug use--both legal and illegal. Illegal drug use is an obvious reason for denial. But the regular use of legal medications may point to an underlying medical condition and could hurt your case as well.

This is not an exhaustive list, but it can give you an idea of some of the factors that are considered after a life insurer receives your application.

What to do if you’ve been denied life insurance coverage

1. Learn why you were denied.  Before an insurance company denies an application, they collect lots of data from several sources to evaluate your risk. If the risk is high, you will be rated, postponed or denied. In any of these circumstances, you are encouraged to ask the life insurance company for the specific reason of denial for your application. A denial stemming from a current exam tends to be the most disturbing, since you may not have known about an illness or disease beforehand. But stay positive and be thankful that the issue was discovered, so that you can take steps to resolve it.
   
   
2. Confirm the results. You signed an authorization for the underwriter to pull your medical records. If poor exam results were cited as the cause of denial, order these records and check with your doctor to verify their accuracy. Sometimes, mistakes are present in the medical records and need to be fixed. In other cases, you could be denied for recreational hazards, criminal records and even financial issues. If these records haven’t been updated or are lacking in detail, they can lead to postponement or denials because the underwriter simply can’t properly assess your risk profile. Make sure all of your records are accurate and notify the insurer if any discrepancies are discovered.
   
   
3. Work with an independent life insurance agent. After you uncover the reason and fix the errors, you should work with an agent to find coverage. Every insurance company has its own criteria for assessing the risk of its applicants, and independent agents know which companies are more likely to approve you based on your health and your lifestyle.

Contact Our Independent Life Insurance Agents for Help

Knowledge is power, so find out why you were denied. Then, straighten out all of your records and work with an experienced independent life insurance agent to obtain the coverage you need.

Contact one of AIG’s experienced agents here or call us at at (800)  947-1270 or (610) 775-3848.

Workers Compensation Insurance as a Third Party for Medicaid

Medicaid is an entitlement program, jointly funded at the state and federal levels, which provides healthcare--both medical and long-term custodial care--to the poorest population of the United States.  Not to be confused with Medicare, the federally funded program available to most U.S. citizens and permanent legal residents who are age 65 or older, eligibility for Medicaid is means-based, and the program has strict income eligibility requirements that vary from state to state.

However, Medicare and Medicaid are not mutually exclusive--it is possible to be on both of those programs at the same time.

It is not unusual for Medicaid recipients to have additional sources of coverage for health care services. Since federal law dictates that Medicaid is the “payer of last resort,” this means that if another insurer or program (a third party) has the legal responsibility for costs involving a Medicaid-eligible individual, that “third party” is normally required to pay all or part of the cost of the claim before Medicaid makes any payments. Workers compensation insurance is one such third party insurer.

The Expansion of Medicaid

In the past, it had been uncommon for workers’ compensation claimants to also be entitled to Medicaid. If you were employed, chances were that you had too much income to qualify. That changed with the Affordable Care Act of 2010. Obamacare, as it is often called, expanded Medicaid coverage and allowed more workers to qualify for the program. Today, all U.S. citizens and legal residents, including adults without dependent children and with income up to 133% of the published poverty threshold, qualify for coverage. 

Workers’ Compensation Insurance and Medicaid Recovery

When Medicaid has paid the costs of an employee's medical treatment that was due to an employment-related injury, the workers' compensation carrier may find itself in the position of reimbursing Medicaid. Even if the carrier is unaware of the employee's entitlement to Medicaid benefits, it may still be liable for payment of past or future medical bills.

In December of 2013, Congress passed The Bipartisan Budget Act of 2013 (“Budget Act”). The Budget Act included a Medicaid Secondary Payer provision, which gave state agencies the ability to recover costs from a beneficiary’s entire settlement, rather than only those settlement proceeds designated as compensation for medical expenses. The Medicaid Secondary Payer provision was initially set to be effective on October 1, 2014. However, on March 31, 2014, Congress passed a bill that delayed the effective date until October 1, 2016, giving Congress and the states two extra years to evaluate the impact of the Secondary Payer provision.

Consequently, it becomes particularly important for a workers comp insurance carrier to evaluate a number of considerations during the settlement stage of a claim. It is also important that claim management teams become proactive when dealing with Medicaid recovery issues:

• Stay updated on any changes in Medicaid Secondary Payer recovery
• Identify claims from those who are receiving Medicaid benefits at the time of the insurance claim or who could become beneficiaries in the future
• Keep all parties that are involved in your settlements informed of Medicaid recovery efforts
• Put all appropriate state agencies on notice of their intervention and recovery rights

There is considerable effort being made to protect Medicaid's interests--especially in cases where Medicaid has absorbed the costs of medical treatment for which another party is deemed responsible. And some states are already beginning to flex their enforcement and recovery muscles in anticipation of Medicaid Secondary Payer becoming effective in October of 2016.

Help With All Your Workers Compensation Insurance Needs

If you have questions about this constantly evolving issue or workers’ compensation insurance in general, or if you would like to consider changes to your worker's comp insurance coverage, then contact us at (800) 947-1270 or (610) 775-3848.