Health & Benefits

August 16, 2015

Discount Health Benefits Plans: A Sensible Alternative To Traditional Insurance Plans

A recent poll revealed that over 70% of Americans are either uninsured or underinsured. Surprisingly, the majority are from middle class households. Many of who are not offered health benefits by their employer or whom can’t afford the high-priced insurance premiums being offered.

In some states, there is an epidemic of children whose teeth are slowly rottening due to the lack of proper dental care. To help bring relief to this growing crisis, discount health care benefits providers have emerged. These companies do not provide health insurance, but they give an alternative that allows consumers to receive discounted fees per service. Unlike traditional insurance plans, these companies often have little or no exclusions, such as pre-existing conditions. Another plus is that consumers with immediate health care needs, can usually be seen by a doctor without having to wait for their coverage to “kick in”.

A potential drawback to discount health benefits plan is that consumers will pay for services upfront or at the time of service; unless other arrangements are made with that individual provider. This, in contrary to paying a co-pay or deductible at the time of service. Consumers with flexible spending accounts or medical savings accounts will be able to take advantage of this circumstance.

In some situations, depending on your health care provider’s policies, consumers have been able to use both the discount health plan alongside their insurance for even deeper savings. For example, you go into the dentist office for an extraction. The bill is $300. You h and your discount card to the insurance department, she gives you the discount, which normally ranges from 50 – 80%. This cuts your bill by up to $240! Leaving you with $60 left to pay. You pay the $60. Then file a claim with your insurance company for the $60. Let’s say your insurance company pays 80% of your bill. They will refund you $48 (80%), leaving you with a net bill of only $12, for what would have cost $300 normal price, or $60 with your insurance alone.

While some consumers are struggling with the high and growing price of insurance, others are discovering the savings of discount health benefits plans. By the year 2010, it is predicted that consumer driven health care, will be the future, leaving traditional insurance plans, to be a thing of the past.

July 24, 2015

Critical Illness Needn’t Hurt Your Bank Account, Too

In the time it takes you to read this sentence, the bills from a critical illness may have forced yet another American to file for bankruptcy. It could be as a result of their own illness or a loved one’s, but the result’s the same: Half of all bankruptcies are due to serious illness, according to a recent Harvard study, and-of those-75 percent were forced to file despite having health insurance.

One new option consumers have to help cover all expenses associated with critical illness is called, appropriately, Critical Illness Insurance. This specialized insurance provides a lump-sum payment should a subscriber suffer from certain specific critical conditions.

Right now, one of the few companies offering such insurance is Stonebridge Life Insurance Company. However, experts say that as Americans continue to survive critical ailments that were fatal only a few years ago, the need for the insurance is increasing. Stonebridge Life Insurance Company gives policyholders a one-time payment of up to $50,000 as soon as they’re diagnosed with a covered cancer, stroke, paralysis or a heart attack. The payment is intended to help people meet basic expenses, such as mortgage payments, car insurance, groceries, child care-even ballet lessons.

“Many people aren’t aware of the financial consequences of surviving a critical illness, especially if they’re unable to work for an extended period of time while they recover,” said Marlene Jupiter, author and expert on personal finance. “Now that medical progress and early detection are helping more people live through serious illnesses, people need to plan for how they’re going to financially survive the aftermath.”

For monthly premiums as low as $20, Critical Illness Insurance from Stonebridge Life is a direct-to-consumer product offering lump-sum payment options of $10,000, $20,000, $30,000 and $50,000. As an added benefit, the plan offers a return of premium option. Customers who sign up before the age of 50 and select this option may receive their paid premiums in full if they don’t make a claim before age 65.

“There is an increasing need for critical illness insurance because it helps close the gap that exists between health and disability plans, making sure that survivors are financially supported throughout their recovery process,” explained Lew Whalen, vice president of Stonebridge.

July 23, 2015

Critical Illness Insurance The Non-Disclosure Problem

If you’re in the unfortunate position of having to make a claim on your critical illness insurance policy, the last thing you want is insensitive hassle or apparent non co-operation from your insurer. But according to numerous newspaper articles, that’s precisely what’s happening. The core problem is that before they’ll pay out, the insurer will always want to make exhaustive enquiries about your past health record. Whilst you’ll have provided them with lots of similar information when you initially applied for the cover, the insurers will now insist that all the information is rechecked. And if at the time you said you weren’t a smoker, they’ll now want this verified by your doctor.

The reasons are obvious. They’re faced with a big claim, typically way over £100,00, and they want to be certain that you told them the entire truth about your health when you first applied. This means that now you’ve claimed, they’ll crawl over your medical records in great detail checking that you disclosed everything on your application. Every small and apparently insignificant detail will be subject to intense scrutiny. The problem is that their reams of correspondence can be quite upsetting for you.

The insurers defend their procedures saying that they need to be certain that when they accepted the business, you disclosed the full truth about the factors affecting your health. They want to be sure that you didn’t cheat by omitting some information in order to dupe the company into issuing a policy when they otherwise might not, or to help you qualify for a lower premium. Either way, non-disclosure as they call it, is cheating and a valid reason for them refusing your claim. It doesn’t even matter if the information you omitted ultimately had nothing to do with the illness that occasioned the claim. The insurers position is that every piece of information you provide was used to work out your premium and any omission affects the calculation.

The insurers are particularly distrustful if the claim arrives within the policy’s first five years. Any claim arising during this period is classed as an “early claim” and the insurers are particularly watchful for policyholders who took out the critical illness insurance already suspecting that that they were already ill.

The problem is that all this intense scrutiny attracts a very bad press. If you’re very sick and distressed, the last thing you want is lots’ of questions and high-h anded hassle from your insurer.

There’s undoubtedly a conflict here. If they are to neutralise the bad press, the insurance companies need to work much harder at softening the enquiry process and they must liase much more closely with their claimants. Insurers must present a much softer centre at what is a most distressing time for their claimants.

All this adverse PR has had two effects on the critical illness insurance market. Applicants have apparently been favouring insurers who publish the lowest rejection rates and others have withdrawn from making any application.

In practice, avoiding insurers who publish high refusal rates has little benefit. That’s because the published figures can be misleading. The latest figures show that Scottish Equitable Protect has refused to pay out on 28% of critical illness claims followed closely by Friends Provident at 25%. If you compare these figures with Scottish Provident at 13.7%, many potential policyholders can be forgiven for favouring Scottish Provident. But that’s not necessarily the best decision.

The problem with interpreting these figures is that the figures themselves can be distorted by how long the insurer has been active in the critical illness market. As rejection rates are highest with policies that have only run for a few years, then companies that are new to the critical illness market will automatically have the highest rejection rates. This leaves companies such as Guardian Financial Services looking good with a rejection rate of just 10%. The truth is that the Guardian has been in the market for over 15 years and has a mature book of business.

And it’s a pity that all this negative publicity has undermined confidence in critical illness insurance. In our view, this insurance plays an important part in protecting family finances but people are being deterred from buying it, leaving their family unit exposed if they become seriously ill. After all, if the main income provider is taken seriously ill, the family’s income can plummet. That means that the tax-free lump sum paid out by these policies can become central to the family’s financial survival.

Our advice is if you think you need critical illness cover press on. But be aware that these policies vary a lot in the cover they offer – so straight price comparisons aren’t really meaningful. Basic plans will cover one or more of the most serious conditions but comprehensive plans cover many more – for example:

Alzheimer’s disease
Aorta graft surgery
Aplastic anaemia
Bacterial Meningitis
Benign brain tumour
Blindness
Cancer
Cardiomyopathy
Chronic lung disease
Coma
Coronary artery by-pass surgery
Creutzfeldt-Jakob disease
Deafness
Dementia
Heart attack
Heart valve replacement or repair
HIV or AIDs from an assault, blood transfusion, occupational duties or accident
Keyhole heart surgery
Kidney failure
Loss of independent existence
Loss of limbs
Loss of speech
Major organ transplant
Motor Neurone disease
Multiple Sclerosis
Paralysis/Paraplegia
Parkinson’s disease
Progressive Supranulcear Palsy
Stroke
Third degree burns
Total and Permanent Disability
Cover for children

This complexity means that you really need independent advice. There are plenty of web sites that can help you. Just search for “critical illness insurance” and make sure you can talk to an adviser before you buy.

July 22, 2015

Critical Illness Insurance Is Critical

A difficult time in life can teach you what’s really important. Just ask anyone whose life took a sharp turn when a medical problem was discovered.

First off there are expenses, a difficulty for any family but which are a special challenge for any family who are covered by a limited medical insurance policy or have no insurance at all.

If you have limited medical insurance, there is sometimes just not enough to pay the bills. You could have costs of staying near a clinic while hoping and praying that you will get well.

Some people have family members and friends who have started get well funds to help pay expenses. But all of this doesn’t answer why there was no critical illness insurance.

This Is Why Critical Illness Insurance Is Important

Critical illness insurance is important as what you are doing is insuring your income , just like you insure your house. You wouldn’t own a house without insurance, so why do you walk around without insurance against a personal catastrophe? You’ll never know anything about expenses until you confront expenses caused by a major illness! From no income coming in to all the savings going out, families can be left in a great bind. Now that you’ve bothered to read this article, call your life insurance broker who sells critical illness insurance and get to know the difficulties you may face. And more positively, how you can solve them.

July 21, 2015

Critical Illness Insurance Do you really need it? Or is it a waste of time?

GREAT NEWS! There’s now a one in five chance of you winning the lottery before you retire.

Getting excited? Think it’s just a matter of time before you win? Think again, it’s not going to happen – but it got you thinking!

Now think of the same odds but this time about bad news. There is a 1 in 5 chance for men and a 1 in 6 chance for women that a long-term critical illness will prevent them from working. Sorry – this time it’s true.

Insurance cannot change those odds but it can alleviate the potential financial wreckage caused by being unable to work through long-term illness and still having a family and home to support.

Convention declares that every good family man should have life insurance. It’s easily understood, it’s accepted and your next door neighbour has it too. But what about it’s close cousin critical illness insurance? You’ll have to walk several streets to find someone who has it. Given the odds, why? After all it pays out a tax-free lump sum immediately an insured critical illness is diagnosed.

The usual reason given is its expense. Yes it is more expensive than life insurance but after all it’s providing cover for a greater risk. You’re much more likely to experience a critical illness than die before your normal retirement age. Indeed, the average age for a claim is 47. So clearly there is much more to the public’s resistance.

Not underst anding the risks or “head in the s and syndrome” are certainly major factors. After all a lzheimer’s disease, bacterial meningitis, brain tumours and leukaemia plus the long list of other illnesses typically covered by critical illness insurance, are not matters we care to think of nor know much about.

Could there be another reason? Well there have been repeated newspaper articles about people who claim on their critical illness policy only to have it turned down on an apparent technicality – the inference being that the insurance company cannot be trusted. Indeed, St andard Life freely admits that it turns down around 20 % of critical illness claims.

The truth is that behind every story of rejection there’s a harrowing story of illness, distress and sorrow – and potential copy for the journalist. But that in itself, is not evidence that the insurance company is guilty of devious behaviour.

Yes insurance companies do make mistakes, but more often than not the claim was invalid from the outset. There are two main causes. Firstly, the policyholder is claiming for an illness that is not one of the critical illnesses scheduled in the policy documentation. Regrettable, but it’s a fact that if the illness is not listed it isn’t insured and the policy won’t pay out.

The moral is to closely compare the illnesses covered by competing insurance companies and buy the one with the most extensive coverage of illnesses. If you don’t, sods law will prevail …….

The second major reason for refusal is a failure to disclose all relevant matters on the original application form. For example, if the applicant fails to disclose in response to the insurance company’s questions that his father a died of a heart attack aged 50 or that he is having medical tests for headaches, then the insurance company will wrongly assess the risks it is being invited to insure. Had the insurance company known this extra information they might have increased the premium, or asked the applicant to go for a medical examination, or waited for the outcome of tests, or even refused to provide cover. By failing to disclose, the applicant has effectively obtained cover on false pretences or at least on inaccurate information.

Thereby lies the second moral. Always provide the truth and the full truth on your application form. Anything remotely relevant to your medical condition must be disclosed.

All this points to the need for professional insurance advice. Critical Illness policies do vary and it can take an experienced eye to evaluate the best policy for your circumstances and pocket. This doesn’t mean that you have to miss out on the discounted premiums available online – but do thoroughly talk it through with one of their telephone based advisers and do make sure you read the schedule of claimable illnesses when it arrives in the post.

Then sit back knowing you’ve taken another important step to protect your family’s finances. Lets all hope that you’re one of the majority who are happy never to claim.

It’s now time to concentrate on enjoying life.

July 20, 2015

Critical Illness Insurance – The Press Are Giving Insurers A Hard Time.

Recent stories in the press have again lambasted the insurers over critical illness insurance. The core problem is that a critical illness claim is not as straightforward as, for example, a claim under life insurance. With life insurance it’s going to be hard for the insurance company to argue that you’re not dead!

By their very nature, critical illness claims are much more complicated. The insurer will need to satisfy itself that the claim is validated in three key areas before it meets the claim: –

Has the illness been correctly diagnosed?

Is the confirmed illness included in the schedule of insured critical illnesses covered by the policy?

Did the policyholder fully disclose their medical history and current state of health on their original application form?

On the first point, it’s obviously in the policyholder’s interest to verify the medical diagnosis – so there’s rarely ever any conflict between the insurance company and the policyholder on that issue. It’s the next two areas which the insurer needs to validate, where conflicts seem arise.

With constant development in the medical knowledge, from time to time there can be some situations where validation falls into a grey area – a policyholder will argue that their specific illness is insured whereas the insurer will argue that it isn’t. Insurance companies are aware of this problem and they often change the wording in their policies in an attempt to clarify the scope of the cover and eliminate areas for dispute. Nevertheless, disputes do happen all too frequently and sparks fly when a policyholder thinks his illness is covered but the insurer disagrees.

A case in point comes before the Courts shortly. Mr Hawkins from Staffordshire is suing Scottish Provident for £400,000 under the terms of his critical illness policy. Basically, his medical advisers believe his illness is insured whereas the insurers’ medical advisers disagree. If the Court find in favour of Mr Hawkins the press will have a field day – and the critical illness insurers will suffer further bad press they can sorely afford.

Another summons, filed recently in the High Court and again involving Scottish Provident, highlights the problem when an insurer considers that a claimant mislead them on his or her original application form. Our underst anding is that if an applicant omits relevant information or provides misleading information on their application from, this amounts to obtaining insurance on false pretences. This summons has been issued on behalf of Thomas Welch from London who is suing Scottish Provident for £206,800. The issue goes back to 2000 when, a few years after first starting his critical illness policy, Mr Welch received confirmation that he was suffering from testicular cancer. The insurer refused the claim because of “non-disclosure alleging that Mr Welch had not been honest about his smoking habit. He does admit that he did smoke earlier in his life but is resolute in saying that he had long since given up when he applied for critical illness insurance. As such, Mr Welch believes that he did complete the application honestly.

We assume that the case will centre upon whether Mr Welch accurately answered the smoking questions on his application. Most insurers define “a smoker” as someone who has smoked, or has otherwise used, nicotine products within the previous 5 years. (Some insurance companies adopt a 1year cut off.) If Mr Welch had indeed smoked during the specified years, he would have been obliged to disclose such information on the application and the insurer would have priced his insurance accordingly. In this context, it is relevant to note that smokers are charged as much as 65% more for critical illness over than non-smokers. We anticipate that Mr Welch’s lawyers will argue either that he did not smoke during the period in question or he omitted the smoking information by pure oversight and in any event, his past smoking is not irrelevant to his testicular cancer. Interesting issues and we’ll let you know the outcome.

Mr Hawkins case is fundamentally different. It illustrates the problems that can arise if policy documents imprecisely describe an illness or if the technical diagnosis of an illness provides the scope for medical professionals to disagree. Either way the issues are entirely outside the policyholders control at a distressing time for them and their families and we must appreciate their anguish. The long-term solution must lie in improving the medical definitions within the policy. It is probable that this will result in more medical jargon that the average man in the street will find difficult to underst and – but perhaps that is preferable to what Mr Hawkins is going through.

Mr Welch’s court case must st and as a clear reminder to everybody that applications for insurance must always be totally accurate and completed in good faith. We recognise that in some cases this may still leave room for dispute ( and Mr Welch’s case may be an example), but if an applicant fails to complete the forms accurately, they are taking the great risk and any claim they make could be rejected.

Rightly or wrongly, the newspapers have a history of giving the insurance companies a hard time, casting them as heartless big business. This serves to reinforce the public’s feeling that insurance companies are devious and not to be trusted – especially it seems, in respect of critical illness insurance. This view is reinforced by the fact that around 20-25% of critical illness claims are rejected (although this rejection rate does vary between insurers). This issue is something that insurers must come to grips with – it’s bad for clients and undermines confidence in insurance – and that must be bad for the development of the insurance industry.

In fact to put no finer point on it, it’s a tragedy. As many as 1 in 6 women and 1 in 5 men will be diagnosed with a critical illness before their normal retirement age*. As such, critical illness insurance is vastly important for the protection of family finances. The problems we have highlighted are obviously contributing to a situation where almost everybody needs critical illness insurance, but fewer and fewer of us are taking it up.

(* Source: Munich Re.)

July 19, 2015

Critical Illness Insurance – Another Scam?

Unless you have substantial savings, even in the UK, contacting a serious illness, such as cancer, can be a very costly affair. Above all, not only do you need to consider how contracting such a critical illness will affect your savings in any medical care bills, but you also need to consider that you may well not be able to earn any income to cover you day-to-day expenditure. As a result, making sure you take out a critical illness insurance may well be one of the wisest and astute financial decisions you make.

What Is Critical Illness Insurance?

In short, a critical illness insurance policy is very much like any other insurance policy you take out. Here, however, your premiums go towards insuring that you do not contract a critical illness. In the event that you do contract a critical illness, your UK insurance provider will pay you out a tax-free lump sum to help you cover the day-to-day costs of having to live with your new medical condition.

Are There Any Limitations With Critical Illness Insurance?

Yes; it is essential that you look at the list of critical illnesses that your insurance policy covers, as these will be the only illness under which the policy will pay-out. In other words, the UK insurance provider will not pay-out on the policy simply because you have a doctor’s certificate that you have a critical illness, it needs to be one of the designated critical illness.

Moreover, if you are considered by the UK insurance provider to be a high risk – for example, if you smoke – then it is likely that either you will not be able to obtain the critical illness insurance, or your insurance premiums will be significantly higher than if this were not to the case. Importantly, you will need to disclose whether or not you have any existing conditions, in which case these will likely not be included, and whether or not your family has a history of the illnesses set out in the policy, in which case this will likely affect your premium payments.

How Will I Be Paid?

As mentioned, with a critical illness insurance your UK insurance underwriter will pay you out a lump-sum tax free amount once you contract one of the critical illnesses listed in the policy. Having paid out the lump-sum amount, your relationship with the UK insurance provider will come to an end. In other words, you will not have an ongoing relationship with the insurance provider paying you intermediate payments.

Is It Worth Having Critical Illness Insurance?

The question of whether or not there is any value in you having a critical illness insurance will depending largely on your age, expenses, and whether or not you have any other insurance. Essentially, critical illness insurance covers an area for which other types of insurance can be obtained. However, unlike other types of insurance, this is a very specific insurance policy paying out for a very specific purpose. That said, there is a strong argument that you can never really have too much insurance and will numbers seemingly showing that more and more of us contracting critical illnesses as we grow as an aging population, this type of UK insurance is always useful.

July 2, 2014

Long-Term Care: The Basics

In the year 2000, almost 10 million people needed some form of long-term care in the United States. Of this population, 3.6 million (37%) were under age 65 and 6 million (63%) were over age 65 (Roger & Komisar, 2003). Almost 70% of people turning age 65 will need long-term care at some point in their lives. This section of the website provides basic information so you can begin to think about how you will h andle the need for long-term care. Your path will be unique to you, and based on your preferences and circumstances. Let’s look at the basic questions covered in this section:

Many people think the phrase “long-term care” refers to an insurance policy. While insurance may be part of your strategy, long-term care encompasses everything from long-term services and supports and finances, to where you will live and how you will navigate the myriad of legal, family, and social dynamics along the way.

Source: U.S. Department of Health and Human Services, “The Basics” http://longtermcare.gov website. Accessed July 2, 2014. http://longtermcare.gov/the-basics/

July 2, 2014

Costs & How To Pay

Just as there are many kinds of long-term care services and supports, so is there a wide range of costs & how to pay for them varies between individuals. And while some people may qualify for a public program to help pay for these expenses, most people use a variety of options, including long-term care insurance, personal income and savings, life insurance, annuities and reverse mortgages to ensure they can pay for the care they require. As our population ages, new financial products are offering yet more options.

Important questions answered in this section:

GO HERE TO VIEW VIDEO: http://longtermcare.gov/costs-how-to-pay/

Source: U.S. Department of Health and Human Services, “Costs & How To Pay” http://longtermcare.gov website. Accessed July 2, 2014. http://longtermcare.gov/savings-calculator/

July 2, 2014

LTC Savings Calculator

The LTC Savings Calculator is as easy as 1, 2, 3 to plan for Long-Term Care.

Go to this page: http://longtermcare.gov/savings-calculator.

Answer the questions below (all fields are required), then submit your information using the “Calculate” button.

Source: U.S. Department of Health and Human Services, “LTC Savings Calculator” http://longtermcare.gov website. Accessed July 2, 2014. http://longtermcare.gov/savings-calculator/

Discount Health Benefits Plans: A Sensible Alternative To Traditional Insurance Plans

The LTC Savings Calculator is as easy as 1, 2, 3 to plan for Long-Term Care.

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