This website uses cookies to ensure you have the best experience. Learn more

Understanding Insurance Coverage Essay

881 words - 4 pages

Introduction
Insurance is a very important part of modern life and business. In this paper I will discuss the basic concepts of insurance, claims-made and occurrence liability policies, factors for selecting an insurance company and policies, and the difference between workers compensation and liability insurance.
What is insurance?
Insurance is a two-way legal agreement between the insurer and the customer. The customer, which may be an individual, business, or other entity, agrees to pay the premiums as required, in exchange for monetary protection from the insurer for any possible substantial loss. Customers usually obtain insurance, not to cover the trivial incidents of life or business, but to cover the potential significant losses which could be a financial hardship for them. The premiums of all customers of the insurance company are pooled together. The insurance applies statistical analysis to determine the chance that a particular event might occur to one of their customers. From this analysis they can determine the premiums which must be collected and the claims which must be paid to keep the insurance company financially profitable. There are many type of insurance including life, property and casualty, car, health, and disability. Each is very specific for what losses then will cover and reimburse (Pareto, n.d.).
“Claims-made” and “Occurrence” Liability
With “claims-made” policies, claims must be submitted within the time of insurance coverage and the event must have occurred after the retroactive date. The retroactive date is usually set at the start date of the new policy to prevent having to cover for past events. If cancelling a claims-made policy or changing over to an occurrence policy, it is important to consider the purchase of an extended reporting period option so there isn’t a break in coverage for claims that have yet to be submitted. “Occurrence” liability means that the event must occur during the time of insurance coverage, although the claim may be made after the end of coverage. Claims will continue to be submitted after the policy period, as long as the statute of limitations allows, which makes it difficult to determine the insurance company’s profit and loss status. For this reason occurrence policies are usually more expensive than claims-made policies. (Nonprofit, n.d.; Rotarius & Liberman, 2000)
Factors to consider when selecting an insurance company and policies
Rotarius and Liberman (2000) provide excellent advice on selecting professional liability insurance for health care organizations. There are many questions that should be asked when making this important decision.
• What is their rating with unbiased appraising services? They suggest using several rating organizations including A.M. Best Company, Moody’s Investor Services or Weiss Rating Service. They advise only to choose insurance companies with an A or A+ rating.
• Can I...

Find Another Essay On Understanding Insurance Coverage

Affordable Care Act (ACA) Effect on the Uninsured

1368 words - 6 pages stated that approximately 46 million Americans were uninsured, however not all of that number is due to the inability to afford coverage. According to a 2009 story written by Christopher Weaver of Kaiser Health News 43% of that number should be classified as “voluntarily” uninsured. This subset of uninsured Americans consist of nearly half being young and healthy therefore less likely to seek medical treatment or health insurance coverage. The

Health Care Reform Essay

1834 words - 8 pages Healthcare in the United States has long been a heated topic of discussion, it seems that the biggest issue with Health care reform is the simple lack of understanding towards health insurance all together. A study done by the journal Health Affairs found that “only 60 percent of the people who should be signing up for the ObamaCare understand all of its key concepts”. Jimmy Kimmel did a segment on his show Jimmy Kimmel Live called “Six of One

Firm Characteristics and Social Insurance Participation: Evidence from China

1483 words - 6 pages has shown a positive association between social insurance participation and firm size (Mao, Zhang, & Zhao, 2013; Rickne, 2013), contradicting the negative associations that were found in previous studies using Substantial scholarly attention has been paid to understanding the factors that influence income inequality, yet social insurance inequality remains largely understudied. It is an increasingly important dimension as it often adds on to the

Affordable Health Care for America Act

2573 words - 10 pages most U.S. citizens and legal residents to have health insurance. There will be a subsidy program that will be implemented along with a state based health insurance exchanges that will assist with the cost and selection of affordable insurance. Except in cases of hardship, once market reforms and affordability credits and subsidies are in effect, individuals will be responsible for obtaining and maintaining health insurance coverage. "Those who

Insurance broker

1039 words - 4 pages We picked broker/agent occupation for our assignment. Responsibilities of the job vary according to the size and type of employer: smaller companies offer less opportunity for specialization than larger firms. Typical duties include:Gathering information from clients, assessing their insurance needs and risk profileBuilding and maintaining ongoing relationships with clients including scheduling and attending meetings and understanding the nature

History of Health Insurance

2211 words - 9 pages diseases can be contained and cured or treated more quickly and cost-effectively. People without health insurance have limited, reduced access to services of preventive care, like cancer screening. Moreover, the benefits of expanding coverage outweigh the costs for added services. [4] Safety-net care from hospitals and clinics improves access to care but does not fully substitute for health insurance. These findings are supported by much research

Health Care Providers

1211 words - 5 pages most states in the United States. Most plants and companies use Blue Cross and Blue Shield for their employee’s insurance coverage. Advertising, networking, and publicity are their way of targeting their market. Understanding the customer better allows customer satisfaction and developing a trusted relationship with the customer. Determine the best possible pricing strategy for at least one of the products or services offered by the health care

All Americans Have a Right to Health Care

1534 words - 6 pages All Americans Have a Right to Health Care Within the previous four years, the number of uninsured Americans has jumped to forty five million people. Beginning in the 1980’s, the American Academy of Family Physicians (AAFP) has been trying to fix this problem of health insurance coverage for everyone with a basic reform. The AAFP’s plan imagined every American with insured coverage for necessary improved services that fall between the

Genetic Profiling

824 words - 4 pages insurance company is profit-driven, as most of them are, then they will charge a high premium for coverage. This is unfair because they are punishing someone for being born with potentially “bad” genes. The purpose of buying life insurance is protection for one’s family and loved ones after their death. The most complicated and unfair part of life insurance is the risk factor equation insurance companies use in order to either deny the potential

Insurance sector in india

4943 words - 20 pages protects against loss or damage to property resulting from hazards such as fire, theft, and natural disasters. Liability insurance shields policyholders from financial responsibility for injuries to others or for damage to other people's property. Most policies, such as automobile and homeowner's insurance, combine both property-casualty and liability coverage. Companies that underwrite this kind of insurance are called property-casualty

Giving to the Rich

2285 words - 9 pages titled, “How Does Insurance Coverage Improve Health Outcomes?”, attempts to support the new law and persuade its readers why everyone should have health care insurance and the benefits of doing so. But my question is still the same. Why? Why can't we make laws that actually make it affordable for an individual pay out of their own pocket, directly to a doctor or pharmacy? The only conclusion I can come to is greed. With this paper I want to

Similar Essays

Complete Guide On Canadian Travel Insurance – Coverage Options And Tips

741 words - 3 pages Most of the people get overwhelmed by the available plans and their coverage schemes. It creates confusions and misleads the buyer in purchasing the right travel insurance plan. This article will help the first-time buyers as well as experienced to compare and buy the best coverage plan for their traveling needs. Different Types of Travel Insurance Policy: First of all the buyer needs to have complete understanding on the available options and

Insuring Your Resources Essay

1056 words - 5 pages expecting. Lastly, you should check to see if your personal insurance plan works for you. If not you can tweak it until it better fits you. 2.In understanding insurance in general, compare and contrast the distinctions of (a) pure risk and (b) speculative risk. Pure risk is risk in which there is only a chance of loss; also called insurable risk” (Hughes, 2009, p.310). Pure risk maybe losing your house in a fire because you do not have

Medical Insurance And Different Types Of Coverage

2282 words - 10 pages led to some insurance companies to start denying payments for non-emergency conditions. This essay has just barely revealed all of the costs and rules regarding what a person might have to pay for good healthcare. What is most important, is that a person gets a health insurance policy that works best for them and gives them good coverage, without doing too much damage to their finances. Works Cited Keys to Understanding Your Health Insurance

Moral Hazard Essay

9362 words - 37 pages consumers in understanding the policy's benefits because they define whether particular services are within the scope of coverage. Insurance companies carefully determine what they consider to be "reasonable" costs of medical services by gathering statistics on what health care providers in a particular area typically charge for identical or similar services. That information helps the company determine the amounts it considers to be reasonable