Insurance and business regulation

Did you get a $100,000 fine for a data breach?

Actually, what is a breach?

Almost every day the news carries a story about a company that has had a “Breach” of their security and PHI has been disclosed. There are so many of them that most go unreported now and only the really big ones get any attention. But what exactly is a breach anyway?

Technically it is “make a gap in and break through …”, so whales breach the surface, people regularly breach their contracts, and babies who come out bottom first, yikes, are “breach birth.” But those are not what the news is talking about!

Breach in the case of PHI and HPIAA (I will define those in a minute) means somebody did not protect the information they have on themselves and other people that they are legally responsible to care for.

So now you ask me “Then Bill a breach might not be just somebody getting into our computer?”

Move to the front chair, you caught the brass ring on that one! (Antique reference to Merry go Rounds for the younger readers)

Yes, a breach can be as simple as sending somebody your log in credentials in an open email. “Who would be watching my email, I’m no big deal?” The bad guys do not have to watch “your” email, they just run a bot that looks for email patterns that look like passwords.

In our case we tell employers every day we will provide a secure format to transmit information to us. They ignore that and then send us a census with every employee’s personal information, including all of their identifying data. By anybody’s definition that is a breach.

It discloses PHI – “PHI is any health information that can be tied to an individual..(Google)”

It violates HIPAA – “HIPAA is the acronym for the Health Insurance Portability and Accountability Act (Hipaastore.com)”

And that causes this “The penalties for noncompliance are based on the level of negligence and can range from $100 to $50,000 per violation (or per record)(Truevault.com)”

Life has truly become a regulatory minefield, but unlike abandoned war mines, there are maps for HIPAA and other legal mines. And this is where I again stress the importance of professionals in your life. Not every “Professional” is the same so you need to do your own due diligence but the stakes are high and violation costs can put you out of business so the search is worth the effort.

And, of course, you can always contact me and say “what was that thing you wrote about, I’m confused.”

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Love Hate with technology

Tech today – fun but do you really want it?

 

I recently read some articles about self reporting technology for insurance claims management. That just has to be good, Right?

 

First was an article about a “Device” that installs on your car and automatically reports all aspects of a claim as it happens. How cool is that?

  • No more recording any details yourself – your carrier already has it.
  • No need to call anybody – a tow truck and self drive rental, and maybe an ambulance, have been dispatched to your location. A drone may even have done a fly by for some pictures.
  • No need to worry about claims payment – a check was sent to everybody shortly after the claim occurred.

 

No need to worry about who was at fault or the other driver’s insurance – both of your cars already reported all of that and the guilty party has already been referred to the police???

 

Hold on just a minute!

 

Ok, let’s say just before an accident in traffic your car reports being stopped at, or near, a bar where you were delivering a package to a client. Then it reports you were speeding or changing lanes erratically, based on an algorithm?  Well you were probably guilty so why waste time waiting for the police, and “ Oh By the Way”, because your car reported you are at fault, some parts of your claim might not be covered.

 

The other item was about automatically reporting  employees, with high medical claims, to employers because they are costing the employer too much money.

 

And how about the tooth brush that reports to your employer when, and how much, you brush your teeth. Yes, that is true! They sent me two of them to try out.

 

Do you really want some electronic device reporting on you to your employer, the police, your insurance company, about your life, let alone your medical claims?

 

The real point here is that it is never a good idea to give up your freedom and privacy for convenience, or out of fear. Whenever you decide it would just be easier to have your life managed by somebody else electronically you might as well check into a care home and get into bed. Real people who are professional, accessible, and might actually have to look you in the eye, are still your best bet to partner with.

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When did you have life insurance and when did you just have premium receipts?

When did you have life insurance and when did you just have premium receipts?

People buy Life Insurance every day somewhere. They go online, they see life insurance agents, they respond to offers from banks and credit unions, and they buy it at their employer. All of these offer opportunities to think you had coverage you didn’t.

In the vast majority of cases applying, and then paying premium, results in real coverage that helps millions of people every year. However, there are some things you might miss that could result in your beneficiary being very disappointed. And you can’t just go back and fix it at that point.

Life insurance is a basically very simple, your beneficiary gets paid if you die. After that there are many ways to make the offer of coverage. Some of these “offers” are Term, Whole life, Variable life, Universal life, Accident only, credit life and more. Each of these provide several ways to pay for them.

So what are some of the unseen potholes you need to think about?

Verification of coverage – In all cases you need to make sure you received “verification of coverage.” This might be a “policy” or it might be a verification of coverage outline or certificate. No matter what the format was you need to read it and keep it where your beneficiary can find it. That document will tell you what coverage you actually have and how to keep it in effect. It will also tell your beneficiary how to file a claim.

Premium payment – Somebody must pay the premium to keep the insurance coverage. Every year we hear from somebody who had found an insurance policy in their parents papers but the parents had forgotten to pay the premium as they got older. After many years of payments the coverage is not there when it is needed the most. In some cases, with policies that included a “cash value”, the policy may have been being kept in force by using the accumulated cash. That means if you find an old policy do not throw it away until you call the insurance company and check on it.

Promotional or “Free” insurance – People frequently get offers for “Free” life insurance from banks, credit cards, car dealers, mortgage companies and credit unions. In most cases this is “AD&D” which is Accidental Death and Dismemberment. This means it only pays in the event of an accidental death or in some cases the loss of some combination of body parts. You have to be a “”member or have an account with whoever made the offer, so it is not enough to just return the offer and think you have coverage. If you are managing the affairs for somebody who dies be sure to contact every credit card company they used to see if it included a credit, or perhaps term, life policy.

Employer group term – Employer provided group term life insurance is one of the most common ways people are covered by life insurance. In most cases all eligible employees are given a basic amount of coverage and the employee may purchase more if they ask. “Eligible” is critical terminology here because if the employee is suddenly no longer eligible, they may not be covered by the insurance company even if they kept paying the premium. These policies typically include “Waiver of premium”, and “Conversion” rights. Waiver is a provision that “Waives premium payment” allowing the benefit to be kept if the insured becomes disabled and cannot pay the premium. Conversion allows the insured to change the coverage to a policy they own and would not lose based on employment eligibility.

This is a very brief look at the subject but it is so important that you should talk to your insurance agent about all the places you may have coverage and see if you really need coverage, and if you do – that it is really there. And by the way, get a real agent, one you can walk in and talk to, one who might really be there if your family needs the help.

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