We received nearly 13,000 calls last month to our free hotline for Washington residents with problems or questions involving insurance. Along the way, we helped consumers recover $776,937 in delayed/denied claims and similar problems.
We have experts in a wide variety of insurance matters, and we can often help resolve difficulties getting claims paid, help you find health coverage, etc.
We're not an insurer, agent or broker. We're the state agency that regulates the insurance industry in Washington state. We tend to get between 11,000 and 15,000 calls a month.
Got a problem or question? Give us a call: 1-800-562-6900 or e-mail us at AskMike@oic.wa.gov.
Senin, 25 Oktober 2010
Jumat, 22 Oktober 2010
Storm headed for western WA, rain and high winds Saturday night and Sunday
The National Weather Service has issued a "special weather statement" for much of western Washington late this weekend. From it:
Washington residents with insurance questions or problems can also call our consumer advocacy staff at 1-800-562-6900. We'll try to help.
A potent storm will slam into the region Saturday night and Sunday, resulting in locally heavy rain and strong winds, especially on the coast. Another blast of strong winds impacting a larger part of the area is possible on Monday.If you experience damage and have insurance questions, try our winter weather information, which covers common insurance questions about everything from sinking boats to fallen trees to power outages.
Washington residents with insurance questions or problems can also call our consumer advocacy staff at 1-800-562-6900. We'll try to help.
Kamis, 21 Oktober 2010
Cease and desist order issued against Choice Home Warranty
Washington State Insurance Commissioner Mike Kreidler today issued a cease and desist order against CHW Group, Inc., doing business as Choice Home Warranty and http://www.choicehomewarranty.com/.
The company is believed to have sold at least 92 home warranty service contracts to Washington residents. The contracts cover repair or replacement on major systems and appliances in the person's home, and promise that Choice Home Warrant will pay for repair or replacement of those that fail.
The problem: the company isn't authorized to transact insurance in Washington state. Nor is it registered here as a service contract provider.
Kreidler ordered the company to mail a copy of the order to all Washington home warranty service contract customers. The company must also report to the state how much it's collected in premiums from Washington consumers.
The company has the right to demand a hearing. The order takes effect today.
We'll post a link to the order shortly.
Updated: As promised, here's the link.
The company is believed to have sold at least 92 home warranty service contracts to Washington residents. The contracts cover repair or replacement on major systems and appliances in the person's home, and promise that Choice Home Warrant will pay for repair or replacement of those that fail.
The problem: the company isn't authorized to transact insurance in Washington state. Nor is it registered here as a service contract provider.
Kreidler ordered the company to mail a copy of the order to all Washington home warranty service contract customers. The company must also report to the state how much it's collected in premiums from Washington consumers.
The company has the right to demand a hearing. The order takes effect today.
We'll post a link to the order shortly.
Updated: As promised, here's the link.
Jumat, 15 Oktober 2010
Which insurers sell individual insurance plans in Washington?
- Asuris Northwest Health
- Group Health Cooperative
- Group Health Options
- Kaiser Foundation Health Plan of the Northwest
- KPS Health Plans
- Lifewise Health Plan of Washington
- Premera BlueCross Individual Plans
- Regence BlueCross BlueShield of Oregon
- Regence BlueShield
- Time Insurance Company
Kreidler orders Regence to cover children
Washington State Insurance Commissioner Mike Kreidler this morning ordered Regence BlueShield this morning to stop illegally denying insurance to children, effective immediately.
“Regence is in clear violation of state law that prohibits insurers from denying insurance to people on the basis of age,” said Kreidler. “I was shocked and deeply disappointed when Regence announced its decision last week to stop selling insurance to kids.”
The Affordable Care Act requires all health plans to cover kids with pre-existing conditions. However, to accommodate the insurance industry’s concerns that people would only enroll their children when they became sick, the federal government let states create a special open enrollment period.
Kreidler issued an emergency rule creating a special enrollment period from Nov. 1-Dec. 15. During this time, anyone looking for an individual health plan for their families or just their children can enroll their kids without having to take a health screen.
But Regence Blue Shield, the largest health insurer in the individual market, notified Kreidler on Sept. 27 that, effective Oct. 1, it would no longer sell individual health insurance policies to kids.
Here's a link to the full press release.
Update: And here's the response from Regence, which says it was shocked and disappointed by the order. From their press release:
“Regence is in clear violation of state law that prohibits insurers from denying insurance to people on the basis of age,” said Kreidler. “I was shocked and deeply disappointed when Regence announced its decision last week to stop selling insurance to kids.”
The Affordable Care Act requires all health plans to cover kids with pre-existing conditions. However, to accommodate the insurance industry’s concerns that people would only enroll their children when they became sick, the federal government let states create a special open enrollment period.
Kreidler issued an emergency rule creating a special enrollment period from Nov. 1-Dec. 15. During this time, anyone looking for an individual health plan for their families or just their children can enroll their kids without having to take a health screen.
But Regence Blue Shield, the largest health insurer in the individual market, notified Kreidler on Sept. 27 that, effective Oct. 1, it would no longer sell individual health insurance policies to kids.
Here's a link to the full press release.
Update: And here's the response from Regence, which says it was shocked and disappointed by the order. From their press release:
It is important to stress that our eligibility changes do not apply to those insured members covered under small or large group policies. We've been very clear that we will insure kids during open enrollment periods when the child is not the sole subscriber -- and we will do so regardless of health status.
Tacoma woman with history of slip-and-fall claims charged with theft
A Tacoma woman who has repeatedly claimed to have slipped and fallen in grocery stores has been charged with theft and attempted theft after claiming to have fallen in two different stores within about 15 minutes.
Brenda J. Johnson, 50, is scheduled to be arraigned today in Pierce County Superior Court. She has been charged with first-degree theft and first-degree attempted theft.
Johnson said she was near check stand No. 2 at a Tacoma Safeway store on Sept. 18, 2009 at 11:46, buying peaches, when she slipped on some liquid and fell, injuring her wrist and ribs. Neither the cashier nor any other employee could recall any such incident.
On the same day at about noon, Johnson said the same thing happened in the frozen food aisle of a Tacoma Fred Meyer store.
In both cases, she said, she was embarrassed and quickly left. She filed claims with both stores, showing medical care and prescription drug receipts totalling more than $5,500.
A subsequent investigation by Insurance Commissioner Mike Kreidler's Special Investigations Unit indicated that she apparently submitted virtually identical medical receipts to each store, including an 8-page emergency room report that was missing some pages.
Medical records obtained through a search warrant indicated that the treatment was unrelated to a fall at either store. The records also showed that there been no expense to Johnson for the care.
The investigation also revealed that Johnson has filed at least five auto-accident medical claims and at least half a dozen slip-and-fall injury claims.
Brenda J. Johnson, 50, is scheduled to be arraigned today in Pierce County Superior Court. She has been charged with first-degree theft and first-degree attempted theft.
Johnson said she was near check stand No. 2 at a Tacoma Safeway store on Sept. 18, 2009 at 11:46, buying peaches, when she slipped on some liquid and fell, injuring her wrist and ribs. Neither the cashier nor any other employee could recall any such incident.
On the same day at about noon, Johnson said the same thing happened in the frozen food aisle of a Tacoma Fred Meyer store.
In both cases, she said, she was embarrassed and quickly left. She filed claims with both stores, showing medical care and prescription drug receipts totalling more than $5,500.
A subsequent investigation by Insurance Commissioner Mike Kreidler's Special Investigations Unit indicated that she apparently submitted virtually identical medical receipts to each store, including an 8-page emergency room report that was missing some pages.
Medical records obtained through a search warrant indicated that the treatment was unrelated to a fall at either store. The records also showed that there been no expense to Johnson for the care.
The investigation also revealed that Johnson has filed at least five auto-accident medical claims and at least half a dozen slip-and-fall injury claims.
Rabu, 13 Oktober 2010
Lewis County couple convicted of insurance fraud
A Lewis County couple have been sentenced to jail for filing a false insurance claim.
Jennifer Mau, 30, and David Eden, 47, were found guilty by a jury on Friday.
Their case began as a moving claim. They rented a U-Haul truck on March 30, 2007 to move their household goods and personal belongings from a Centralia storage facility to their new home. They claimed that the U-Haul truck leaked rainwater, destroying $16,789 worth of her property.
Mau reported the loss to U-Haul and filed a claim. The couple said they threw out the damaged property at a landfill.
The insurer had the U-Haul truck water tested for leaks. No leaks were found. The insurer, Republic Western Insurance, denied Mau's claim and turned the case over to state Insurance Commissioner Mike Kreidler's Special Investigations Unit. The SIU's investigation included checks with local weather stations, which reported little or no precipitation that night.
The court sentenced Mau to 60 days in jail, with the option of electronic home monitoring. Eden was sentenced to 15 days in jail. (Both sentences are stayed pending a possible appeal.)
Jennifer Mau, 30, and David Eden, 47, were found guilty by a jury on Friday.
Their case began as a moving claim. They rented a U-Haul truck on March 30, 2007 to move their household goods and personal belongings from a Centralia storage facility to their new home. They claimed that the U-Haul truck leaked rainwater, destroying $16,789 worth of her property.
Mau reported the loss to U-Haul and filed a claim. The couple said they threw out the damaged property at a landfill.
The insurer had the U-Haul truck water tested for leaks. No leaks were found. The insurer, Republic Western Insurance, denied Mau's claim and turned the case over to state Insurance Commissioner Mike Kreidler's Special Investigations Unit. The SIU's investigation included checks with local weather stations, which reported little or no precipitation that night.
The court sentenced Mau to 60 days in jail, with the option of electronic home monitoring. Eden was sentenced to 15 days in jail. (Both sentences are stayed pending a possible appeal.)
Cease-and-desist order issued against Capital HomeShield
Washington State Insurance Commissoiner Mike Kreidler has issued a cease-and-desist order against a Florida-based home warranty company doing business as Capital Home Shield.
The North Miami Beach company -- which was not registered as a service contract provider or insurer in Washington state -- nonetheless sold a contract to a Washington homeowner. He complained to us after he had difficulty getting them to pay for a repair to his stove. The company subsequently paid the claim.
Under the contract, Capital Home Shield, which is a doing-business-as name of MN Home Warranty Corp., promised to pay to repair or replace major systems and appliances that broke.
Kreidler ordered the company to to stop selling unauthorized contracts in Washington and to turn over a list of all its Washington clients, as well as reporting all premiums they've paid so far.
According to the local Better Business Bureau, the company has an "F" rating for repeatedly failing to respond to complaints.
The North Miami Beach company -- which was not registered as a service contract provider or insurer in Washington state -- nonetheless sold a contract to a Washington homeowner. He complained to us after he had difficulty getting them to pay for a repair to his stove. The company subsequently paid the claim.
Under the contract, Capital Home Shield, which is a doing-business-as name of MN Home Warranty Corp., promised to pay to repair or replace major systems and appliances that broke.
Kreidler ordered the company to to stop selling unauthorized contracts in Washington and to turn over a list of all its Washington clients, as well as reporting all premiums they've paid so far.
According to the local Better Business Bureau, the company has an "F" rating for repeatedly failing to respond to complaints.
Everett man who signed up for insurance AFTER crash pleads guilty
A 40-year-old Everett man who caused a three-car collision last fall has pleaded guilty to attempted insurance fraud, a gross misdemeanor.
On Oct. 8, 2009, Bieniek was driving his 1999 Ford F150 pickup. He'd owned it for about 5 years but didn't have insurance on it.
He claimed that just minutes before the collision, he'd picked up the truck from a friend in a parking lot, opened his laptop computer and bought insurance online from Geico Insurance.
But Geico, after pulling the company's online log, determined that Bieniek got the coverage after the wreck, not before. The company turned the case over to the Washington state insurance commissioner's Special Investigations Unit. Bieniek was charged with insurance fraud ("false claims or proof") in King County Superior Court in July.
On Friday, Bieniek pleaded guilty to attempted insurance fraud. He was sentenced to 6 months' probation, 120 hours of community service and a $500 victim penalty assesssment.
On Oct. 8, 2009, Bieniek was driving his 1999 Ford F150 pickup. He'd owned it for about 5 years but didn't have insurance on it.
He claimed that just minutes before the collision, he'd picked up the truck from a friend in a parking lot, opened his laptop computer and bought insurance online from Geico Insurance.
But Geico, after pulling the company's online log, determined that Bieniek got the coverage after the wreck, not before. The company turned the case over to the Washington state insurance commissioner's Special Investigations Unit. Bieniek was charged with insurance fraud ("false claims or proof") in King County Superior Court in July.
On Friday, Bieniek pleaded guilty to attempted insurance fraud. He was sentenced to 6 months' probation, 120 hours of community service and a $500 victim penalty assesssment.
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