Features 4 7 9 10
White House Efforts To Promote ObamaCare Fall Flat
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QQ Solutions Releases QQ Catalyst V2.5 Adding Major New Capabilities To Popular Agency Management System
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FTC Moves Against Massive Mobile Phone “Cramming” Crooks 10 Smartphone “Must Have” Features - by Kim Komando Private Limitation of Action - Expert Analysis & Commentary - by Barry Zalma, Esq.
The ObamaCare Nightmare Is Just Beginning - OP/Ed by Spencer Lehmann, RHU AIA Statement On Nomination of Max Baucus To Be Next Ambassador to China - We Like Him Far Away Too... Where Are The Worst Drivers In The U.S.? Car Insurance Comparison.Com Shows They Are Worst In The South Scientists Point The Hubble At A Tiny, Empty Patch Of Sky - And Discover Thousands Of Galaxies New England Journal Of Medicine Study Reveals New Data On Distracted Driving Among Teens How An Obama Devotee Wraps Her Mind Around The Abject Failure Of ObamaCare - Interesting
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Florida Announces Arrest Of Orlando Attorney Charged With Stealing P.I.P. Settlement Money Think All AA Batteries Are The Same? Watch This Consumer Report And You May Be Surprised N.Carolina Woman Arrested For Filing False Bills With Insuror Wisdom From A Surprising Source: Dirty Jobs Mike Rowe Has Your Password Been Lited In A Data Breach? Find Out Here! Poor MSNBC Host Chris Matthews - The Thrill (Up His Leg) Is Gone The Ghost Of Columbia University: A True American Mystery Create Original Art As You Get Rid Of Fire Ants - It Can Be Done Who Is King Of The Supercars? Bugatti Veyron VS Lamborghini Aventador VS Lexus LFA VS McLaren MP4-12C Florida Commissioner Announces Appointment Of Chief of Staff And Deputy Chief of Staff
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President Obama Has Often Blamed Fox News For ObamaCare Problems Fox Money-Guy Neil Cavuto Responds
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California Agent Arrested For Premium Theft & Providing Bogus Insurance California Business Owner Must Refund $4.2 Million in Workers Comp Fraud Ohio Agent Sentenced To Two Years Probation For $7,000 Premium Theft And Insurance Fraud
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WHITE HOUSE EFFORTS TO PROMOTE OBAMACARE FALLS FLAT...
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Giving Satirists With Photoshop A Rare Opportunity To Spoof The Effort
n a desperate attempt to put a positive spin on his faltering health care reform following months of embarrassment and bad news, President Obama turned to Madison Avenue - or at least a Madison Avenue wannabe - to promote his agenda. The ad features a broadly smiling Barack Obama holding a “Get Covered” sign reading, “Nobody should go broke just because they get sick!”
Nice sentiment, I guess, and it might actually help sell the program IF the American people had all been out of the country for the last several months and IF millions more people had not LOST their insurance as a result of ObamaCare than were able to secure it and IF ObamaCare actually reduced the cost of health care insurance - which by all indications it has not. In fact it may have doubled and tripled the cost of health care insurance for millions of Americans with higher premiums and outrageous deductibles. How many American’s could write a check for the $10,000 deductible found in many OC plans - while adding thousands to their premium costs? And then there is that pesky co-pay. A serious illness could easily cost a family $30,000 out of pocket. That’s going broke, Mr. President. For most Americans, ObamaCare fixed nothing. Barack Obama’s message that somehow ObamaCare will keep you from going broke is simply a bad joke - a 4
lie within a lie - something we’ve all grown used to from this administration as Obama’s approval rating falls to the lowest of his stay in office and the lowest presidential rating in 62 years. The White House has been spoofed a hundred times as creative types replaced the President’s message with their own parody. One said, “Get Covered because socialism has worked so well elsewhere, we had to try it here!” Here’s a couple more of our favorites:
“Because you know you want to pay twice as much for less coverage with a $10,000 deductible! (And we’re hoping you’re too stupid to notice!)
“Because Only Six (6) People Have Signed Up - And It’s Embarrassing As Hell!
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FTC MOVES AGAINST MASSIVE MOBILE CRAMMING OPERATION THAT HEAPED MILLIONS IN UNWANTED CHARGES ON CONSUMERS’ MOBILE PHONE BILLS You Didn’t Really Win Those Justin Bieber Tickets... Defendants Pitched ‘Love Tips,’ ‘Fun Facts,’ and Free Justin Bieber Tickets
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he Federal Trade Commission is taking action to stop a mobile phone cramming operation that has placed tens of millions of dollars on consumers’ mobile phone bills without their permission. In its complaint, the FTC seeks to shut down the operation and recover money lost by consumers. The FTC’s complaint charges that Lin Miao and Andrew Bachman, through a number of companies they owned and controlled, pitched “love tips,” “fun facts,” and celebrity gossip alerts sent by text message. The practice, known as mobile cramming, relies on the fact that consumers often don’t closely examine their monthly statements, or many assume that charges are legitimate. “This case puts another dent in the armor of scammers who use mobile cramming to take advantage of consumers across the country,” said Jessica Rich, director of the FTC’s Bureau of Consumer Protection. “The FTC will continue working to protect consumers from unwanted thirdparty charges on their mobile phone bills.” According
to
the
complaint,
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consumers allegedly received text messages with random factoids that they dismissed as spam without realizing they had received them through a paid subscription service they did not knowingly buy. In one instance, a website told visitors they had won free Justin Bieber tickets, which they could claim by filling out an online quiz. Part of the process required consumers to enter their phone number, and while consumers didn’t receive the Justin Bieber tickets, their phone numbers were likely signed up for one of the defendants’ paid services. The charges continued to appear on consumers’ bills until the consumers noticed them and took action to unsubscribe. The charges, typically $9.99 per month, often appeared on consumers’bills with inscrutable names like “77050IQ12CALL8663611606” and “25184USBFIQMIG” and in many instances, consumers did not notice the variations in the amount of their bills from month to month. When consumers did notice the charges, the process of getting a refund was often highly cumbersome. In some cases, consumers could reach representatives of the company, who would promise refunds that never arrived. The FTC’s complaint alleges that the
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defendants violated the FTC Act by deceiving consumers, leading them to believe they were obligated to pay for the defendants’ premium text message services. The defendants also violated the FTC Act by unfairly billing consumers for services they did not ask for. The defendants in the case are Tatto, Inc. (also doing business as WinBigBidLow and Tatto Media); Bullroarer, Inc. (also doing business as Bullroarer Corporation Pty. Ltd.); Shaboom Media, LLC (also doing business as Tatto Media); Bune, LLC; Mobile Media Products, LLC; Chairman Ventures, LLC; Galactic Media, LLC; Virtus Media, LLC; Lin Miao and Andrew Bachman.
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10 SMARTPHONE MUST-HAVE FEATURES Really Cool Info - by Kim Komando
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ny new smartphone has a gimmick. Whether it’s wireless charging, fingerprint scanning or even eyetracking, there’s always an amazing feature you “can’t live without.” But let’s be honest: many of those features you really can live without. On the other hand, some of the futuristic technology available in next-generation smartphones is really useful. But which features do you need in your toolbox and which are just the icing on the cake? This definitive list ranks 10 useful features your smartphone needs to have.
1. A long-lasting battery Y o u r smartphone c o u l d
have a shrink-ray or turn lead into gold and it would still be useless without juice. There are ways to boost the battery life of your gadget, but at the end of the day a larger battery is going to last you longer. The Droid Maxx is the undisputed king of batteries. It will get you close to 48 hours of use. The Galaxy Note 3 has a respectable battery life at 12-16 hours of use, but it’s still well behind the Maxx. The iPhone 5S is around 10 hours and the Samsung Galaxy S4 brings up the rear at 9 hours.
2. Warp-speed processing Speed is still the ultimate prize in the smartphone arms race. You notice when apps lag or when swiping takes an eternity. The iPhone 5s is the fastest
smartphone on the market. Its A7 chip is even light-years ahead of blazing fast phones like the Samsung Galaxy S4 or the surprisingly quick Motorola Moto X. But don’t despair if your phone feels a little sluggish - there are ways to speed it up.
3. Crystal-clear display Smartphones are as much about enjoying media as they are about communicating. You watch movies, play games and view photos on your mobile screen and you want the crispest display around. In this case that award goes to the Samsung Galaxy S4. It has the best resolution and most pixels per inch. The LG G2 and Nokia Lumia 1020 are close behind, but it’s Samsung’s super AMOLED display technology that sets it ahead. While screen on the iPhone 5s and 5c can’t match the size or pixel density of their competitors, it’s still a solid highresolution display and many people prefer it for its color accuracy.
4. A great camera You don’t have to be a pro photographer to see the difference between modern phone cameras and the ones on your old flip-phone. A great camera is important for more than just great photos! You can use your camera for some surprising other things, like visual search. Nokia’s Lumia 1020 includes an elite ZEISS lens, image stabilization and a whopping 41 megapixels. See Kim Komando Pg 33
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PRIVATE LIMITATION OF ACTION Expert Analysis & Commentary by Barry Zalma, Esq. Insurer – Even Under ERISA – May Privately Limit the Time to Sue
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artford Life & Accident Insurance Co. (Hartford) is the administrator of Wal-Mart Stores, Inc.’s (Wal-Mart) Group Long Term Disability Plan (Plan), an employee benefit plan covered by the Employee Retirement Income Security Act of 1974 (ERISA). The Plan’s insurance policy requires any suit to recover benefits pursuant to the judicial review provision in ERISA to be filed within three years after “proof of loss” is due. Petitioner Heimeshoff filed a claim for long-term disability benefits with Hartford. After petitioner exhausted the mandatory administrative review process, Hartford issued its final denial.
Barry Zalma, Esq., CFE is a California attorney specializing in insurance coverage, insurance claims handling and fraud who serves as a consultant and expert for insurers and policyholders. He founded Zalma Insurance Consultants in 2001 and serves as its senior consultant. He recently published an e-book, “Getting The Whole Truth,” which is available at his Web site, www.zalma.com. Go to Zalma Books at http://www.zalma.com/zalmabooks. htm.
Almost three years after that final denial but more than three years after proof of loss was due, Heimeshoff filed a claim for judicial review. Hartford and Wal-Mart moved to dismiss on the ground that the claim was untimely. The District Court granted the motion,
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recognizing that while ERISA does not provide a statute of limitations, the contractual 3-year limitations period was enforceable under applicable State law and Circuit precedent. The Second Circuit affirmed. Justice Thomas, writing for a unanimous Supreme Court in Heimeshoff v. Hartford Life & Accident Insurance Co., 12-729 (U.S. 12/16/2013) noted that a participant in an employee benefit plan covered by ERISA may bring a civil action to recover benefits due under the terms
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of the plan. Courts have generally required participants to exhaust the plan’s administrative remedies before filing suit to recover benefits. ERISA does not, however, specify a statute of limitations for filing suit. Filling that gap, the plan requires participants to bring suit within three years after “proof of loss” is due. Because proof of loss is due before a plan’s administrative process can be completed, the administrative exhaustion requirement will, in practice, shorten the contractual limitations period. The question presented is whether the contractual limitations provision is enforceable.
FACTS In 2005, petitioner Julie Heimeshoff began to report chronic pain and fatigue that interfered with her duties as a senior public relations manager for Wal-Mart Stores, Inc. Her physician later diagnosed her with lupus and fibromyalgia. Heimeshoff stopped working on June 8. On August 22, 2005, Heimeshoff filed a claim for long-term disability benefits with Hartford Life & Accident Insurance Co., the administrator of Wal-Mart’s Group Long Term Disability Plan (Plan). Her claim form, supported by a statement from her rheumatologist, listed her symptoms See Zalma Pg 31 The Underwriter’s Insider
QQ SOLUTIONS RELEASES QQ CATALYST™ V2.5, ADDS MAJOR NEW CAPABILITIES TO ITS POPULAR INSURANCE AGENCY MANAGEMENT SYSTEM
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eerfield Beach, FL - QQ Solutions, Inc., one of the largest providers of insurance agency management systems for independent agencies, announced the latest release of its revolutionary cloud-based insurance agency management system, QQ Catalyst™. Catalyst version 2.5 adds support for commercial lines and a contact import feature for importing customers and prospects from several file formats. The update also includes File Manager improvements, several feature enhancements, as well as additional IVANS carrier download certifications. With a dynamically growing customer base – currently over 425 new subscribers since its launch in early 2013 – agencies using older systems can easily migrate to Catalyst. Catalyst is also the easiest agency management system to learn and use. With industry leading features and innovation, like its patent pending “Stack” and “Guided Workflows”, Catalyst will dramatically improve agency productivity and efficiency. Catalyst is truly mobile and works on any device with a modern browser, including PCs, Macs, iPads, iPhones, Android devices, Microsoft Surface tablets, Chromebooks, and other mobile devices. QQ Solutions’ industry leading customer on-boarding, training and support programs make transitioning to and learning Catalyst fast and easy. www.underwritersinsider.com
Plus, Catalyst’s context-aware on-page training videos, built-in help and unique Guided Workflows keep users on track, eliminating errors and following best
Journal, QQ Solutions is a software-asa-service (SaaS) company that provides feature-rich, affordable solutions that help independent insurance agencies
practices. For agencies migrating from older agency management software, database conversions are available.
grow revenues, enhance productivity and operate more efficiently.
Mark Malis, Chief Executive Officer of QQ Solutions added, “Catalyst is performing beyond our expectations and our customers love it. Now, with the addition of commercial lines support, contact and prospect file import and other enhancements, Catalyst is even better and more agencies can take advantage of this great new cloudbased system.” Named one of the “25 Fastest-Growing Technology Companies” in South Florida by the South Florida Business
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One of the largest providers of insurance agency management systems for independent insurance agencies, QQ Solutions supports over 22,000 users nationwide. The company’s mission is to help independent insurance agencies compete in the digital world by leveraging the latest cloud technology, social media, digital marketing and realtime services. To learn more about QQ Solutions products, please call the company at 1.800.940.6600, or visit the QQ Solutions website at: QQSolutions.com. 11
WHAT WILL 2014 BRING US? THE OBAMACARE NIGHTMARE IS JUST BEGINNING.
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OP/ED BY SPENCER A. LEHMANN, RHU
he good parts of the ACA pale in comparison to the Godforsaken mess that Obama and his Gang of Chicago-style Thugs have given “US”. It will be nothing short of a miracle if we are able to keep the good and toss the rest, after January 1st, when the full force of this law smashes Americans in the face. Imagine what the now estimated 15 Million more Americans who have now had their policies canceled, added to the estimated 50 to 100 Million more Americans who will have their policies canceled by September of 2014 when the Small Business Mandates hit, and at minimum we will have 100 Million Americans uninsured - by a law that was only expected to insure 15 Million additional Americans over the 85% of Americans who already had good coverage, and were very happy with it. Barack Obama, his appointees, and the Congressional Democrats, have visited destruction on America never before seen. The real damage is beyond anyone’s imagination. Sound demagogic? Sound overly dramatic? Anyone who doubts these words just has to do the math. When January 1, 2014 comes, we will have at minimum, 45 Million uninsured Americans (the 30
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million estimated by the CBO and the now 15 Million who represent the 6 million canceled policies). Now, add to that number, the unknown millions of Americans who will not have been
able to enroll in any of the exchanges, state or federal. What happens when these massive millions of Americans begin to have heart attacks, and are rushed to the hospital, and are told that they need a heart bypass, or some other procedure to keep them alive (stents?), BUT! They don’t have any insurance. Who is going to give them free coverage knowing they will never be reimbursed? What happens when these massive millions of Americans begin to have serious problems and are rushed to the hospital, and are told that they have cancer, and need radiation, or chemo, or surgery to keep them alive, BUT! They don’t have any insurance.
Spencer A. Lehmann is a Registered Health Underwriter (RHU), whose company, Lehmann/Wood & Associates, Inc., specializes in Group and Individual Long Term Care insurance and Medicare Supplemental Coverage. Mr. Lehmann retired from his company in 2005 and now spends his time writing on Health Care Insurance and Political Issues, both of which have encompassed over 40+ years of his life. He has been an actively involved member of the National Association of Health Underwriters (NAHU) since 1978, and serves on the Board of Directors of several Charitable Organizations’ helping Special Needs Children, and Inner-City Children to experience and participate in the world of the Arts and Music. In his free time he plays golf with his wife, Fran, who usually wins.
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Who is going to give them free care knowing they will never be reimbursed? And what about all those Americans who have accidents and are seriously injured, and have no insurance? Clearly that list goes on into infinity. Did you know that lawyers are a truly “Protected Class” in America? We have no federal “Lawyer Reform,” aka Tort Reform, to protect the public from inappropriate actions such as frivolous lawsuits filed that have no basis in being valid or deserving of credibility. No wonder; 40% of the U.S. House of Representatives are lawyers, and 60% of the U.S. Senate are
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members of the Bar. President is a lawyer.
The current
Know why lawyers make so much money? They sue, and get a lot of money, usually from settlements, and often from insurance companies who provide E&O, Malpractice, and other forms of insurance. Forming “class action lawsuits” and going after those perceived as the guilty parties who harmed those who deserved protection, is another means by which lawyers attain their wealth. In the case of the PPACA Who are the defendants going to be? President Barack H. Obama, Kathleen Sibelius, and all of the Congressional Democrats who did not care about America in their “Rush-to-Claim-Fame,” who created this poorly made law they are now insisting on implementing, even though the implementation is as bad as the law itself. Who will be the party that will have to make good on the benefits promised but not provided? We, the U.S. Taxpayers, will pay the bill. That bill will likely run into many billions of dollars. My fervent hope is that at least when all is said and done, Barack Obama and his comrades in commission of this
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crime, the Democratic Party Members of Congress, are held accountable for what they have done, and pay a price, even if that price is no more thaN the recognition that history will judge them very harshly for the harm they caused America.”
Editor’s Note: Without a doubt, prior to ObamaCare, the most direct, obvious and substantial fix to the cost of health care in the U.S. would have been tort reform - yet the Democrats and the Obama team completely and totally ignored the monstrous cost to Americans of lawyer-driven frivolous lawsuits against health-care providers, medtech and bio-tech companies. Why would these wonderful, compassionate, caring liberals who’s only thought, ambition and dream is to lower the cost of health care for all Americans, particularly the “poor,” forego this wonderful opportunity? Here’s why Virginia: Because it’s not about compassion, care or concern for the poor or the cost of health care. It’s about special interest money. Lots of it. Follow the money: The Association of Trial Lawyers of America - just one legal special interest group among many,
gave $25.6 million in campaign finance contribution since 1989 - 89% of it to Democrats. At the same time, they spent another $29.4 million in lobbying federal officials and lawmakers - all but a fraction of those lobbying funds going to Democrats. To say that the Democrat congress has been bought and paid for by trial lawyers would not be inaccurate. And it seems to be a good investment for the lawyers. The proof is in the PPACA law. The law cuts health care provider fees, sometimes drastically. The law increases health-care premiums, (by one estimate) an average of 99% for men and 62% for women. The law costs and restricts insurors and agents in numerous ways - as well as having to stand as the president’s bogyman whenever the need arises. Only one group - the one group most responsible for rising health care costs - goes unscathed: The trial lawyers. Texas is a classic case of a state once absolutely infested with trial lawyers running amuck throughout the health-care system. When Republicans won a legislative majority, they enacted meaningful reform 10 years ago. The result? True health-care reform: [HERE]
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AIA STATEMENT ON PRESIDENT OBAMA’S NOMINATION OF MAX BAUCUS TO BE THE NEXT U.S. AMBASSADOR TO CHINA
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ASHINGTON, D.C. December 20, 2013 – Stephen Simchak, director of international affairs for the American Insurance Association (AIA), today issued a statement on President Barack Obama’s nomination of Senator Max Baucus (D-MT) to be the next United States Ambassador to the People’s Republic of China. If confirmed by the U.S. Senate, Baucus would succeed outgoing Ambassador Gary Locke. Mr. Simchak’s statement follows: “AIA congratulates Sen. Baucus on his nomination to be the next U.S. Ambassador to China. We urge the Senate to confirm him.
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“Throughout his congressional service, Sen. Baucus has been a leader for international trade and investment policies that level the playing field and open markets for U.S. business abroad. “China’s rapid economic growth and continued expansion of its insurance sector make it an important market for U.S. property and casualty insurers. Additionally, as China seeks to join new negotiations such as the Trade in Services Agreement (TiSA), Sen. Baucus’s engagement and leadership in Beijing will be an invaluable asset.
“AIA looks forward to continuing to work with Sen. Baucus on engagement with the Chinese government on competitiveness issues of U.S. insurers in China. They include the U.S.-China
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Bilateral Investment Treaty (BIT) negotiations, the U.S.-China Joint Commission on Commerce and Trade and the U.S.-China Strategic and Economic Dialogue.” Editor’s Note: Frankly, we also believe that China is an excellent place for Mr. Baucus - Outer Mongolia would be even better. Sen. Max Baucus was one of the key architects of the disastrous ObamaCare fiasco - later admitting that it was a “train wreck.” As for “policies that level the playing field,” this is usually liberal codespeak for wealth redistribution or international “affirmative action,” where developing countries are given advantages to the detriment of the United States. The Underwriter’s Insider
CAR INSURANCE COMPARISION.COM RANKS THE WORST DRIVERS IN THE U.S. Driving in the South is a Hazard! See Your State and the Entire Article [HERE]
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THE HUBBLE SPACE TELESCOPE POINTS ITS INCREDIBLE LENS AT A TINY POINT OF BLACK SPACE - AND DISCOVERS THOUSANDS OF GALAXIES
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rap your mind around this: The Earth, all our sister planets and our star, the Sun, comprise our single solar system with a diameter of approximately 5.65 billion miles. To put that in perspective, at the rate the Apollo astronauts journeyed to the moon, (approximately 25,000 MPH), it would take about 25.5 years to cross our little solar system.
in diameter. That’s a trip of about 645,700,000,000,000,000,000 miles.
In our galaxy, the Milky Way, there are 100’s of billions of such star systems, all orbiting around a super-massive black hole. A light year, the distance light can travel in one year at 186,000 miles per second, is approximately 5.87 trillion miles. The Milky Way is estimated to 110,000 light years
Not too long ago, space scientists decided to point our most powerful telescope - the orbiting Hubble - at a very small point of black sky for a 10 day time exposure. (time exposures allow even tiny quantities of photons to collect on the sensors) The area of the sky covered was about the size of
Pretty big, eh? Not really. About as big as a single grain of sand compared to all the grains of sand on Earth - when compared to the size of the known universe. And what’s known about the universe and what it contains continues to expand and amaze.
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a grain of sand held at arm’s length. The scientists were prepared to see nothing but blackness yet their first attempt yielded 3,000 galaxies in the image and a second attempt in another tiny “black” location yielded over 10,000 galaxies - with each of those galaxies containing 100’s of billions of star systems much like ours. So how big is the observable universe? Because the universe is expanding (at an ever-increasing accelerated rate) objects that were once much closer are now much farther away. Most astronomers put the edge of the observable universe at about 46-47 billion light years away - in any direction measured. That’s big.
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NEW ENGLAND JOURNAL OF MEDICINE STUDY REVEALS NEW DATA ON DISTRACTED DRIVING AMONG TEENS
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recent series of studies by the New England Journal of Medicine reveals some interesting data on novice drivers - but none of it particularly surprising. The extensive study included accelerometers, cameras, global positioning systems, and other sensors installed in the vehicles of 42 newly licensed drivers (16.3 to 17.0 years of age) and 109 adults with more driving experience and were conducted from June 2006 through 2008 and January 2003 through July 2004. According to the research notes: “In both studies, adults provided written informed consent, and adolescents (i.e., those under the age of 18 years) provided written informed assent. Both studies were approved by the institutional review board of Virginia Polytechnic Institute and State University.” During the study, there were 167 crashes or near crashes among the 42 novice drivers and 518 crashes or near crashes among the 109 experienced drivers. Researchers determined that newly licensed drivers participated in relatively few “secondary” tasks such as cell phone calls or checking email at first - but increased the incidence of secondary tasks beyond the incidence of more experienced www.underwritersinsider.com
drivers months later as they became more comfortable and acclimated to the operation of the vehicle.
During the same study period, the incidence of secondary tasks among experienced drivers did not change. Not surprisingly, the study found that the risk of a crash or nearcrash among newly licensed teens increased significantly if the teen was dialing a cell phone, eating, texting, reaching for some object in the vehicle or looking at a roadside object. Among the group of experienced drivers, only cell phone dialing was associated with an increased risk of
a crash or near crash - giving little evidence that certain state laws (such as New York) prohibiting all but hands-free phone use while driving are useful in the prevention of accidents. It was the dialing, usually still necessary with handsfree phone use, that was raising the risk of accident - not the talking. Researchers concluded: “Our analysis, which separated talking and dialing tasks, showed that talking on a cell phone was not associated with a significant increase in the risk of a crash among novice or experienced drivers, whereas dialing was associated with an increased risk in both groups. In contrast to dialing and other high-risk tasks such as texting and reaching for a cell phone or other object, talking on a cell phone does not require the driver to look away from the road ahead.”
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Breaking Industry News
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ast year, Florida ticketed 326,651 drivers for failing to provide proof of insurance. In many instances, 77% to be exact, those tickets were dismissed after proof of insurance was later offered. This is an expensive waste of time for state government and law enforcement. In early December, Gov. Rick Scott and the Florida Cabinet approved regulation that would allow drivers to show proof of insurance on their electronic devices - including cell phones and tablets. The “E-Copy” will be available through an app provided by the carrier.
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. Scott Penny, Regional President and Chief Acquisitions Officer of Brown & Brown, Inc. (NYSE: BRO), together with Rick Roesel, the principal of Agency Services Consolidated, Inc. and Preserve Extended Protection Plan, Inc. (collectively, “Agency Services”), announced in December that Brown & Brown of Kentucky, Inc., a subsidiary of Brown & Brown, Inc., has acquired certain assets of Agency Services. Founded in 1991, Agency Services Consolidated provides warranty and related protection products to auto dealerships in Ohio, Indiana, Kentucky and West Virginia. Preserve Extended Protection Plan was established as a managing general agent for a national extended warranty program for the RV industry. Agency Services Consolidated and Preserve Extended Protection Plan have combined annual revenues of approximately $2.1 million. As part of this transaction, the operations of Agency Services will combine with the recently acquired assets of O’Neil Financial Services and
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operate as a new branch location of Brown & Brown’s recreational vehicle and auto division under the leadership of Mike Neal.
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n Jan. 1, 2014, Roberts Markel Weinberg P.C. and Butler | Hailey will merge to establish a new law firm, bringing together two well established Texas practices, both rated by Martindale-Hubbell as preeminent law firms. The combined entity, which will operate as Roberts Markel Weinberg Butler Hailey PC (RMWBH), will have offices in Houston, Sugar Land, Austin, San Antonio and Dallas. The five principals, Jeffrey Roberts, Marc Markel, Gregg Weinberg, Rick Butler and Roy Hailey, are each board certified in their respective practice areas by the Texas Board of Legal Specialization.
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ife insurance policy holders who become diagnosed with a chronic illness can now access their policy’s death benefits, income tax free (based on current tax laws), through a new, innovative rider offered by American General Life Companies (American General), a part of AIG. The Accelerated Access Solution is available on AG Secure Lifetime GUL II, the highly flexible Guaranteed Universal Life Insurance issued by American General Life Insurance Company.
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ecommended reading by the Wall Street Journal’s James Taranto: How a liberal Obama-Fan wraps her mind around the abject failure of ObamaCare: Margaret Talbot, a staff writer for the New Yorker, who was among those finding their existing health insurance policies cancelled, can’t bring herself to be much critical of ObamaCare even when it results in a $800 additional premium per month - with a $12,700 “out of pocket” cost should she actually want to use the plan. Rather, she loses a night of sleep and then,
The Underwriter’s Insider
like the true believer she is, comforts herself with this clever bit of Marxist rationalization: “The new health-care law exists for the common good, not just the individual consumer. . . . We are better off as a society-more compassionate, but also healthier--when we can all get the care we need. So yes, I’ll subsidize someone else’s prenatal coverage. . . . And I’ll remember to be relieved that my own access to health care is guaranteed.” It’s good that Margaret is feeling better, and we hope for her sake, she stops there rather than remembering that ObamaCare has resulted in millions of cancellations of superior health-care plans with only a pitiful few having been able to replace them with higher cost ACA plans. We hope she doesn’t even think about the millions of families that DON’T have an extra $800 in their monthly budget or an extra $12,700 laying around for their out-of-pocket costs should they actually need to use their insurance. [MORE HERE]
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ommissioner of Insurance Jim Donelon announced that rates for workers’ compensation insurance will decrease in Louisiana effective May 1, 2014. Commissioner Donelon recently approved a 5.1 percent decrease in workers’ compensation loss costs submitted by the National Council on Compensation Insurance (NCCI). NCCI is a national organization which analyzes workers compensation data and files loss costs or rates in 35 states.
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isk Transfer, a national insurance leader in underwriting, innovation, and portfolio management, announced in December new partnerships with a group of major insurance carriers to meet robust company growth and increased demand. 2013 has been one of the most successful years for Risk Transfer and www.underwritersinsider.com
its clients. With its existing carriers and the addition of several new carrier partners, Risk Transfer is poised to continue growing and revolutionizing its industry specialties in 2014. The new partnerships offer a range of products including, but not limited to, a broader class code appetite, “A” Rated (A.M. Best) guaranteed loss and loss sensitive coverages (Master, MCP, Carve-Out, ASO/Pay-As-You-Go) as well as alternative solutions such as captive options. Risk Transfer Holdings continues to provide unparalleled service to the Professional Employer Organizations industry, with a focus on workers’ compensation as well as other lines of insurance.
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fter Tower Group’s management announced their plan to sell its minority share of the Canopius Group Ltd. for $69.7 million to pay off $70 million of outstanding credit, A.M. Best downgraded the financial strength to B (Fair) from B++ (Good). Just last August, A.M. Best had downgraded the group from A- to B++ when Tower gave an indication that reserve changes were impending.
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ortegra Financial Corporation (NYSE: FRF) is pleased to announce that it has completed the sale of Bliss & Glennon, an excess and surplus lines wholesale insurance broker and managing general agency, and eReinsure, a neutral online platform used by clients to manage the placement of facultative reinsurance to AmWINS Group, Inc.
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am R. Boone, Jr., Regional Executive Vice President of Brown & Brown, Inc. (NYSE: BRO), and Troy Brown, the Chief Executive Officer of ICA, Inc., today announced that a subsidiary of Brown & Brown, Inc. has acquired certain assets of ICA, Inc. With origins dating back to 1991, ICA was founded by Troy Brown. With annualized net
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revenues of approximately $13.2 million, the firm provides insurance claims adjusting and related services, including third party administration (TPA) services, throughout the United States. Following the transaction, the acquired ICA operations will continue to operate from their existing locations in Charlotte, North Carolina; Richardson, Texas; and Gold River, California, under the leadership of Troy Brown.
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ere’s one for the guys: Sports Illustrated has posted 79 hot videos on the production of their 2013 SI Swimsuit Issue - including the body paint models. Not for the faint hearted - and probably not safe for work! [HERE]
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ccording to a new Pew Research Center analysis, six-in-ten Americans (60%) say that “humans and other living things have evolved over time,” while a third (33%) reject the idea of evolution, saying that “humans and other living things have existed in their present form since the beginning of time.” The share of the general public that says that humans have evolved over time is about the same as it was in 2009, when Pew Research last asked the question. [MORE]
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he White House admitted last Sunday morning that only 1.1 million people have used the ObamaCare website to signup for insurance by Christmas Day - and only half of those signups may have actually paid a premium (the government refuses to release this critical figure) and have not therefore enrolled. Even if every one of the signups had fully enrolled - the number is 3 million fewer than the 5 million people whose health-insurance policies have been cancelled as a direct result of ObamaCare regulations and mandates. 19
FLORIDA ANNOUNCES ARREST OF ORLANDO ATTORNEY CHARGED WITH STEALING P.I.P. SETTLEMENT MONEY
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ALLAHASSEE – CFO Jeff Atwater today announced the arrest of Orlando Attorney Raymond (Ramon) Ismael Melendez of the Melendez Law Firm, P.A. for allegedly stealing insurance settlement proceeds totaling nearly $80,000 from three personal injury clients. The charges allege that between February 2011 and June 2012, Melendez withheld notification of the settlement agreements from his clients and hid the money for personal use. “Attorneys are trained to earn the trust of their clients and serve their clients’ interests, not steal the settlements they are hired to secure,” said CFO Jeff Atwater. “Thanks to the dedicated work of law enforcement and our investigators, this man can no longer defraud the system or the public’s trust.” An investigation by the Department of Financial Services’ Division of Insurance Fraud revealed that on three separate occasions, in cases against three different insurance companies, Melendez negotiated settlements on behalf of his client and deposited the settlement checks into his public service fund trust account. Rather than notifying the client of the settlement, Melendez lied and told each client that no settlement had been reached and their cases remained in litigation.
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The money was then moved from the trust account and converted to Melendez for personal use.
He was booked into the Orange County Jail and remains the subject of ongoing investigations. Anyone who feels they may have fallen Melendez is victim to his actions charged with is encouraged to one count of contact the Division organized scheme of Insurance Fraud’s to defraud, one Orlando field office count of grand at (407) 835- 4402. theft second Citizens who provide Jeff Atwater, Florida CFO degree and two tips can remain counts of grand theft third degree. anonymous.
THINK ALL AA BATTERIES ARE THE SAME? WATCH THIS CONSUMER REPORTS VIDEO - YOU MAY BE SURPRISED
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N.C. WOMAN ARRESTED FOR FILING FRAUDULENT BILLS WITH INSURER
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ALEIGH -Insurance Commissioner Wayne Goodwin today announced the arrest of Loletia Gail Causey, 36, of 120 Moore St., Siler City; she was charged with one count each of insurance fraud and obtaining property by false pretense. Department of Insurance criminal investigators allege that Causey submitted inflated and fraudulent medical bills in support of a claim with Southern General Insurance Company after an Aug. 4, 2013, car accident in Chatham County. Investigators allege that Causey exaggerated the extent of her medical injuries and submitted the fraudulent medical bills in an attempt to defraud the insurance company of nearly $11,000.
WISDOM FROM A SURPRISING SOURCE: DIRTY JOBS MIKE ROWE
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ho knew? Turns out TV’s Mike Rowe, famous for tackling some of the dirtiest jobs on Earth in the popular series, Dirty Jobs, happens to also be an articulate and sage analyst of some of the largest issues facing the country today as you will see from the interview below with Nick Gillespie on www.reason.com. Should all children be herded to college? Are white collar jobs really more rewarding? Why does America demonize dirty jobs? How compliance is killing the economy? Is safety truly “first?” It’s a long (41 minute) video and well worth the entire watch - but we’ve included a timeline for some of the highlights to shorten you search if you have limited time:
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• • • • • • • •
• •
His bad experience with a high school guidance counselor (3:20) Why he provides scholarships based on work ethic (6:57) The problem with taxpayersupported college loans (8:40) Why America demonizes dirty jobs (11:32) The happiest day of his life (13:14) Why following your passion is terrible advice (17:05) Why it’s so hard to hire good people (21:04) The hidden cost of regulatory compliance (23:16) The problem with Obama’s promise to create shovel ready jobs (33:05) Efficiency versus effectiveness (34:17) Life after Dirty Jobs (38:24)
Causey was arrested on Dec. 11 in Chatham County and placed under a $10,000 bond. The Department of Insurance employs 20 sworn state law enforcement officers dedicated to investigating and prosecuting claims of insurance and bail bonding fraud. Since Insurance Commissioner Wayne Goodwin took office in 2009, criminal investigators have made more than 800 arrests, resulting in more than 430 criminal convictions. These efforts have delivered more than $55 million in restitution and recoveries for victims. www.underwritersinsider.com
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“The Final Authority on Everything!” Has Your Password Been Lifted In A Data Breach?
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guess I’m like everyone else. I’ve got dozens of online sites I use that require a password. Because I can’t memorize 67 unique passwords and don’t like to have to look up every password every time, I tend to use the same password for many of those sites. I keep hearing about big companies being hacked for data and it seems possible some bad guy has my password and I’ve become concerned they could use that to access my banking account or email. How can I find out? Love the Insider - keep up the good work! F.G. New York, NY The latest buzzword in ‘Net security is “PWND,” a derivation of “OWNED,” and it applies to online passwords. If your password was included in a security breach, it can be said to have been Pwnd. And there is good reason to be concerned. According to one ‘Net security expert, the following major companies have been hacked for usernames, passwords and password hints. Here’s just the big company names and the number of compromised passwords grabbed by hackers: Adobe -152,445,165 Stratfor - 859,777 Gawker - 532,659 Yahoo! - 453,427 Vodafone - 56,021 Pixel Federation - 38,101 Sony - 37103 How to find out if your password has been pwnd? Troy Hunt’s Have I been pwned? website consolidates the databases from seven major www.underwritersinsider.com
ADVISOR
breaches for a single search. You need only to type in your the email address you normally use for login and the site will instantly tell you if your password may have been compromised. Click [HERE] to access the site. I learned from the search that two of my passwords were taken with the Adobe data breach. Reportedly, the security on Adobe’s site was substandard and lacking in strong encryption. Almost as alarming: In most cases, the password hints were taken along with the associated passwords. The bad guys now know your mother’s maiden name, your paternal grandfather’s first name, your first boyfriend/girlfriend, your favorite movie and the street you grew up on. This data would make it much easier for a determined bad guy to learn or reset your password on a site that that uses hints. It’s almost tougher
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to protect “hints” then it is passwords, unless you want to take the trouble to give bogus answers to hint questions and keep track of them in a secure database you keep on your home computer. There a lots of tricks on creating strong passwords that are easy to remember. One method is to use an acronym formed from an easy to recall phrase, such as “My Dog Has Black Fleas.” The “core” of your password would be “mdhbf.” Capitalize your first letter to comply with the requirements of many sites leaving you with “Mdhbf.” Now add “@88 (or any other combo of numeric and non-alphanumeric) to the end for a very strong, 8 digit, easy to recall password: “Mdhbf@88.” Doesn’t mean squat, however, when Adobe or Yahoo hands it out to hackers like Halloween candy...
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2-20 or 20-44 Agent Needed In Pembroke Pines, FL
FREE CLASSIFIED RULES: Submit all ads online at: www.underwritersinsider. com/classifieds. Ads must be less than 501 characters plus a title line. Eligible free classifieds include help wanted, position wanted, personal ads, agency for sale/purchase, or the one-time sale of an item or items. Place Ad HERE! REGULAR CLASSIFIED RULES: Submit all ads online at: www. underwritersinsider.com/classifieds. Only $1.00 per word, including title line and response info. Payment must be received prior to print date. Ads run 3 mo.
Comm.P&C Producer Central Florida Commercial Insurance sales from a retail agency / broker or direct writer with a proven track record. Must have 3 to 10 years experience, 220 license, with an industry focus or mix of targeted niches. Must have aggressive sales skills and credible business relationship development abilities. Central Florida. Michael@einsgroup.com 10-8
INSURANCE BOOK OF BuSINESS WANTED Looking for seasoned, quality book in SE Florida. 35 year veteran will slowly ease your exit or quick buyout - your terms. Email: Appropriaterisk@gmail.com 10-11
Wholesale Broker/Carrier
Asst. Controller Hartford
License Insurance Agent 220 - Kissimmee Area
Strong Stat/GAAP with corporate tax is required. Will consider negotiating relocation assistance. Contact:
We are looking 220 Insurance Agent License in Kissimmee Florida. A detail-oriented professional with excellent timemanagement, organization and computer skills High school diploma or equivalent (GED) with a valid state driver’s license and reliable insured transportation. Currently posses an active 220 License Call us at 407-847-2539 10-9
Jeanine Drahota Lost Dutchman Search 480-563-7676 jkd@lostdutchmansearch.com 10-7
TAMPA, FL Area Part Time CSR Must like and know computers - near Hwy 301 and MLK. Flexible hours, low key environment. Pay commensurate with experience. Contact: cp.kazor@gmail.com 10-6 24
CSR 440 or 220 Agent N Miami area Looking for a 2-20 agent or CSR Bilingual ( English-Spanish ), Excelent on Customer service Email resume to jamie@ jmendezandassociates.com 10-1
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Great opportunity for the agent looking for the opportunity to be paid by production rather than salary. Our Pembroke Pines office is looking the right people to write commercial and/or personal lines. Email cr2dome1@ gmail.com for more information. 10-7
Roswell, GA Premium Finance Sales Opportunity Are you ready to take your sales career to the next level? Est. in 1984 and based in Roswell, GA, Advanced Insurance Systems Inc. is a fast paced, high growth technology company that develops and markets premium finance software throughout N. America. While working mostly insidesales in our Roswell office, you will be challenged by the development of new business and the on-going support for existing clients. Help move sales opportunities through demos, proof of concept and responding to requests for information and proposals. Resumes to:
Arthur@financemaster.com
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Experienced 2-20 Commercial Agent in Boca Raton, FL Great opportunity for the experienced Agent looking for the opportunity to be paid well by production, rather than salary. Our office in Boca Raton is looking for a results oriented commercial agent. Compensation will be far higher than industry standards, including renewals. Contact email address with resume and cover letter: agencyops@gmail.com 10-11 The Underwriter’s Insider
Experenced Commercial Lines CSR-Tampa Area Established large Independent Agency seeks experienced Commercial Lines CSR. Duties include all aspects of customer service incl. telephone calls from customer and underwriters, issue COI, Auto ID Cards, Evid. of Prop. Market new and renewal policies, prepare proposals, process invoices, binders, policies, endorse., audits, recommend., etc. This position requires a minimum of 4 years of commercial account handling. Knowledge of AMS360 management system will be a plus. Contact: susank@adcock-insurance.com 10-8
P&C Carrier Asst. Controller Upper NY State Stat/GAAP - solid yellow book required.Company will negotiate relocation at offer. Great area to raise a family. Enjoy all outdoor sports - hunting, fishing, hiking, water sports, skiing. Contact: Jeanine Drahota Lost Dutchman Search 480-563-7676 jkd@lostdutchmansearch.com 10-7 “The ultimate result of shielding men from the effects of folly is to fill the world with fools.� - Herbert Spencer
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Multinational Account Executive
NY/NJ/CT area
International property & casualty insurance skills including professional lines, directors & officers too. Manage, marketing servicing and be a resource for multinational or domestic P&C Programs. Carrier or Broker background preferred. Selfstarter, foreign language skills a plus. NY/NJ/CT area Contact: Michael@einsgroup.com 10-8
FREE CLASSIFIEDS HERE 2-20 Agent Wanted Today Insurance Services is looking for friendly, sharp, and PATIENT agent partners to take advantage of the health care reform opportunities, and the sizzling auto insurance market! I can help you- Can you help yourself? www.todayins.com CALL TODAY! 321-360-8516
IMPORTANT! Florida Insurance & Series 6 License Qualification Courses Now Forming! A.D. Bankers Since 1979 SEE OUR AD HERE!
10-7
Experienced CSR Wanted - New Port Richey area Experienced Commercial Lines CSR wanted for Roe Insurance, Inc in New Port Richey, Fl. 34655. Applied Systems experience required, will service approx 250 small C.L. clients, mostly in the nonprofit industry. Contact: greg@roeins.com 10-6
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Gainesville, FL Area
4-40 or 2-20 Needed Insurance Den Inc needs a 2-20 or a 4-40 licensed agent. Email: insuranceden@aol.com Fax: 352-628-5619 Phone: 352-628-2331 10-5 25
SAY WHAT? Notable Quotes You May Have Missed!
Soon, even the mention of his name will be blasphemy...
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the national embarrassment experienced when President Obama, flirting with Denmark’s attractive Prime Minister Helle Thorning-Schmidt, took a “selfie” along with Thorning-Schmidt and British Prime Minister - while Michelle absolutely steamed... The image, humiliating to the First Lady as well as the nation, ran in the worldwide press for weeks.
I want to talk today about a controversial word. It’s a word that has been with us for years, and like They Don’t Immigrate - They Metastasize it or not, it’s indelibly printed in the pages of American history. A word that was No new building permits will be issued. I think originally intended as a derogatory that’s enough mosques for Moscow. Muscovites term, meant to shame and divide and are becoming irritated by people who speak a demean. The word was conceived of different language, have different customs, and by a group of wealthy white men who display aggressive behavior.” - Moscow Mayor Sergei needed a way to put themselves above Sobyanin, who was once quoted as saying, “Muslims and apart from a black man; to render don’t immigrate, they metastasize and will destroy him inferior and unequal and to diminish their host country if allowed.” his accomplishments. - Perpetually angry, left-wing whackdoodle Poor Chris -The Thrill Is Gone... and MSNBC host Melissa HarrisPerry actually keeping a straight Don’t you feel, I think everybody feels an face while attempting to make absence of communication from the time Melissa Harris-Perry the preposterous case that the he’s been elected. And it’s not about not being term “ObamaCare” is racist - ignoring the fact that the left-wing enough or too left. That’s not his problem. President himself proudly used the term hundreds of It’s connection. And Mrs. Obama, she’s an amazing times - until the disastrous rollout of the law connecting asset. And what has she done? Obesity? How about him a little too solidly to what must be the most connecting with the American people about being incompetently managed website launch in the history of Americans? I don’t think she’s, I don’t think she’s the Internet. Melissa apparently conveniently forgot the happy. I don’t think once widely-used term “HillaryCare,” during the Clinton they like being in the administration as the then First Lady Hillary Clinton White House. The attempted and failed to bring her health care reform American people can to law. Was the term “HillaryCare” created by wealthy tell that. They don’t black men to diminish Hillary? You can’t make this stuff seem thrilled at the up... fact the American “Boobs and Bores” people have selected them as our first It’s official — the government of the United States family. I don’t sense of Obama consists of boobs and bores and is led by the gratitude, the a narcissist. It is no consolation that Great Britain joins happiness level, us in racing to the bottom. President Obama’s flirting the thrill of being with Denmark’s prime minister would be shameful on president. Bill any occasion. That it happened at the memorial for Clinton loved being Hardball Host Chris Matthews, captured at the exact moment Nelson Mandela only adds to the embarrassment.” president every he felt the thrill go up his leg... - From a story in the New York Post in response to minute and you
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knew it.” - Disappointed, far-left MSNBC Hardball host Chris Matthews, who once famously commented that he was so enthralled with then candidate Obama, he “felt a thrill going up [his] leg” when hearing the politician speak, now taking a much harsher tone after analysis of the president’s actual performance in office. As for Michelle’s “connecting with the American people about being American,” Chris would do well to remember her oft repeated quote during the 2008 election cycle where she brazenly babbled she had never really been proud of her country - until her husband was nominated to the Democratic ticket. The American people have not forgotten.
The MSNBC Smug Club
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A club where the smug go to exchange hateful opinions and reassure each other it’s acceptable.” - CNN host Don Lemon defining MSNBC after a segment mocked Mitt Romney’s family photo, which included his adopted black grandson. Radically-left MSNBC host Melissa Harris-Perry and her whack-doodle panel apparently thought the black child being pictured alongside the white family was absolutely hysterical.
The Ghost of Columbia University A True American Mystery
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I am a graduate of Columbia University, Class of 1983. That’s the same class Barack Obama claims to have graduated from. We shared the same exact major- Political Science. We were both Pre Law. It was a small classabout 700 students. The Political Science department was even smaller and closer-knit (maybe 150 students). I thought I knew, or met at least once, (or certainly saw in classes) every Wayne Allen Root fellow Poly Sci classmate in my four years at Columbia. But not Obama. No one ever met him. Even worse, no one even remembers seeing that unique memorable face. Think about this for a minute. Our classmate is President of the United States. Shouldn’t someone remember him? Or at least claim to remember him? So I asked every classmate I met at our 30th reunion, many of them Political Science majors, if they ever met, or saw, or heard of
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Obama. The answer was a resounding NO from every one of them. I asked if they found this strange, or worried how this was possible? They all answered YES. I asked if they thought it was possible to be a Political Science major and never meet a fellow major in our small classes? They all gave me a very strange look and answered NO. So I asked, “How could this be possible? Can you explain this?” No one had an answer. Keep in mind these people I spoke to are allto a man and woman- dedicated liberal Democrats who voted for Obama. I’m guessing 90% are major Democrat contributors. My Columbia classmates are the crème of the crop of American society. Lawyers, doctors, billionaire hedge fund members, stars of the media. They adore Obama. But they all admit they never met him in their four years at Columbia. Why did he have no friends, why did he never show up in a class? Something’s wrong. Something smells rotten at Columbia...” - Columnist/Author Wayne Allen Root, a man who should have spent 4 years in the company of fellow classmate Barack Obama while doing his underclass years at Columbia University - but never once remembers seeing or meeting the future president in a classroom or anywhere else. Odder still, neither could any other alumni at a recent 30th class reunion! For more on the mystery of Barack Obama’s time at Columbia University: [MORE]
What Were They thinking?
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So now the government is mandating my healthcare insurance choice - and they promise to punish me if I fail to get in step with the central government’s dictates. But my family is barely making ends meet. We did not have insurance because we choose to feed the kids and pay the mortgage instead. The ObamaCare family premium is thousands a month and we just don’t have it. We don’t have half of it. We don’t have a tenth of it. Sure, we are due some tax subsidies in April 2015, but this is January 2014! Where the hell are we supposed to scratch up $22,000 between now and then? And if we have to use the coverage, where are we supposed to find the $10K deductible and the co-pay? There must be millions of families just like us. This is the “Affordable Health Care Act?” Are they kidding? This is the lunatic health care act! BTW, my husband just got reduced to part-time so his contractor employer didn’t have to comply with ObamaCare mandates. The world has gone freaking insane. Get me outta here.” - Blogger D.Liniate commenting on a recent Wall Street Journal OP/ Ed on the cost and impact of ObamaCare.
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December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
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March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
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POUR MOLTEN ALUMINUM DOWN A FIRE-ANT NEST AND THE RESULT IS ART!
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WHO IS KING OF THE SUPERCARS? BUGATTI VEYRON VS LAMBORGHINI AVENTADOR VS LEXUS LFA VS MCLAREN MP4-12C
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ZALMA as “‘extreme fatigue, significant pain, and difficulty in concentration.’” In November 2005, Hartford notified Heimeshoff that it could not determine whether she was disabled because her rheumatologist had never responded to Hartford’s request for additional information. Hartford denied the claim the following month for failure to provide satisfactory proof of loss. Hartford instructed Heimeshoff that it would consider an appeal filed within 180 days, but later informed her that it would reopen her claim, without the need for an appeal, if her rheumatologist provided the requested information. After two additional physicians retained by Hartford reviewed the claim, Hartford issued its final denial on November 26, 2007. On November 18, 2010, almost three years later (but more than three years after proof of loss was due), Heimeshoff filed suit in District Court seeking review of her denied claim
pursuant to ERISA. Hartford and provide certain pre-suit procedures Wal-Mart moved to dismiss on the for reviewing claims after participants ground that Heimeshoff’s complaint submit proof of loss (internal review). was barred by the The courts of Plan’s limitations appeals have “There should be no provision, which uniformly required stated: “Legal action that participants dispute, therefore, from cannot be taken exhaust internal this day forward, that against The Hartford review before a private limitation of . . . [more than] 3 bringing a claim years after the time for judicial review. action provision in a written proof of loss A participant’s policy of insurance is is required to be cause of action furnished according under ERISA enforceable and that to the terms of the accordingly does the insured, seeking to policy.” not accrue until the plan issues a enforce – by litigation The U.S. Supreme final denial. – a policy term must Court granted do so within the time certiorari to resolve The parties in this a split among the case have agreed allowed by the contract Courts of Appeals by contract to a of insurance.” on the enforceability 3-year limitations of this common period. The contractual contract specifies limitations that this period provision. begins to run at the time proof of loss is due. Because proof of loss is due before a participant can exhaust ANALYSIS internal review, Heimeshoff contends Statutes of limitations establish that this limitations provision runs the period of time within which a afoul of the general rule that statutes claimant must of limitations commence upon bring an action. accrual of the cause of action. Absent As a general a controlling statute to the contrary, matter, a statute a participant and a plan may agree of limitations by contract to a particular limitations begins to run period, even one that starts to run when the before the cause of action accrues, as cause of action long as the period is reasonable. “‘accrues’”—that is, when the plaintiff can file suit and obtain relief. ERISA and its regulations require plans to
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The Supreme Court has recognized that statutes of limitations do not inexorably commence upon accrual. Because the parties have agreed by contract to commence the limitations See Zalma Pg 35 31
Experts and Consultants for Insurance Disputes 4441 Sepulveda Boulevard Culver City, California 90230 310-390-4455 zalma@zalma.com http://www.zalma.com
Consultation from Zalma Insurance Consultants (ZIC) can save you or your client thousands of dollars in the defense or prosecution of an insurance dispute. ZIC provides expert advice and counsel insurers and plaintiffs’ counsel find indispensable. Consultation from ZIC can save you, your counsel or client hundreds of hours of investigative and legal work. ZALMA INSURANCE CONSULTANTS is a service of Barry Zalma, Inc. a California professional corporation. Barry Zalma is an internationally recognized expert on insurance coverage, insurance claims handling, insurance bad faith, insurance fraud detection, the defeat of false and fraudulent claims, Barry Zalma, Esq. insurance claims handling, and the resolution of insurance disputes. As a consultant, expert witness, lawyer, author, mediator or arbitrator he serves all parties who need consultation or expert testimony on matters relating to insurance coverage, insurance claims handling, insurance fraud and the tort of bad faith. Barry Zalma founded Zalma Insurance Consultants to help resolve any insurance claim problem faced by you or your clients that do not need Mr. Zalma’s services as a lawyer. His experience and skill as a consultant and expert witness can make the difference before a jury or other trier of fact. For more than 44 years as a claims person and insurance coverage attorney, Barry Zalma has represented insurers, advised insurers on claims handling, interpreted coverages and testified as an insurance coverage, insurance bad faith, insurance claims handling and insurance fraud expert on behalf of insurers and policyholders in state and federal courts.
Expert Testimony
Zalma Insurance Consultants serves insurers, policyholders, underwriters, brokers, agents, adjusters, public insurance adjusters, lawyers and any person involved in an insurance dispute. Because he is an attorney licensed to practice law in the state of California M r. Zalma may be prohibited by California case law from acting as a consultant or expert witness and, therefore, refuses to serve in any situation where a past client of his law firm, Barry Zalma, Inc. is adverse to anyone seeking his services.
Y ou can obtain M r. Zalma’s C.V . at http://www.zalma.com and his e-book publications http://www.zalma.com/zalmabooks.htm and blogs daily at Zalma on Insurance, http://zalma.com/blog.
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KIM KOMANDO
It’s clearly the best camera phone because it’s more camera than phone! The iPhone 5s and the HTC One are also very respectable shooters. Their image sensors have larger pixels, which gives you better color range and excellent low-light images.
How cool would it be to control your TV with your smartphone? You’ll never search for the remote again! Phones like the HTC One and Samsung Galaxy S4 include Infrared transmitters as well as apps to help you control your TV. Of course, there are third-party infrared add-ons for the iPhone and other Android phones.
9. Fingerprint sensor Apple’s most gabbed-about feature on the new 5s was definitely the fingerprint sensor. It’s not really any more secure than traditional lockscreen passcodes, but it does save you time. The HTC One Max Android phone also has one, but few other phones do at this time. See Kim Komando Page 37
5. NFC Near Field Communications allows your smartphone to transmit data to other phones and tablets in the vicinity. It’s really handy for sharing pictures and music. You can even use it to pay at stores and restaurants! Plenty of great Android and Windows phones offer NFC, but not Apple.
6. Multiple windows You’d never settle for seeing just one window on your computer, why would you on your phone? Samsung Galaxy phones, as well as LG’s G2, Optimus and Enact are superb at letting you see multiple apps at once. Other Android phones and the iPhone stick to displaying a single app at a time.
7. Plenty of storage space Most smartphones come with anywhere between 16 and 32 gigabytes of storage. Extra space is a nice luxury, but these days you’ll be saving most of your media in the cloud.
8. Infrared remote control
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FLORIDA COMMISSIONER ANNOUNCES APPOINTMENT OF CHIEF OF STAFF AND DEPUTY CHIEF OF STAFF
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ALLAHASSEE, Fla. – Florida Insurance Commissioner Kevin McCarty today announced that Rebecca Matthews has been appointed Chief of Staff for the Office of Insurance Regulation. Ms. Matthews has been serving in the
Interim Chief of Staff capacity since October 25, 2013. Monte Stevens has also been named as Deputy Chief of Staff with a primary focus on government affairs. Ms. Matthews joined the Office in 2008. During her tenure with the Office, Ms. Matthews’s primary areas of oversight included government affairs initiatives, covering both legislative and cabinet affairs; market research and technology; and serving in an advisory role to the Chief of Staff for agency administration and operations. Prior to joining the Office, Ms. Matthews served as Legislative Affairs Director for both the Florida Department of Management Services and the
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Florida Lottery. She also served in lead communications positions, including as Vice President of Communications at the Florida Bankers Association. Ms. Matthews received her Bachelor of Science degree in Communications from Florida State University with a minor in Political Science. Mr. Stevens previously led government affairs efforts for the Office during 2007 - 2012. Most recently, Mr. Stevens served as the Director of Government Affairs and Public Policy at the Florida Medical Association. Additionally, he served as a Senior Legislative Analyst in the Florida House of Representatives Majority Office and as Deputy Director of Legislative Affairs at the Florida Department of Financial Services and Florida Agency for Health Care Administration. Mr. Stevens has a Bachelor’s degree in Political Science from the University of Missouri-Kansas City and a Master’s degree in Communication Studies from Kansas State University.
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ZALMA period at a particular time the Supreme Court found more appropriate guidance in precedent confronting whether to enforce the terms of a contractual limitations provision. “[I]n the absence of a controlling statute to the contrary, a provision in a contract may validly limit, between the parties, the time for bringing an action on such contract to a period less than that prescribed in the general statute of limitations, provided that the shorter period itself shall be a reasonable period.” Order of United Commercial Travelers of America v. Wolfe, 331 U.S. 586, 608 (1947). The duration of a limitations period can be measured only by reference to its start date. Each is therefore an integral part of the limitations provision, and there is no basis for categorically preventing parties from agreeing to an end date but not to a start date. The principle that contractual limitations provisions ordinarily should be enforced as written is especially appropriate when enforcing an ERISA plan. ERISA allows employers large leeway to design disability and other welfare plans as they see fit. Once a plan is established, the administrator’s duty is to see that the plan is maintained pursuant to that written instrument. The Supreme Court concluded that the focus on the written terms of the plan is the linchpin of a system that is not so complex that administrative costs, or litigation expenses, unduly discourage employers from offering ERISA plans in the first place. Heimeshoff’s cause of action for benefits is likewise bound up with the written instrument. The Supreme Court www.underwritersinsider.com
concluded that it must give effect to the Plan’s limitations provision unless it can determine that the period is unreasonably short, or that a controlling statute prevents the limitations provision from taking effect. Neither Heimeshoff nor the United States claims that the Plan’s 3-year limitations provision is unreasonably short on its face. And with good reason: the United States acknowledges that the regulations governing internal review mean for “mainstream” claims to be resolved in about one year, leaving the participant with two years to file suit. Even in this case, where the administrative review process required more time than usual, Heimeshoff was left with approximately one year in which to file suit. Heimeshoff does not dispute, and the court acknowledged, that a hypothetical 1-year limitations period commencing at the conclusion of internal review would be reasonable. Heimeshoff and the United States warned the court that it will endanger judicial review to allow plans to set limitations periods that begin to run before internal review is complete. The United States suggests that administrators may attempt to prevent judicial review by delaying the resolution of claims in bad faith. But administrators are required by the regulations governing the internal review process to take prompt action and the penalty for failure to meet those deadlines is immediate access to judicial review for the participant. Moreover, even in the rare cases where internal review prevents participants from bringing actions within the contractual period, courts are well equipped to apply traditional doctrines that may nevertheless allow participants to proceed. If the administrator’s
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conduct causes a participant to miss the deadline for judicial review, waiver or estoppel may prevent the administrator from invoking the limitations provision as a defense. To the extent the participant has diligently pursued both internal review and judicial review but was prevented from filing suit by extraordinary circumstances, equitable tolling may apply. Finally, in addition to those traditional remedies, plans that offer appeals or dispute resolution beyond what is contemplated in the internal review regulations must agree to toll the limitations provision during that time. The Supreme Court, therefore, held that the Plan’s limitations provision is enforceable and affirmed the judgment.
ZALMA OPINION Although this case did not make the headlines it is important to every insurance professional. Like ERISA plans almost every first party property policy, every health and disability policy, contain a private limitations of action provision. As Justice Thomas said, the written terms of the plan is the linchpin of a system that is not so complex that administrative costs, or litigation expenses, unduly discourage the issuance of a policy of insurance. There should be no dispute, therefore, from this day forward, that a private limitation of action provision in a policy of insurance is enforceable and that the insured, seeking to enforce – by litigation – a policy term must do so within the time allowed by the contract of insurance. The private limitations of action provision will be enforced as long as there is no ground for estoppel or other excuse for failure to file a timely suit. 35
CALIFORNIA INSURANCE AGENT ARRESTED FOR THEFT AND PROVIDING BOGUS INSURANCE Department of Insurance issues consumer warning and urges potential victims to call
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EDDING, Calif. - Rodger Edward Winkler, 64, a property and casualty agent was arrested by Shasta County District Attorney investigators and charged with numerous felonies including grand theft, insurance fraud and petty theft, for allegedly collecting insurance premiums from clients and issuing bogus insurance certificates. The California Department of Insurance urges anyone who purchased insurance from Winkler to contact their insurance company and verify coverage.
they did not receive the coverage promised. Two of the consumers contacted the insurance companies when they did not receive their policies and were told the policies were canceled for non-payment of premium. Other consumers who paid Winkler and received insurance certificates found out the certificates were allegedly fraudulent after the insurance companies confirmed the policy information on the certificates was bogus.
Investigators found that Winkler collected more than $6,000 from clients for workers' compensation, general liability, and commercial automobile insurance coverage and allegedly failed to forward the premium exposing his clients to the risk of "Winkler's crimes Rodger Edward Winkler uncovered loss. are particularly offensive because he potentially The Department of Insurance victimized consumers twice," said is taking enforcement action to Insurance Commissioner Dave Jones. suspend Winkler's agent license "When Winkler stole premiums and prohibit him from transacting from consumers and issued bogus insurance business. The department insurance certificates, he left them is also asking anyone that purchased vulnerable to additional loss because insurance from Winkler and find they they actually did not have coverage do not have legitimate coverage to for their car, home or business." contact the Consumer Hotline at 800927-4357. The department received several requests for assistance from Winkler is currently out on $50,000 consumers who claimed that after bail and is scheduled for arraignment paying Winkler for insurance coverage 36
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CA BUSINESS OWNER TO REFUND $4.2 MILLION IN WORKERS' COMP FRAUD
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RESNO, Calif. - Richard Lopez Escamilla Jr. 47, was sentenced in Kings County Superior Court on December 4, 2013 to one felony count of insurance fraud and was ordered to pay restitution of nearly $4.2 million to SCIF, SeaBright Insurance and Employment Development Division. Escamilla was also sentenced to serve six years in prison for defrauding two insurance companies by underreporting employee payroll and unemployment insurance tax evasion. "This is a win for California consumers, insurers and taxpayers," said Insurance Commissioner Dave Jones. "This case isn't just about one crook who stole from two insurance companies, business owners across the state end up paying the real price for workers' compensation fraud through higher premiums and those costs are passed to consumers." In a joint investigation with the King's County district attorney's office and the Employment Development Department, investigators uncovered evidence that Escamilla, owner of ROC Harvesting, a farm labor contracting company allegedly misrepresented previous claim information to his insurer in order to illegally reduce his workers' compensation premium. Additionally, Escamilla underreported his employee payroll to further reduce his premium costs. The Underwriter’s Insider
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OHIO AGENT SENTENCED TO TWO YEARS OF PROBATION FOR $7,700 THEFT AND INSURANCE FRAUD
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OLUMBUS – Ohio Lieutenant Governor and Insurance Director Mary Taylor announced that former life insurance agent Russell Lowery, of Olmsted Falls, was sentenced in Cuyahoga County Common Plea Court to two years of probation for theft and insurance fraud and ordered to pay $7,714.31 in restitution to the insurance company. His license has been revoked by the Department. “Insurance fraud is not a victimless crime as it increases the cost of insurance,” Taylor said. “Those who choose to break the law will pay the price for their irresponsible actions.” A Department investigation determined that Lowery filed 69 bogus life policy applications in 2009 and received advanced commissions from the insurance company in which the policies were written.
We hang the petty thieves and appoint the great ones to public office. - Aesop Table of Contents
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