Simply Junior

Whenever you ask a talking head paid by the insurance industry, “How do you calculate the premium rate?” the answer is always the same. There’s a big smile of sincerity and that reassuring voice says, “We look at the driver. It’s all about who you are and what you drive.” And that, of course, is how it should be. Actuaries are paid to estimate the risk of accidents and, as they keep telling us, the statistics never lie. These actuaries are like pack rats. They collect every last detail of every accident that gets reported. It doesn’t matter whether it’s a police report, a claim to the insurers from a hospital for treating accident victims, or reports in local newspapers. They have information about accidents going back to the time we were switching over from real horses to horse-powered engines. So ask how many men aged 33 have had an accident at 2 a.m. while driving a red Ford Contour in the rain with a new moon and, with the click of a mouse, you will have the answer by return. It’s the detail that’s so impressive. More importantly it shows exactly how many claims are made by male as opposed to female drivers, and what the average value of the claims is.

All around the world, the statistical evidence shows women making fewer claims and, when they are involved in accidents, the amount claimed tends to be lower.

The reason for this is that, in general, women drive within the law. They do not try to beat the lights or drive too fast on city streets so, if there is an accident, they are traveling more slowly and the impact is less damaging both to the vehicles and the people inside. Not surprisingly, this excellent safety record has been rewarded by lower premiums. Where the risk is lower, drivers pay less. Except, in Europe, this will change next year.

The European Court for Human Rights has just ruled that men and women must pay the same premiums. At the end of 2012, there must be a new system in place to calculate premiums without relying on gender as a key factor. So what’s going on? Well, ask yourself, is it fair to charge someone more to insure their vehicle just because they are male. No one asks to be born male or female so why penalize all those who have the bad luck to be born male? Keeping this real, men don’t crash because their sexual apparatus gets caught in the steering wheel. People get into accidents because they drive badly. There’s no point in forcing people to pay more because of something they are powerless to control. There’s every reason to base auto insurance quotes on actual driving records because, if the record is bad and the premium rate is high, it gives those drivers an incentive to improve their driving. Calculating premiums should be very personal, looking at how well each individual drives. Grouping everyone together on the basis of their gender for issuing auto insurance quotes is arbitrary and unfair (at least, in Europe).

There’s a strange contradiction about insurance. It’s an annoying burden every month when the time to pay the premium comes around but, if the worst should happen, it’s a wonderful thing to have had that insurance policy in place. With the family budgets really tight as the recession shows little sign of going away, the monthly bank statement shows the insurance instalments disappearing. You look at your own health. That’s great. You have never had a day of serious illness in your life. It’s the same for your partner. You cannot avoid feeling a little resentful. All those dollars, every month. And then there’s an accident or one of you does unexpectedly fall ill. It’s then you discover whether that plan you have been paying into is actually worth the money.

The market for health plans is divided in a slightly complicated way. It’s really to ensure the insurance companies make a profit as the cost of treatment keeps on rising way faster than inflation. So it reflects a balancing act between allowing the patients some say, and denying them any real control, over access to treatment. The plan most popular with the insurance industry is Managed Care. This requires you to get the insurer’s permission before you attempt to access treatment. The first contact doctor must be from an approved list, and he or she must refer you on for further diagnostic tests or treatment. Failure to get this referral usually means the insurer will refuse to pay. The second option is a Fee For Service Plan where you pay a lump sum at the beginning of each year, followed by monthly instalments. This covers you for the medical services listed in your policy. Basic plans only cover consults with your doctor and a simple set of tests. More expensive plans have a better range of coverage but there are usually co-payments.

Health Maintenance Organizations (HMOs) are networks of healthcare professions. If you stay within the network, your medical needs are covered although, in most plans, co-payments will be required. The next step up is a Point of Service Plan (POS). This is a variation on the HMO and allows a networked doctor to refer you to an outside expert. Finally, there are Preferred Provider Organizations (PPOs) which offer more choice than an HMO or POS both in the doctors you can access and the treatments you can have, e.g. usually include preventative medicine.

Because the service offered by this site is free, you can get as many health insurance quotes as you like for each of the main types of plan. This gives you more information on which to make your decision. But it’s fair to say the decision is not an easy one unless you read the detail of each plan with some care. With all the health insurance quotes available, you are often forced to balance coverage against cost, i.e. you buy the amount of coverage you can afford. This makes the choices something of a gamble. Do you pick emergency care in the event of an accident or focus on a list of the most common diseases or disorders? Do you include long-term care against the possibility you might be more permanently disabled by whatever happens? There is no right or wrong answer to these questions. In the end, it all comes down to what you can afford and what helps you to sleep best at night.

There are times when you get an overview and then it hits you, “Somethings just don’t add up.” Well, you remember Wellpoint, don’t you? This is the friendly company that, around January or February, announced it was going to increase premium rates by up to 39% in a number of states around the Union. President Obama got himself all worked up, citing them as the real reason why all the Democrats in Washington should band together and take a stand against the insurance industry. Then, sure as eggs is eggs, there was a stampede to get the healthcare reform bill to the President for him to sign it into law. Those Democrats sure did have fun beating on Wellpoint. So the big question is what happened next? Here’s one of the largest corporations in the insurance market demanding premium increases. Did it get its way?

The answer starts off in California where the maximum rate of 39% was due to take effect. The state referred the proposed increase to independent auditors for an opinion. The answer came back negative. It seemed Wellpoint couldn’t add up. Well, that’s oversimplifying things a little. But the reality is that the numbers Wellpoint offered to support their premium increases were based on some very shaky mathematical assumptions. When news of the report became public, Wellpoint withdrew the proposed increase. Acting on this, Kathleen Sebelius who is Secretary of the Department of Health and Human Services sent out a letter to all state insurance commissioners encouraging them to review every proposed premium increase. This is the first sign that the balance of power is shifting against the insurance industry and in favor of the consumer. For too long, insurance companies have hidden behind complicated mathematical explanations and gamed the system. With the Affordable Care Act now law, Sebelius is encouraging every state to give itself the power to approve rate increases. The first sign of continuing good news for consumers comes out of Connecticut where Attorney General Blumental forced an audit of Blue Shield and Anthem Blue Cross, both Wellpoint subsidiaries. Connecticut’s Insurance Commissioner Sullivan rejected these companies requests for increases last year. It seems likely the same thing will happen this year.

By moving so quickly to encourage states to review all proposed rate increases, Secretary Sebelius is demonstrating one of the key advantages now available to the Federal Government under the new laws. That the interests of the consumer will be put before the interests of the health insurance industry. This means every state should be going through a routine of analysis every time premium rate increases are proposed. The assumptions, evidence, claims histories and trends asserted should all be rigorously tested. If there are any problems, the increases should be denied. The aim should always be to ensure affordable individual health insurance plans are available to the majority of people living in the US. For too long, the insurers have been allowed to bamboozle regulators with math and complicated explanations. With independent audits now coming into play, the kind of success enjoyed by the citizens of California should be felt around the US.

As with every group of businesses, there’s an association for the insurance industry. It’s called the Insurance Information Institute. When individual insurers fear adverse publicity, the III usually gets the job of making general announcements. That way, the news comes out with less damage to the member companies. So, for example, when there was flooding because of the melting snow and then the torrential rains, it was left to the III to warn people that the majority of policies do not cover damage caused when sewers back up. That’s not the most reassuring of news. Making equally bad reading was a report that premium rates for property insurance were likely to rise by an average of 3% this year. This reflects both the aforementioned bad weather and the rise in the costs of repairs. You might not have noticed it yet, but builders have been steadily increasing their charges. The price of gas has been rising, labor costs are up, replacement materials are more expensive – it’s all bad news even though there’s supposed to be a recession.

So why might you have a heart attack when your renewal notice hits the mailbox? Although the politicians may not have accepted the reality of climate change, the insurance industry is watching the statistics and reassessing weather risks state-by-state. There’s been tornadoes and major storms across the southern states. Their premiums will be rising faster. The other common reason flows from the insistence that you all shop around for your next policy. In the days of habit, you picked an insurer and bundled your auto and home policies. This earned you a discount and everyone was happy. As more people use internet search engines to find the cheapest auto insurance, they are breaking the bundle and the rate for the remaining home policy goes up sharply. You should always look at all your policies together and not deal with separate policies.

How to keep premium rate increases to a minimum? First remember CLUE. The Comprehensive Loss Underwriting Exchange is another insurance industry body that stores information about every claim you make. If you propose changing insurers, the first thing new companies check before giving you a quote is whether you have recently made a claim. If so, you will be quoted a higher premium. The moral of this story is not to claim unless you are looking at a really big loss. Then there’s the recession and its effect on your credit score. Most insurers include the score in their formula to decide whether you are a responsible person. The assumption is that people with good credit records will also take care of their homes. Before you start shopping around, do whatever you can to improve your score. For useful advice, try www.myfico.com and www.whatsmyscore.org.

In other words, no matter how great the temptation to track down cheap home insurance using the internet, think carefully about bundles, the claims you have made, and your credit score. These are factors under your control and, unlike blindly increasing your deductible which is you deciding to insure yourself, will produce long-term savings on your homeowners insurance quotes. Remember, it’s better to get quality home insurance at an affordable price than cut-price insurance that fails to cover you when your sewers dump their contents in your kitchen.

The distinction made by the insurance industry is between term and permanent life insurance. So you either buy a policy for a fixed term of years which then expires, or the policy is “permanent”, i.e. it usually stays valid and enforceable during your life. The other elements of permanence cover the premium rate which can remain the same throughout your life and the terms of the policy which continue to apply regardless of any change in your health or other circumstances. Never liking to leave anything really simple and straightforward, the industry then divides policies into three basic types. The first is the so-called whole life policy which many consider the most appropriate because the insurers tend to offer minimum guarantees. Why are guarantees useful? For someone aged in their twenties, it is difficult to predict what will happen over the next fifty years (allowing for the average life expectancy). Despite the fact that stock markets have shown steady growth over time, this is partly due to inflation. The buying power of the dollar today will be worn away by price increases, so the numbers representing stock values have to keep rising to keep pace. This is not an increase in real values. It simply prevents a loss of value. So, if an insurer today guarantees you a minimum rate of return over your lifetime, and that rate is better than inflation, it looks a good deal to take it. Better the known than the unknown.

The second type of policy is the universal which offers more flexibility, allowing you to vary the amount you pay into the fund according to changes in your financial circumstances. When you are new to the world of employment, pay is low and so you start with a low premium rate. As your pay increases, you increase the premium rate. If there is a family emergency, you can elect not to pay for a period of time. The key difference is that a whole life policy collects and adds dividends to the cash value, whereas the universal simply pays interest on the cash in hand. Despite this, there are minimum values guaranteed but they tend to be lower than the guaranteed amounts in whole life policies. The third type of policy, the variable, appeals to those with a higher risk appetite. It gives you more control over the investments. Some insurers do offer you guidance on investment strategies, but the price of your management is you take responsibility for generating the returns. The insurer does not give anything more than a token guaranteed minimum for the benefits payable to your dependents.

As suggested in previous articles, the promise of growth in cash value, whether through investment or the payment of interest, is something of a smokescreen. When you are going through the life insurance quotes to decide which policy might represent the best buy for you, do not focus on the investment opportunities. Analyze the life investment quotes to find the policies offering permanence on the best terms. What you should consider is the possibility of problems with your employment. Is there a way you can keep the policy in place if you cannot afford to pay the same level of premium? Some allow you to convert the policy to one fully-paid-up, using the cash value to buy future years. Others allow you to suspend payment for a period. Since your main purpose should be protecting the interests of your dependents, keeping the policy in place is the most important factor.