Month: June 2016

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The quality of the health care that you receive can have a major impact on your health and well-being; it is surprising, then, to discover that many people do not know the first thing about determining the quality of the health care that they receive from their medical facilitators. All too often, patients rely solely on referrals from their HMOs or choose a facility at random. The fact of the matter is that doing your research before settling on any given medical facilitator is imperative. There are several ways to do this, including reading quality reports, looking at consumer ratings and checking for accreditation information.

Checking For Accreditation Information

When a private, unbiased and independent group gives a medical facility or provider its seal of approval, it is called accreditation. In order to receive accreditation from such independent groups, a hospital, nursing home or other medical facility must meet many strict national guidelines and standards. Accreditation is also an ongoing process, meaning that facilities are reviewed periodically to ensure that they are still up to par with current standards. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the National Committee for Quality Assurance (NCQA) are two of the best-known accreditation bodies in the healthcare industry.

Reading Quality Reports

There are several quality reports, or report cards, published regarding medical facilities and providers each year. Such reports judge and rate the quality of care provided by medical facilitators, allowing patients to get a better feel for which facility is right for them. Government-sponsored report cards are among the most well-respected; the US Department of Health and Human Services, for instance, publishes a report that compares hospitals around the USA. Another topnotch quality report is one concerning nursing homes that is published by the Centers For Medicare and Medicaid Services.

Looking At Consumer Ratings

While reports and accreditation are valuable tools, getting a feel for the human side of healthcare is also important. To learn how fellow patients have ranked various medical facilities in an area, people can check online for consumer ratings. Such ratings can cover a myriad of different topics and subjects, and often include basic customer service ratings in order to give patients an idea about the level of service at individual facilities. When combined with quality reports and accreditation information, consumer ratings can help patients form an overarching idea about the quality of hospitals, clinics and individual medical facilitators in their area.

Being Proactive About Healthcare

In order to receive the best service possible from their healthcare providers, patients must do their research. Simply assuming that any given medical facilitator will provide exceptional service is foolhardy at best, and dangerous at worst. Being proactive about the quality of the care that is received is the responsibility of every single patient. By holding medical facilitators accountable for the level of care that they provide, the quality of healthcare services as a whole will improve. Doing this research takes very little time and can make a huge difference.

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Source by Zoumanan Debe

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Do you need to get a UB04 form completed for an insurance company? What is a UB04 form? Where do you find one? And how do you fill it out? We run across these questions often in the world of medical billing. Most medical health insurance claims are filed on CMS 1500 forms (sometimes called HCFA forms). These are more common to most people. Many billers do not know when to use the CMS forms and when to use the UB 04 forms.

The UB04 claim form is used by facilities rather than physicians for their health insurance billing. Hospitals, rehabilitation centers, ambulatory surgery centers, clinics, etc need to bill their services on the UB04 form in order to get paid. Physician billing is done on the CMS 1500 claim forms.

Every once in awhile we get a call from a person who is trying to get an insurance claim paid and they are told by the insurance company that they must file the claim on a UB04 claim form. These people do not have a clue what this form is or how to complete it. They may have had to admit a loved one into a drug and alcohol rehab facility and now find that the facility does not participate with their insurance plan. These facilities often do not file UB04 forms and can not help the family get reimbursed by the insurance company.

Many times the family has paid up front for the services of the facility and are now trying to get the insurance company to reimburse them. Insurance policy may The pay out of network but the claim must be filed correctly on a UB04 form . Often times people are trying to collect many thousands of dollars on the claim. Required fields on the UBO4 form include rev codes, value codes and type of bill. What do you put in these fields? These forms can be very confusing. Where do you get the correct information to complete the forms? And which fields are required on the form? If the facility does not have a UB04 form to fill out, where do you get one?

Unfortunately the answers are not easy. The Rev codes represent the procedure codes. The type of bill is a three digit number that represents the type of facility, the bill classification and the frequency of the bill. The value codes are required fields only in certain situations. It is very difficult to complete these forms correctly without previous experience or proper training. Another catch is that the forms were changed in May 2007 to allow for use of the NPI number. You must understand NPI numbers completely to determine where you should be entering an individual NPI number or a group NPI number. And when you try to find UB04 forms for sale, you find they are available in boxes of 2500.

If you find yourself needing to file a claim on a UB04 form and do not know what you are doing, make sure you look into it fully. Claims are often denied time after time for information being incomplete or incorrect. If your claim is for a lot of money, you may not want to wait months for payment.

Copyright November 2008 – Alice Scott

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Source by Scott alice

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Trying to shop for life insurance when you have multiple sclerosis can be daunting. It helps to consult experts in life insurance for people MS with, so they can guide you through the process. But it also helps to know what the actual insurance companies look for when underwriting this type of policy.

What do life insurance underwriters look for when they determine the rating for someone with multiple sclerosis?

• Type of multiple sclerosis. A person with Relapsing / Remitting Multiple Sclerosis is most likely to get a medically underwritten policy like someone of good health can get. The rates will be higher for people with multiple sclerosis, but rates vary widely from company to company. So it is very important to use agents experienced in writing life insurance for people MS with in order to get the lowest rate. There are several No Exam policies that work well for people with the Progressive forms of multiple sclerosis, as well.
• When diagnosed. Most companies like to wait a year after diagnosis so they can see the pattern the person's MS takes before making an offer. However, there are also policies that one can get shortly after being diagnoses with multiple sclerosis.
• Symptoms. It seems that no two people MS with have exactly the same symptoms, and therefore underwriting life insurance for those with multiple sclerosis is complicated. The fewer the symptoms, the better the rate will be, and the more life insurance choices one has. Symptoms considered are: need of assistance for walking, depression, incontinence, nerve pain, memory loss, and whether one needs home health or institutionalized care. Whether or not you are capable of working fulltime is also a consideration for medically underwritten policies. There are policies to cover almost every symptom, so never assume you are uninsurable due to MS!
• Treatment. Medically underwritten products are easiest to get by people who have had good results with Copaxone, Rebif, Avonex, and other MS treatments approved. However, there are policies for people with no treatment, all the way to people who have had a stem cell transplant.

It can be frustrating for people MS with to buy life insurance when they are able to do what anyone else does, yet still find themselves paying more than someone with no health problems. But even people with perfect health pay higher rates if they have a parent with heart disease. There is no way around paying more, but agencies that specialize in multiple sclerosis life insurance can help you pay a lot less.

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Source by Peggy Mace

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There are many arguments as to who really needs a complete life insurance package and who needs some form of coverage in the form of rider. Does you spouse really need a rider if you already have a life insurance policy? Does you child or dependent really need one too?

To answer this question correctly we must understand the basic needs life insurance coverage meets …

A life insurance policy is basically meant for breadwinners or persons whose demise will cause hardship for their survivors. Although there are other reasons why people buy life policies this is the main reason.

Some insurers have certain riders to cater for spouses and dependents. Such riders add term life coverage for such a spouse or dependent. It certainly makes more sense to buy a dedicated term life insurance for such a person if you think it's necessary. You'll almost always get a far lower rate per $ 1,000 coverage for the person in question if you get another complete term life insurance policy.

For the dependent, you really do not need any form of life insurance for a child unless you want to start a foundation in their memory or make a donation to their favorite charity if they pass on. If you're thinking in such lines then you'll serve that cause better by getting another life insurance policy for such a child or dependent instead of a rider.

We can make an exception for rare cases (like child actors) where the family fortunes will be dramatically altered if such a child passes on. Life insurance is a real necessity then. Like I explained when I talked about the main reason for a life insurance policy, such a child contributes considerably to the family's finances. Therefore the loss of that child will result in the loss of such financial contribution with the attendant consequences.

If you've decided to buy a life insurance for yourself, spouse or dependent, you'll get far better rates if you get and compare many quotes from many different insurers. This is because the difference in rates from insurers for a particular policy could range from a few hundreds to a couple of thousand dollars.

If you already have a policy, you can also reduce your current rates by getting and comparing life insurance quotes from insurers you did not get quotes from before you bought your present policy.

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Source by Chimezirim Chinecherem Odimba

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Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed.

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government can not know what is best for them. These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government's responsibility is to protect its citizens, sometimes even from themselves.

Two opposing arguments arising from two opposing ideologies. Both are good arguments but neither can be the supporting argument for implementing or denying universal health care. The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments than those already presented. Ethical issues would center on the moral right. Discussion would begin with not "What is best for me?" but rather "How should we as a society be acting so that our actions are morally correct?"

Ethics refers to determining right and wrong in how humans relate to one another. Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned with individual rights and freedoms.

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct. Here are some questions that could be used in ethical decision making for health care reform.

• What action will bring the most good to the most people?
• What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other?
• What action in and of itself shows caring and concern for all citizens?

As the answer to all these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform. They are the only developed country without a national health care system in place for all citizens. They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere.

However, all ethical decision making is structured around values. In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

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Source by Beverly OMalley

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When we experience muscle pain, one thing is for sure: we want to get rid of it as soon as possible. As a provider of in-home massage therapy services, people often contact my company first when seeking relief from things like neck pain, low back pain, and other pain. In most cases we do recommend massage, but oftentimes when the condition is severe, it will be in conjunction with therapies and / or recommendations from other health care providers in order for an individual to get the most immediate and effective results.

So where should a person with muscle pain turn first and why? Primary Care Physician? Chiropractor? Massage Therapist?

Making the right choice largely depends on how a person answers the following questions:

• What is the severity of the condition and how long has it been present?
• What is your general health condition and history, including family medical history?
• Are you willing to take medication prescribed by a traditional medical doctor or must the therapy be all "natural"?
• Is the pain caused by something specific like an injury or a pre-existing condition?
• What kind of insurance, if any, is available and what services will it cover?
• If there is no insurance to cover therapy, what kind of budget do you have to pay for treatments out of pocket?

This may seem like an overly conservative if not complicated approach if we're just talking about a stiff neck, but the idea is to identify any potentially more serious health conditions, and also to avoid paying for anything that could be covered by insurance.

First let's get the insurance question out of the way. When it comes to massage therapy, often the only kinds of insurance policies that will pay for it (including at home massage) are auto insurance or workman's compensation insurance for car and work injuries. Massage therapists can not officially diagnose any condition, so a doctor's prescription is always required. A lot is there more to this Particular side-topic, so for additional information about how this works, please see an articles the I have already written about what kinds of insurance covers massage therapy .

It should also be noted that normal health insurance may cover physical therapy, but this is quite different from massage therapy and often requires a prolonged treatment plan.

Next and perhaps more importantly; when someone approaches us with serious pain, we want to make sure that it's not something they should see a doctor about first. If it is something with a sudden onset, highly abnormal (not just a stiff neck), or possibly associated with other health problems (just to name a few possible red flags) we might recommend seeing a medical doctor first. This assumes that the individual would be open to using medication, because in addition to the myriad of tools at physician's disposal, it is highly likely that a doctor will prescribe an anti-inflammatory or possibly a prescription pain killer if the pain is severe.

It's important for people to understand that while massage therapy can be very effective in reducing pain caused by muscle tension and related restrictions, it can only achieve so much with one visit. Typically, in order to address more chronic kinds of pain, multiple sessions will be required to make significant headway. Therefore, it is often not a bad idea to see a doctor who may be able to prescribe medication to help the condition, both in terms of reducing pain immediately, and also for reducing inflammation in general, which is often largely responsible for musculoskeletal pain. These efforts can actually make subsequent massage therapy sessions even more effective.

Think of the tight muscles like a frozen stick of butter. If you try to press into it when it's right out of the freezer, it's almost impossible to make a dent. However if it has been defrosted to room temperature (like muscles on an anti-inflammatory), it could be in a much easier state to work with in the care of able hands. This being said, it's also important to be careful about the use of pain killers before getting a massage and advise the therapist of the current use of any medications.

Another option for those with muscle pain which would fall somewhere in between going to a medical doctor and seeing a massage therapist would be going to see a chiropractor. While a chiropractor can not prescribe medication, they can diagnose certain conditions, perform x-rays, and provide natural therapy including "adjustments" among some other things that massage therapists are not authorized to do. In some cases they may also be able to accept normal major medical health insurance along with a co-payment. For some people this is a good "in-between" option providing a relatively high level of care that is also "natural". At the same time, there can be drawbacks.

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Source by Daniel Melmed

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In June 2009, a 22-year-old Honolulu mother of three young children was sentenced to a year in prison for illegally accessing another woman's medical records and posting on a MySpace page that she had HIV.

The State of Hawaii brought charges against the woman under a state statute criminalizing the unauthorized access to a computer; and which categorized the conduct of the defendant as a class B felony.

According to accounts of the incidents that led to the woman's conviction, there was a feud between the victim and the victim's sister-in-law, a friend of the defendant. The defendant, who worked as a patient service representative at the hospital where the victim was a patient, accessed the computer for the victim's sister-in-law.

Over the course of approximately ten months, the defendant accessed the patient's medical records three times through a computer. After she learned of the victim's medical condition, the defendant posted on her MySpace page that the victim had HIV. In a second posting, she said the victim was dying of AIDS.

The victim complained to hospital officials of the unauthorized access. After an internal investigation the hospital terminated the defendant's employment.

The defendant's conduct, of course, was egregious and inexcusable. The one-year jail term handed down by the Court exceeded the term recommended by the prosecutor. Nevertheless, beyond the issue of holding the defendant accountable for her actions some may question to what extent the hospital should bear responsibility for the breaches of confidentiality that occurred.

Federal law imposes statutory burdens on health care providers to protect against the improper use or disclosure of private health information and to reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.

Specifically, the Health Insurance Portability and Accountability Act of 1996's ( "HIPAA") privacy regulations became effective on April 14, 2003. HIPAA is intended to protect consumers' health information, allow consumers greater access and control to such information, enhance health care, and finally to create a national framework for health privacy protection. HIPAA covers health plans, health care clearinghouses, and those health care providers that conduct certain financial and administrative transactions electronically.

In addition to the privacy regulations, HIPAA's security rules became effective on April 21, 2005. Together the privacy and security regulations are the only national set of regulations that governs the use and disclosure of private, confidential and sensitive information.

Under HIPAA's Security Rule, the standards for the protection of electronic information covered by HIPAA are divided into three groups: Administrative safeguards, Physical safeguards and Technical safeguards.

A couple of the most significant required safeguards under HIPAA are the Administrative "Sanction Policy" and "Security Awareness Training" safeguards.

The sanction policy standard requires a communication to all employees regarding the disciplinary action that will be taken by the covered entity for violations of HIPAA. The sanction policy should have a notice of civil or criminal penalties for misuses or misappropriation of health information and make employees aware that violations may result in notification to law enforcement officials and regulatory, accreditation, and licensure organizations.

The security awareness training standard requires all employees, agents, and contractors to participate in information security awareness training programs. Based on job responsibilities, the covered entity should require individuals to attend customized education programs that focus on issues regarding use of health information and responsibilities regarding confidentiality and security.

The HIPAA privacy and security regulations require a privacy officer and security officer to be designated by the covered entity. The privacy and security officer should continually analyze and manage risk by thoroughly assessing potential risks and vulnerabilities, and implementing related security measures.

The US Department of Justice ( "DOJ") clarified the penalties that may be assessed and against whom for HIPAA violations. Covered entities and individuals whom "knowingly" obtain or disclose individually identifiable health information in violation of HIPAA may be fined up to $ 50,000, as well as imprisonment up to one year.

Offenses committed under false pretenses allow penalties to be increased – a $ 100,000 fine, with up to five years in prison. Finally, offenses committed with the intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain or malicious harm permit fines of $ 250,000, and imprisonment for up to ten years.

Given the security breach that led to the tragic events, including the one-year jail term for the defendant, Hawaii employers, health care providers and health plans should review their privacy and HIPAA policies and conduct an audit of their practices in order to protect against the improper use and disclosure of private health information and to reduce the risk of privacy breaches in their own organization.

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Source by Roman Amaguin

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INTRODUCTION

The word "Fear" has only four alphabets like love but both of them have very different e meaning. Whatever man (malor female) does for the love of their families always starts with the background of fear. Generally so many times we have been asking our selves that, what will happen if we were not there, but we keep on asking rather then doing something for it. Time is precious, it never stops for any one and we are living in the world of uncertainty; the uncertainty of job, the uncertainty of money, the uncertainty of property and like this the story goes continuous for the whole life of a man.

A thriving insurance sector is of vital importance to every modern economy. Firstly because it encourages the habit of saving, secondly because it provides a safety net to rural and urban enterprises and productive individuals. And perhaps most importantly it generates long- term invisible funds for infrastructure building. The nature of the insurance business is such that the cash inflow of insurance companies is constant while the payout is deferred and contingency related.

This characteristic feature of their business makes insurance companies the biggest investors in long-gestation infrastructure development projects in all developed and aspiring nations. This is the most compelling reason why private sector (and foreign) companies, which will spread the insurance habit in the societal and consumer interest are urgently required in this vital sector of the economy. Opening up of insurance to private sector including foreign participation has resulted into various opportunities and challenges in India.

LIFE INSURANCE MARKET

The Life Insurance market in India is an underdeveloped market that was only tapped by the state owned LIC till the entry of private insurers. The penetration of life insurance products was 19 percent of the total 400 million of the insurable population. The state owned LIC sold insurance as a tax instrument, not as a product giving protection. Most customers were under- insured with no flexibility or transparency in the products. With the entry of the private insurers the rules of the game have changed.

The 12 private insurers in the life insurance market have already grabbed nearly 9 percent of the market in terms of premium income. The new business premium of the 12 private players has tripled to Rs 1000 crore in 2002- 03 over last year. Meanwhile, with regard to state owned LIC's new premium business has fallen.

Innovative products, smart marketing and aggressive distribution. That's the triple whammy combination that has enabled fledgling private insurance companies to sign up Indian customers faster than anyone ever expected. Indians, who have always seen life insurance as a tax saving device, are now suddenly turning to the private sector and snapping up the new innovative products on offer.

The growing popularity of the private insurers is evidenced in other ways. They are coining money in new niches that they have introduced. The state owned companies still dominate segments like endowments and money back policies. But in the annuity or pension products business, the private insurers have already wrested over 33 percent of the market. And in the popular unit-linked insurance schemes they have a virtual monopoly, with over 90 percent of the customers.
The private insurers also seem to be scoring big in other ways- they are persuading people to take out bigger policies. For instance, the average size of a life insurance policy before privatization was around Rs 50,000. That has risen to about Rs 80,000. But the private insurers are ahead in this game and the average size of their policies is around Rs 1.1 lakh to Rs 1.2 lakh- way bigger than the industry average.

Buoyed by their quicker than expected success, nearly all private insurers are fast- forwarding the second phase of their expansion plans. No doubt the aggressive stance of private insurers is already paying rich dividends. But a rejuvenated LIC is also trying to fight back to woo new customers.

INSURANCE TODAY

In 1993, Malhotra Committee, headed by former Finance Secretary and RBI Governor RN Malhotra, was formed to evaluate the Indian insurance industry and recommend its future direction. The Malhotra committee was set up with the objective of complementing the reforms initiated in the financial sector.

With the setup of Insurance Regulatory Development Authority (IRDA) the reforms started in the Insurance sector. It has became necessary as if we compare our Insurance penetration and per capita premium we are much behind then the rest of the world. The table above gives the statistics for the year 2000.

With the expected increase in per capita income to 6% for the next 10 year and with the improvement in the awareness levels the demand for insurance is expected to grow.
As per an independent consultancy company, Monitor Group has estimated a growth form Rs. 218 Billion to Rs. 1003 Billion by 2008. The estimations seems achievable as the performance of 13 life Insurance players in India for the year 2002-2003 (up to October, based on the first year premium) is Rs. 66.683 million being LIC the biggest contributor with Rs. 59,187 million. As of now LIC has 2050 branches in 7 zones with strong team of 5,60,000 agents.

IMPACT OF GLOBALISATION

While nationalized insurance companies have done a commendable job in extending the volume of the business, opening up insurance sector to private players was a necessity in the context of globalization of financial sector. If traditional infrastructural and semipublic goods industries such as banking, airlines, telecom, power etc., have significant private sector presence, continuing a state of monopoly in provision of insurance was indefensible and therefore, the globalization of insurance has been done as discussed earlier. Its impact has to be seen in the form of creating various opportunities and challenges.

The introduction of private players in the industry has added colours to the dull industry. The initiatives taken by the private players are very competitive and have given immense competition to the on time monopoly of the market LIC. Since the advent of the private players in the market the industry has seen new and innovative steps taken by the players in the sector. The new players have improved the service quality of the insurance. As a result LIC down the years have seen the declining in its career. The market share was distributed among the private players. Though LIC still holds 75% of the insurance sector the upcoming nature of these private players are enough to give more competition to LIC in the near future. LIC market share has decreased from 95% (2002-03) to 81% (2004-05). The following company holds the rest of the market share of the insurance industry.

TABLE – 1

IMPACT OF GLOBALISATION

NAME OF THE PLAYER MARKET SHARE (%)

LIC 82.3

ICICI PRUDENTIAL 5.63

BIRLA SUN LIFE 2.56

BAJA ALLIANZ 2.03

SBI LIFE 1.80

HDFC STANDARD 1.36

TATA AIG 1.29

MAX NEW YORK 0.90

AVIVA 0.79

OM KOTAK MAHINDRA 0.51

ING VYASA 0.37

AMP SANMAR 0.26

METLIFE 0.21

PRESENT SCENARIO OF GLOBALISATION

In a tough battle to expand market shares the private sector life insurance industry consisting of 14 life insurance companies at 26% have lost 3% of market share to the state owned Life Insurance Corporation (LIC) in the domestic life insurance industry in 2006-07 . According to the figures released by Insurance Regulatory & Development Authority, the total premium of these 14 companies have shot up by 90% to Rs 19,471.83 crore in 2006-07 from Rs 10, 252 crore.

LIC with a total premium mobilisation of Rs 55,934 crore has been able to retain a market share of 74.26% during the reporting period. In total the life insurance industry in first year premium has grown by 110% to Rs 75, 406 crore during 2006-07. The 2006-07 performance has thrown a few surprises in the ranking among the private sector life insurance companies. New entrants like Reliance Life and SBI Life had shown a huge growth of over 381% and 210% respectively during the year. Reliance Life which has become one of the top five companies ended the year with a premium of Rs 930 crore during the year.

Though ICICI Prudential Life Insurance remained as the No 1 private sector life insurance company during the year. Bajaj Allianz overtook ICICI Prudential in terms of monthly market share in March, for the first time ever. Bajaj's market share among private players in non-single premium for March stood at 29.1% vs. ICICI Prudential's 23.8%. Bajaj gained 4.6 percentage point market share among private sector players for FY07.

Among other private players, SBI Life and Reliance Life continued to do well, each gaining 4% market share in FY07. SBI Life's growth was driven by increasing contribution from ULIP premiums. Another notable developments of the 2006-07 performance has been the expansion of retail markets by the life insurance comapnies. Bajaj Alliannz Life insurance has added 20 lakh policies while ICICI Prudential has expanded over 19 lakh policies during the year.

With the largest number of life insurance policies in force in the world, Insurance happens to be a mega opportunity in India. It's a business growing at the rate of 15-20 per cent annually and presently is of the order of Rs 450 billion. Together with banking services, it adds about 7 per cent to the country's GDP. Gross premium collection is nearly 2 per cent of GDP and funds available with LIC for investments are 8 per cent of GDP.

Yet, nearly 80 per cent of Indian population is without life insurance cover while health insurance and non-life insurance continues to be below international standards. And this part of the population is also subject to weak social security and pension systems with hardly any old age income security. This itself is an indicator that growth potential for the insurance sector is immense.

A well-developed and evolved insurance sector is needed for economic development as it provides long term funds for infrastructure development and at the same time strengthens the risk taking ability. It is estimated that over the next ten years India would require investments of the order of one trillion US dollar. The Insurance sector, to some extent, can enable investments in infrastructure development to sustain economic growth of the country.

Insurance is a federal subject in India. There are two legislations that govern the sector- The Insurance Act- 1938 and the IRDA Act- 1999. The insurance sector in India has become a full circle from being an open competitive market to nationalisation and back to a liberalised market again. Tracing the developments in the Indian insurance sector reveals the 360 ​​degree turn witnessed over a period of almost two centuries.

Important milestones in the life insurance business in India

1912: The Indian Life Assurance Companies Act enacted as the first statute to regulate the life insurance business.

1928: The Indian Insurance Companies Act enacted to enable the government to collect statistical information about both life and non-life insurance businesses.

1938: Earlier legislation consolidated and amended to by the Insurance Act with the objective of protecting the interests of the insuring public.

1956: 245 Indian and foreign insurers and provident societies taken over by the central government and nationalised. LIC formed by an Act of Parliament- LIC Act 1956- with a capital contribution of Rs. 5 crore from the Government of India.

In a tough battle to expand market shares the private sector life insurance industry consisting 14 life insurance companies at 26% have lost 3% of market share to the state owned Life Insurance Corporation (LIC) in the domestic life insurance industry in 2006-07. According to the figures released by Insurance Regulatory & Development Authority the total premium these 14 companies have shot up by 90% to Rs 19,471.83 crore in 2006-07 from Rs 10, 252 crore.

LIC with a total premium mobilisation of Rs 55,934 crore has been able retain a market share of 74.26% during the reporting period. In total the life insurance industry in first year premium has grown by 110% to Rs 75, 406 crore during 2006-07. The 2006-07 performance has thrown a few surprises in the ranking among the private sector life insurance companies. New entrants like Reliance Life and SBI Life had shown a huge growth of over 381% and 210% respectively during the year. Reliance Life which has become one of the top five companies ended the year with a premium of Rs 930 crore during the year.

Though ICICI Prudential Life Insurance remained as the No 1 private sector life insurance company during the year Bajaj Allianz overtook ICICI Prudential in terms of monthly market share in March, for the first time ever. Bajaj's market share among private players in non-single premium for March stood at 29.1% vs. ICICI Prudential's 23.8%. Bajaj gained 4.6 percentage point market share among private sector players for FY07.

Among other private players, SBI Life and Reliance Life continued to do well, each gaining 4% market share in FY07. SBI Life's growth was driven by increasing contribution from ULIP premiums. Another notable development of the 2006-07 performance has been the expansion of retail markets by the life insurance companies. Bajaj Alliannz Life insurance has added 20 lakh policies while ICICI Prudential has expanded over 19 lakh policies during the year.

OPPORTUNITES

– A state monopoly has little incentive to innovative or offers a wide range of products. It can be seen by a lack of certain products from LIC's portfolio and lack of extensive risk categorization in several GIC products such as health insurance. More competition in this business will spur firms to offer several new products and more complex and extensive risk categorization.

– It would also result in better customer services and help improve the variety and price of insurance products.

– The entry of new players would speed up the spread of both life and general insurance. Spread of insurance will be measured in terms of insurance penetration and measure of density.

– With the entry of private players, it is expected that insurance business roughly 400 billion rupees per year now, more than 20 per cent per year even leaving aside the relatively under developed sectors of health insurance, pen More importantly, it will also ensure a great mobalisation of funds that can be utilized for purpose of infrastructure development that was a factor considered for globalisation of insurance.

– More importantly, it will also ensure a great moblisation of funds that can be utilized for purpose of infrastructure development that was a factor considered for globalisation of insurance.

– With allowing of holding of equity shares by foreign company either itself or through its subsidiary company or nominee not exceeding 26% of paid up capital of Indian partners will be operated resulting into supplementing domestic savings and increasing economic progress of nation. Agreements of various ventures have already been made to be discussed later on in this paper.

– It has been estimated that insurance sector growth more than 3 times the growth of economy in India. So business or domestic firms will attempt to invest in insurance sector. Moreover, growth of insurance business in India is 13 times the growth insurance in developed countries. So it is natural, that foreign companies would be fostering a very strong desire to invest something in Indian insurance business.

– Most important not the least tremendous employment opportunities will be created in the field of insurance which is burning problem of the present day today issues.

CHALLENGES BEFORE THE INDUSTRY

New age companies have started their business as discussed earlier. Some of these companies have been able to float 3 or 4 products only and some have targeted to achieve the level of 8 or 10 products. At present, these companies are not in a position to pose any challenge to LIC and all other four companies operating in general insurance sector, but if we see the quality and standards of the products which they issued, they can certainly be a challenge in future . Because the challenge in the entire environment caused by globalisation and liberalization the industry is facing the following challenges.

– The existing insurer, LIC and GIC, have created a large group of dissatisfied customers due to the poor quality of service. Hence there will be shift of large number of customers from LIC and GIC to the private insurers.

– LIC may face problem of surrender of a large number of policies, as new insurers will woo them by offer of innovative products at lower prices.

– The corporate clients under group schemes and salary savings schemes may shift their loyalty from LIC to the private insurers.

– There is a likelihood of exit of young dynamic managers from LIC to the private insurer, as they will get higher package of remuneration.

– LIC has overstaffing and with the introduction of full computerization, a large number of the employees will be surplus. However they can not be retrenched. Hence the operating costs of LIC will not be reduced. This will be a disadvantage in the competitive market, as the new insurers will operate with lean office and high technology to reduce the operating costs.

– GIC and its four subsidiary companies are going to face more challenges, because their management expenses are very high due to surplus staff. They can not reduce their number due to service rules.

– Management of claims will put strain on the financial resources, GIC and its subsidiaries since it is not up the mark.

– LIC has more than to 60 products and GLC has more than 180 products in their kitty, which are outdated in the present context as they are not suitable to the changing needs of the customers. Not only that they are not competent enough to complete with the new products offered by foreign companies in the market.

– Reaching the consumer expectations on par with foreign companies such as better yield and much improved quality of service particularly in the area of ​​settlement of claims, issue of new policies, transfer of the policies and revival of policies in the liberalized market is very difficult to LIC and GIC.

– Intense competition from new insurers in winning the consumers by multi-distribution channels, which will include agents, brokers, corporate intermediaries, bank branches, affinity groups and direct marketing through telesales and interest.

– The market very soon will be flooded by a large number of products by fairly large number of insurers operating in the Indian market. Even with limited range of products offered by LIC and GIC, the consumers are confused in the market. Their confusion will further increase in the face for large number of products in the market. The existing level of awareness of the consumers for insurance products is very low. It is so because only 62% of the Indian population is literate and less than 10% educated. Even the educated consumers are ignorant about the various products of the insurance.

– The insurers will have to face an acute problem of the redressal of the consumers, grievances for deficiency in products and services.

– Increasing awareness will bring number of legal cases filled by the consumers against insurers is likely to increase substantially in future.

– Major challenges in canalizing the growth of insurance sector are product innovation, distribution network, investment management, customer service and education.

ESSENTIALS TO MEET THE CHALLENGES

– Indian insurance industry needs the following to meet the global challenges

– Understanding the customer better will enable insurance companies to design appropriate products, determine price correctly and increase profitability.

– Selection of right type of distribution channel mix along with prudent and efficient FOS [Fleet On Street] management.

– An efficient CRM system, which would eventually create sustainable competitive advantages and build a long-lasting relationship

– Insurers must follow best investment practices and must have a strong asset management company to maximize returns.

– Insurers should increase the customer base in semi urban and rural areas, which offer a huge potential.

– Promoting health insurance and using e-broking to increase the business.

CONCLUSION

Thus, in the last on basis of above the discussion we can conclude that need for private sector entry is justifiable on the basis of enhancing the efficiency of operation, achieving greater density and insurance coverage in the country and for greater mobilization of long-term savings for long gestation infrastructure projects. In the wake of such competition it is essential for the government monopolies (LIC and GIC) that they quickly up grade their technology, restructure themselves on more efficient lines and operate as broad run enterprise. New players should not be treated as rivalries to government companies, but they can supplement in achieving the objective of growth of insurance business in India.

* Lecturer, Department of Commerce, Bharathiar University, Coimbatore-46
| Email – Buarticlecommerce@yahoo.com

** Ph.D Scholar, Department of Commerce, Bharathiar University, Coimbatore. | Email – Parentbala@sify.com

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Source by Bala Murugan

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What is PIP?
PIP is the common abbreviation for Personal Injury Protection. PIP is for benefits payable under the Florida auto insurance policy which is mandated by the Florida motor vehicle No Fault Auto Insurance law.

What is the name of the Florida law that requires PIP?
Florida Motor Vehicle No Fault Law is the name of the Florida statute that requires PIP coverage on all vehicles registered in the state of Florida.

Who is insured by PIP?
The named insured and all resident relatives are covered under the PIP coverage of your Florida auto insurance policy. Resident relatives are not required to be listed drivers on the policy for coverage to apply.

Which vehicles are covered by PIP?
All cars owned by you and listed on your Florida auto insurance policy is covered by the PIP portion of your policy. Also, any trailer designed for use with a private passenger vehicle and not used for business is considered a covered vehicle.

What does PIP cover?
Personal Injury Protection benefits include: Medical benefits, disability benefits, and death benefits.

What is the amounts payable when PIP coverage applies?
The amount of death benefit payable for an insured person is $ 5,000.
Medical benefits are payable at 80% of the amount incurred due to a covered injury. Disability benefits are payable at 60% of any lost wages incurred due to a covered injury. The total amount payable under PIP for any one accident is $ 10,000.

Is there a deductible under PIP coverage?
Florida Motor Vehicle Law allows a deductible of no more than $ 1,000 for PIP coverage. Choosing a deductible is optional and will lower the premium if you elect one. Also, work loss exclusion is allowed under the law and if elected your premium will be lower and you will not receive any benefit from lost wages due to a covered injury.

Is PIP an optional coverage?
PIP is not optional coverage for any vehicle registered in the state of Florida as mandated by the Florida Motor Vehicle No Fault Law.

Does someone else have to be at fault to collect payments under PIP?
No. Regardless of fault PIP coverage from your insurance policy provides benefits for a covered injury.

Do all insurance policies have PIP coverage?
Not all states require automobile insurance policies to have PIP coverage. All registered vehicles in Florida are required to carry PIP coverage. When Florida FR44 insurance for DUI drivers or Florida SR22 for other high risk drivers is required they are in addition to PIP.

When does coverage under PIP apply?
Coverage applies when the named insured or any resident relative is injured while occupying a motor vehicle. Also, coverage applies if an insured person is stuck by a motor vehicle as a pedestrian.

Do PIP benefits increase by the number of cars on my policy?
No. A premium is collected by your insurance company for each motor vehicle listed on the policy; however, this does not increase benefits.

If I have health insurance to cover my injuries does PIP still apply?
If an insured person sustains injury due to a covered event benefits are payable under PIP regardless of any health insurance the injured person carries.

Are an attorney and a law suit required to collect payments under PIP?
No. All top rated standard insurance companies will pay the PIP benefits to a covered person with out the need of an attorney or law suit.

What happens if I cancel my PIP policy and have a registered vehicle?
Your insurance company will notify the Florida Motor Vehicle Department of the cancelled policy. A notice will be sent to the registered vehicle owner inquiring about the status of any new policy which may have been purchased. Failure to respond to the notice or maintain required PIP coverage will result in the registered vehicle owner's driver's license being suspended.

I live in Florida part of the year do I still require PIP coverage?
Any vehicle registered in the state of Florida is required to carry PIP coverage even if that vehicle is not in use or is in another state part of the year.

Am I covered by my PIP if I 'm driving outside the state of Florida?
A Florida resident who is covered under the PIP portion of a Florida auto insurance policy is covered while driving that vehicle outside the state of Florida.

What is extended or additional Personal Injury Protection Coverage?
This is optional coverage not mandated by Florida Motor Vehicle Law which is offered by some companies. For an additional premium your insurance company may increase the total amount payable under PIP over the $ 10,000 mandated by law. Your company may also increase the percentages payable under the medical and disability portion of the PIP benefits. Typically the increase for medical would be from the 80% required by law to 100% and the disability benefit from the required 60% of lost wages to 80% of lost wages.

What happens if PIP coverage applies from more than one policy?
If there is other applicable Personal Injury Protection for the same injury the most that is collected is the maximum $ 10,000 amount required by law. Each company's policy will be responsible for their pro-rata share of benefits payable.

Does the insurance company decide which doctor or hospital I use?
No. Any doctor or hospital will be paid under the PIP benefit for medically necessary treatment due to a covered injury.

What exactly does resident relative mean?
Any relative by any degree of blood or marriage and usually resides at the home of the named insured. This includes a resident relative residing temporarily somewhere else, such as a student away at college.

What is excluded from benefits being paid under PIP?
If you own a car that is not insured under your auto insurance policy and are injured in that vehicle benefits will not apply. Any injury sustained by a person operating a covered auto without your express or implied permission. Any intentional bodily injury will not be covered. Any injury sustained in the commission of a felony will not be covered. A person other than you or a resident relative and has coverage under another Florida auto policy which has PIP benefits.

Is PIP insurance the same from one company to another?
Yes. Florida law prescribes all aspects of PIP insurance which companies and policyholders must adhere to. Mandated Florida FR44 insurance for DUI drivers and SR22 insurance for other high risk drivers are also the same from one company to another.

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Source by Clifford J Schimek

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A new pregnancy if full of excitement and anticipation; you look forward to that bouncing new baby and holding it in your arms. Many couples choose to wait until the second trimester to break the news to family and friends. There is a realization that the first few months of pregnancy can be risky. If a couple loses their baby during this time, they prefer to mourn privately.

A common problem is first trimester spotting or bleeding. Approximately one quarter of women who deliver healthy babies experience some spotting early in her pregnancy. However bleeding may be an indicator of a pending miscarriage, and sometimes a doctor may suggest bed rest to improve the chances of a successful delivery and healthy mother.

First Trimester Bed Rest

Bed rest for a couple of days is tolerable for most women – and their finances. But sometimes the bed rest can extend for weeks or months. If mom's income is needed to help make ends meet financially, the loss of income places an unneeded, unwanted, and unhealthy strain on an already difficult situation. Adding stress on top of first trimester bleeding can not be good for mom or her baby. Bed rest should relieve stress, not add to it.

Sometimes a family just can not afford having mom miss extra time from work. Rather than taking the bed rest she her doctor suggests, she returns to work hoping for the best. What a horrible dilemma that many women face: choosing between the health of her baby, and financial ruin. There must be a better way.

Short Term Disability for Bed Rest

Short term disability insurance is vital in situations like these. It replaces mom's income during the time she misses work for her pregnancy, whether it's during the first trimester, second trimester, third trimester, or on her maternity leave. The income replacement allows mom to rest comfortable at home without worrying about how to pay the bills, rushing back to work too soon, or ignoring doctor orders.

The most amazing aspect of short term disability coverage is the incentives to sign up before getting pregnant. First, in order to cover any pregnancy, the policy must begin before getting pregnant. Second, there is an opportunity to buy insurance for a planned event: her normal labor and delivery.

By buying insurance that covers a planned event you can beat the insurance company at its own game. Short term disability pays a six week benefit for normal vaginal delivery and an eight week benefit for a normal c-section delivery – less the elimination period. The projected benefit for normal delivery is two to three times the average annual premium.

Short Term Disability Creates Maternity Income

This means that women planning a pregnancy can use short term disability insurance to create maternity leave income. And at no additional premium cost comes the added security of knowing that you are also covered if your doctor orders bed rest during your first trimester, or any other time during your pregnancy.

Do yourself and your future pregnancy a huge favor. Purchase short term disability insurance before getting pregnant.

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Source by Kevin Haney