Insurance Term of the Day: Occupational Disease

 

Have you ever seen the show about the world’s dirtiest jobs? Wouldn’t you love to be a sewer inspector or a cleaner of crime scenes? While these jobs sound exciting compared to your average day at the office, dirty jobs expose workers to chemicals and other substances that put these people at risk of getting injured or ill. All businesses are required to have a workers compensation policy for situations that require medical care for employees. However, workers compensation isn’t always just about injury–it can be for diseases that are specifically associated with completing tasks for that job.

A disease that is acquired as a result of occupational exposure is called an occupational disease. Workers comp insurance may provide similar benefits for diseased employees as the insurance provides for injured employees. The diseases that can be defined as “occupational diseases” vary depending on state law. For example, according to The Balance, Virginia Law clearly defines an occupational disease like this: “the term “occupational disease” means a disease arising out of and in the course of employment, but not an ordinary disease of life to which the general public is exposed outside of the employment.”

An occupational disease is not a disease that one is just as easily exposed to outside of the workplace. For example, if you are exposed to strep throat because a coworker has strep throat, you are not covered by workers compensation. A disease like strep is an exposure you face every time you are in public.

When an employee feels a disease has been contracted from the workplace, most states require direct proof that associates the disease with the line of work. It only makes sense that one would be required to provide proof of correlation when seeking financial coverage for a disease. The specific job title is a huge part of whether coverage will be provided or not. A job title must require a task that could link to the disease in question. If a task could not link the employee to the disease contracted, coverage is not provided.

Firefighters are commonly victims of occupational diseases, which can easily be contracted by smoke inhalation. If a long-term firefighter contracts a form of cancer or another disease from their line of work, this could be considered an occupational disease. As always, the employee must provide proof of correlation, which relates their line of work with the disease. At the same time, the employer may attempt to object the accusation if the employee is not assigned to tasks which could have caused the disease in question.

Occupational diseases usually occur over time. Often, insurance companies will limit the length of time which the disease can be claimed through insurance coverage. For example, some policies may require an employee to report the occupational disease within two years of discovering the possible link of occupation to the disease.

Common exposures linked to occupational disease:

  • Mold
  • Dust
  • Chemicals

In summary, illnesses that are considered occupational disease according to state law can be covered by workers compensation.

By: KayLynn P.

Insurance Term of the Day: Auto Accident Report Form

In this society, everything is documented. History has always been recorded; medical records kept on file, even sports games have statistics! Having documentation is crucial to keep facts straight and accurate. Have you ever had to record a significant event in your lifetime? Many of us have: it’s called a police auto accident report.

If the police come to the scene of an accident, they may provide an accident form to complete following the accident. Trying to fill out paperwork after a traumatic event may prove to be difficult. However, after reading more about what an accident report is for, you’ll understand why it’s an essential part of the process.

When filing a claim for your accident, your insurance company will need all of the information included in the accident report. Police will typically only come when there are serious injuries, or if drugs/alcohol were a cause of the accident. If the police did not come to the scene, you may find an accident report at your local DMV, or you can get one at your local police station.

Most auto accident report forms ask for the following information regarding the accident:

  • All of your basic information: name, address, birthday, etc.
  • Details regarding the accident must be written down, like the date, time, and location. Be very specific while explaining the location, especially if you aren’t familiar with the area. Include information like the intersection and any nearby land markers.
  • It’s important that you document details about the weather conditions at the time of the accident.
  • Vehicle information for both parties involved, including the year, make, and model of both cars. Write down the license plate number.
  • Record as much information about the other driver as you can. Ask to take a look at their license and write down their name, address, drivers license number, date of birth, etc.
  • Information for any passengers that were present at the time of the accident must be included as well.
  • Include statements from witnesses, plus additional personal information of the witness as well.

Writing down the basic information is simple. Possibly the most difficult portion of an auto accident report is the section where you are asked to write a paragraph describing the accident in as much detail as you can. Reliving the accident in order to record the details can cause anxiety. Breathe deeply and take your time as you remember the event.

Take photos. With access to a camera, you have the ability to take photos of everything: the other party’s driver’s license, license plate, insurance card, as well as all damages to both vehicles. A clear, easy to read photo makes it easy to record the information for the report.

Remember this! The number one priority while filling out an auto accident report form is: accuracy!! Accuracy is crucial to avoid the costs of an inaccurate report.

By: KayLynn P.

17

Insurance Term of the Day; Risk Management

Have you ever thought of buying insurance as an investment? From one perspective, insurance is like investing in your future. You put a little money towards your insurance each month, and in return, your insurance company provides support when you are faced with a detrimental loss. The price of your insurance premium doesn’t seem so costly after your insurance covers a loss that could have otherwise cost you your financial stability. When threatened by a covered loss, insurance is an investment that can help provide financial security from an event. A pretty good investment,  wouldn’t you say?

Now, think of it from the insurance company’s perspective. The minute your policy is effective, the insurance company becomes financially responsible for the losses that are covered by your policy. By insuring you, the insurer is risking its own financial loss. It is true that the insurer will initially receive payment from you. However, should any of the covered losses occur, you could end up costing your insurance company the cost of your premium, multiplied many times. So, for the insurers, agreeing to insure you is accepting the risk that you could end up costing them a substantial amount of money. The possibility of a loss multiplies with the number of customers the company insures. This kind of financial risk must be analyzed and managed to keep the losses at a minimum.

Understanding the extent of the risks your business could face is crucial for the success of the business. Risk management is a way of maintaining financial security by avoiding taking on too great of a risk.

To successfully manage risks, these risks must first be identified and analyzed. Basically, the risk is anything that poses the threat of causing injury, damage to property, or any other kind of loss. Monitoring risk allows insurers to control the frequency and impact of losses. Once the risks are identified, insurers may choose to work with you to mitigate any risks.

Here are a few ways that risk mitigation can benefit you as the policyholder:

  • Mitigating risks gives the insured the opportunity for a better price on the premium
  • By giving you an understanding of the risks you face, you can prepare for a loss in advance to avoid the risk
  • Risk management helps stabilize the safety of the employees and customers of a business

Think about risk management and how you can mitigate your own risks.

By: KayLynn P.

Insurance Term of the Day: Grace Period

For over a year, Jerry spent the majority of his time, energy, and resources as he tried to get his cabinet building business to take off. The business required more money than expected, and Jerry started to panic about having enough funds to pay his rent. Any late fees on rent would set him and his business back. His first client came just in time. Upon finishing the job, however, his client broke the news that she couldn’t pay until nearly a week after Jerry’s rent was due! He was compassionate but feared for the success of his business. With no other option, he went to his landlord and explained everything. His landlord graciously granted him an additional week without late fees. Jerry vowed to pay his rent on time every month thereafter to express his gratitude.

Has anyone ever been gracious to you in a way that makes you want to be better the next time around?  Life has a funny way of testing us, and sometimes, our circumstances are out of our control. Insurance companies understand this, and sometimes, companies will offer you a grace period.

As you know, when you don’t pay your insurance premium, your insurance company will have no choice but to cancel your policy, leaving you without coverage. For the times when fate happens, or your memory fails you, call your independent insurance agent immediately to ask about the grace period on your policy.

The grace period is the amount of time you have after the due date to pay your premium to avoid a lapse in coverage. This length of time is regulated by each state, company, and type of policy. The grace period for your policy can be found within your contract. Regardless of the grace period, paying after your due date may result in a financial penalty or a late fee.

Beware! Some states allow insurance companies to drop coverage within as little as 24 hours after the due date.

Do not be mistaken by the grace period. If payment has not been made by the last day of the grace period, coverage is terminated, effective the day the payment was due. Any losses that occur during the grace period will not be covered if payment has not been made by the final day. In other words, the grace period does not provide coverage following a non-payment. A grace period is for unique, unforeseen circumstances that may prevent an on-time payment.

Insurance companies will drop your policy for non-payment. In some instances, they may allow you to reinstate your policy. To reinstate your policy, your insurance company may require you to:

  • Have your home inspected to ensure there were no losses during coverage lapse
  • Pay a larger down payment
  • Pay your policy premium in full
  • Sign a no-loss statement. Any unreported loss will likely be specifically excluded from the policy.

Having a policy cancel due to non-payment will likely result in insurance companies flagging you as being a high-risk to insure. If you are a high-risk customer, your insurance rates will likely increase dramatically.

If your insurance company is gracious enough to offer an extended grace period for payment, return the favor by avoiding the mistake of a late payment! Remember: it’s crucial for your own financial stability that you pay your insurance premiums on time!

By: KayLynn P.

Insurance Term of the Day: Non-Renewal

Once upon a time, there lived a woman named Jane Doe. She was very satisfied with her relationship: her partner supported her, protected her, and always had her back when she made mistakes. Jane Doe wanted to stay with her partner, as she felt safe and comfortable. One day, however, Jane Doe received a break-up letter. It was titled: non-renewal.

Here are some valuable relationship lessons you can learn from your insurance company:

  1. When you build a bad track record, your partner will leave.
  1. When your partner feels like they are contributing more to the relationship, they will leave.
  1. When you move out of state, your partner will lose touch with you.

Receiving a non-renewal from your insurance company essentially means that you have been dumped. Your insurance company has rejected any future renewals of coverage. Why would someone get non-renewed?

  1. A bad driving record will get you non-renewed. Speeding and other traffic violations, or a DUI, significantly increases the risk of insuring you. Careless driving is essentially taking advantage of the coverage your insurer has agreed to provide.
  1. Filing too many claims can get you non-renewed, especially when you are at fault for the accident. The great thing about insurance is that the relationship is a two-way street. You give a little, so that the insurance company can give a lot–when necessary. After too many claims, the relationship is no longer balanced, and your insurance company has no choice but to non-renew your policy.
  1. Your insurance policy must be issued in the state you live in. When you move to a new state, your insurance company can non-renew you. You may have to find a new independent agent that is licensed in the state you move to.

Non-renewals are very serious. It is urgent that you find insurance coverage and have the policy issued the day your policy expires. A lapse in coverage could affect your insurance rates for years. The moment you receive a non-renewal letter, ask your independent agent to help you shop around for other insurance.

By: KayLynn P.

Insurance Term of the Day: Commercial Insurance

You hear about insurance almost everyday. Insurance affects our lives more than you know. When you go out to eat, the restaurant is insured. When you go to a doctor or to the grocery store, every business you visit must have insurance. Typically, when referring to insurance, you may think of what’s known as “personal insurance,” which includes auto, home, motorcycle, RV, health, etc. Commercial insurance is a whole different ball-game that you may not have even thought about before.

There are many layers to commercial insurance that would take a book thicker than an encyclopedia to explain it. However, in summary, commercial insurance is insurance for businesses that provide a service or a product. The business could be held liable for injuries and/or damages to consumers. Coverage is also for things like theft and property damage.

What are some common types of commercial insurance? 

  1. First and foremost, property insurance. Business owners need this coverage to protect their business building and business personal property in case of a loss. If there is an unexpected fire or other damage, this coverage provides the protection needed.
  2. Builder’s risk insurance. This coverage is to protect buildings while in the process of being constructed.
  3. Mechanical breakdown coverage. This coverage provides protection for the accidental breakdown of equipment and machinery. Intentional damage is not covered.
  4. Crime insurance. The purpose of crime insurance is to provide protection from theft and burglary on the property. This includes money, up to a specific amount.
  5. Business interruption insurance. If there is any lost income or other expenses, business interruption helps recover the lost money. Salaries and net profits can be replenished after having to close the business due to property damage.
  6. Inland marine insurance. When property is in transit, off premises in storage, or between locations, it is covered by this coverage.
  7. Debris removal coverage. Any debris on the property as a result of a fire, windstorm, etc. is covered with this coverage.

There is so much more to commercial insurance. If you are a business owner, you know that this is just the tip of the iceberg.

By: KayLynn P.

Insurance Term of the Day: Appraisal

One thing you should always remember about the insurance industry is this: insurance is constantly evolving and changing, just like the rest of the world. There is not much in this world that consistently remains the same.

This is also important to remember when dealing with insurance claims, specifically, appraisals. Have you ever heard the term appraisal? What exactly is it?

Appraisals are mentioned in your homeowners insurance policy in the Loss Settlement section. The purpose is to assist you and your insurance company in coming to an agreement regarding how much should be paid out on a claim. When the policyholder and the insurer cannot agree on how much a settlement, an appraisal helps both parties come to an agreement without the need of a lawsuit. Appraisals do not involve specific coverages, but instead focus only on the amount of loss.

If you think your loss is greater than the insurance company has offered to pay, you may request an appraisal per the terms of your policy. Appraisers must be neutral and unbiased. Both the policyholder and the insurance company will hire an appraiser to determine the amount of loss using different strategies. If the two appraisers come up with different amounts of loss, they will then communicate to come to an agreement on how much the claim is worth.

The appraisal process ensures that a lawsuit is not necessary, saving you money on a lawyer. Should the two appraisers disagree on the amount of loss, an umpire may get involved to settle the dispute. The umpire is chosen by both appraisers. If the disagreement ensues, a lawsuit may become necessary at this point.

The appraisal process ensures that you are getting the fair amount for your insurance claim. Because everything is constantly changing, insurance companies may mistake exactly how much the claim is worth. Pricing always varies–whether it’s the cost of materials to replace something, or even the cost of labor.

When do you need a home appraisal?

  • When you are about to sell your home, in order to determine the fair market value of the property.
  • Appraisals are needed in order to calculate property taxes.
  • When it comes to insurance, you’ll need an appraisal to determine the value of your home when there is a dispute.

By: KayLynn P.

Insurance Term of the Day: Agreed Value and Stated Value

When going through the aftermath of a car accident, there may be many terms that you’ve never heard before. Have you ever wondered how the insurance company determines how much to pay you for your totalled vehicle? There are multiple forms of estimated value for cars: ACV (Actual Cash Value), stated value, and agreed value. But what are the differences between the three? How will the value of your car be determined with your specific insurance policy? How your vehicle is valued will depend on the type of insurance policy you have.

What is ACV? Actual cash value is what your vehicle is worth on the day you crashed it. What was your vehicle worth, in cash, right before the accident occured? The insurance company will use a series of strategies to determine this value. At this point, the adjuster will come into the situation.

If the vehicle is a total loss, the adjuster will inspect the car for damages. The adjuster will use a specific source to view the average value of your exact vehicle, based on the year, make, and model. They may ask you a series of questions, like how many miles are on the car, for example. However, if you find a credible source that indicates your vehicle may be worth more than what the adjuster offers you, he/she has the ability to adjust the value of your car accordingly.

What is agreed value? Agreed value means that there is an agreement between the insurance policyholder and the insurance company regarding exactly how much will be paid out if the vehicle is totalled. Before the contract is even signed, the amount you will be paid out on a claim is determined. There is no negotiating what you will receive for a total loss. By providing documentation proving the worth of your vehicle, the value that will be paid out of a claim is guaranteed. Agreed value is often used for a classic car policy.

In summary, damages are paid up to actual cash value; a total loss is paid the agreed value by the insurance company.

What is stated value? Stated value allows you to pick your coverage limits by telling the insurance company what the vehicle is valued at, using proper documentation. Often, an appraisal on your vehicle is necessary to determine its worth. Stated value is going to be a less expensive insurance policy than a standard policy. Stated value actually helps determine your insurance rates, but doesn’t necessarily determine what the payout would be for a total loss of the vehicle. This is because insurance companies choose to pay out either actual cash value, or stated value, whichever is less. In summary, stated value simply gives you the ability to insure the car for less than it’s worth in special circumstances.

Check with your personal insurance agent to find out how your car would be valued in case of an accident.

By: KayLynn P.

Insurance Term of the Day: MedPay

The moments following a car accident are overwhelming. Snapping back into reality after a detrimental event can be tough. It all feels surreal. You feel like it’s a dream until you’re pinched, and you wake up. By “pinch”, I mean, the pain of the accident suddenly hits you.

A car accident is terrifying. Once you realize you’re grateful you’re still alive, it gets better. When you’re injured, though, the pain can last weeks, months, even years. We all wish we could just leave the pain at the scene of the car crash, but unfortunately, it follows you.

When all these things happen so quickly, it can be hard to deal with the pain, the anxiety, and the reality of losing your vehicle. The only support system that provides any kind of relief following an accident is your insurance company. For this reason, it’s essential to have sufficient, proper coverages to ensure a swift, effortless recovery.

Next time you’re purchasing your auto insurance, be cautious of which coverages you are declining. These coverages become a lifesaver in the event of an accident. One of the important coverages that is often overlooked is called MedPay, or, Medical Payments coverage. Check your auto policy to see if you have MedPay on your policy, or not.

What is MedPay?

MedPay provides coverage for medical payments for the insured and any additional passengers in the car. MedPay is coverage for any injuries to you and other passengers as a result of an accident. It’s the financial cushion that prevents stress and debt. MedPay provides coverage regardless of who’s at fault in the accident.

How does MedPay vary state by state?

  1. Some states require MedPay, while other states do not provide the coverage at all.
  2. Depending on the state and insurance company, the maximum policy limits will vary.
  3. Some states require you to have MedPay on every vehicle on the insurance policy; the insurance company will not put MedPay on only one vehicle. The limits are required to be the same for every vehicle.

What are a few examples of what MedPay covers? 

  • Emergency rooms visit fees, including ambulance
  • Any surgery or x-rays required as a result of the accident
  • Other doctors’ bills

Ask your independent insurance agent exactly what MedPay will cover based on your insurance company. Coverages vary.

By: KayLynn P.

Insurance Term of the Day: Additional Insured

When you purchase an insurance policy, you are considered the “policyholder”. As the policyholder, you are the official owner of the insurance policy–your name is directly listed on the insurance declarations page. When an incident occurs on your property, but another person is at fault, are they still covered if they are not named on your policy? Not always. There are many factors that go into deciding whether or not the claim will be paid out.

What does “additional insured” mean? Basically, additional insured is referring to anyone who is not the named policyholder that is covered by the insurance policy. Depending on the specific policy, the additional insured may be covered for one event, or for the entire existence of the policy.

This coverage typically applies to commercial policies. Coverage for the “additional insured” is not quite as extensive as the coverage provided for the actual policyholder. Coverages vary depending on the policy, state, and insurance company. However, the additional insured usually has what’s called defense coverage, and coverage for lawsuits from a third-party involved in the loss.

If you may need to add an additional insured to your policy, contact your independent insurance agent to see what the guidelines are for your specific insurance carrier.

By: KayLynn P.