What is Insurance?
Insurance is, “a contract whereby, for a stipulated consideration, one party undertakes to compensate the other for loss on a specified subject by specified perils. The party agreeing to make the compensation is usually called the “insurer” or “underwriter;” the other, the “insured” or “assured;” the agreed consideration, the “premium;” the written contract, a “policy;” the events insured against, “risks” or “perils;” and the subject, right, or interest to be protected, the “insurable interest.” (Black’s Law Dictionary 946. 4th Ed. Rev. 1968)
An insurance policy is a contract in which an individual or entity (the policyholder) pays an insurance company (the insurer) in regular payments in exchange for financial protection over specific risks or losses. For example, medical insurance helps to cover medical costs, such as hospital visits, hospital stays, and medications. Similarly, auto insurance helps to cover damages incurred from car accidents. Insurance payments are known as premiums. Insurance contracts typically limit the amount of costs that an insurance provider may be required to pay.
The McCarran-Ferguson Act (15 U.S.C. § 1011) grants many aspects of insurance regulation to individual state governments. However, federal laws like federal taxes do apply to insurance, and must be acknowledged. Insurance is important to the legal system, as it helps protect individuals, those who cause harm to individuals through negligence, and any third party that is faced with the burden of compensating for an injury.
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HIPAA- A Barrier Between You & Your Medical Records?
Back in 1996, when the Health Insurance and Portability and Accountability Act (HIPAA) was signed into law, the intention of the law (especially Title IV) was to protect a patient’s right to privacy, reduce fraudulent activity, streamline data systems and improve the health insurance system overall.
For years prior to the law’s passage, there was no federal standard for obtaining your medical records. Without the patient’s knowledge, records were being given to insurance companies, sent to landfills or just flat-out lost. Alerted by highly publicized lapses in medical record confidentiality (a garbage truck crash that sent medical records flying all over the highways, a doctor selling a computer without deleting patient information from the hard drive, and the list went on and on), lawmakers decided a better system was needed. So the whole theory behind HIPAA regs are that your medical records are just that, […]
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Panel Physicians and Workers Comp
So you got hurt at work and need to see a company doctor. Now what?
After you have given notice of your injury, your employer may require you to treat with one of their “panel physicians” through their insurance carrier. If your employer has a list of panel physicians or “company doctors,” you will be required to treat with one of the doctors on the list for the first 90 days of your injury.
Under the Workers’ Compensation Act, your employer is required to advise you of their list of panel physicians at the time of your hire and also at the time of your injury. They are also required to have you sign an acknowledgement that you are aware this policy and provide you with the list upon your injury.
If for some reason you do not like the doctor that you have chosen, […]
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Follow the Golden Rule . . . Give Notice As Soon As Possible
If you are hurt at work, the most important thing to remember is to report the injury to your employer through your supervisor at the time of the injury. Every injury should be reported, no matter how small you may think it to be. Any injury could potentially become a liability, not only to your health but also to your finances if it is unreported. Telling your employer that you are injured is your responsibility and it is called “giving notice.”
Too many times an employee will feel a “pop” in their knee, a pain in their shoulder or their back, and let it go for days or weeks. Not reporting an incident or injury can allow your employer to deny your claim through their insurance carrier. This can initially prevent your medical expenses and/or wage loss from being paid if the treating physician should later remove you from work due to the injury. […]
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