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Is coverage for preexisting conditions welfare?
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coboardhead



Joined: 26 Oct 2009
Posts: 2034

PostPosted: Tue Mar 20, 2012 6:20 pm    Post subject: Reply with quote

dan wrote

Quote:
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isobars wrote:
Quote:
Of course mandated coverage for preexisting conditions (without offsetting higher premiums) is collectivism, welfare, socialism ... whatever label one wishes to apply to taking money by force of law from the majority and giving it to the minority for an event whose likelihood is 1.0. The whole concept of "insurance" is to spread the cost of events/losses that are UNCERTAIN (likelihood < 1.0) within the policy's term. Covering an expense -- medicine, surgery, death, automobile damage, a diagnosis, etc. -- that is certain or has already happened isn't insurance; it's as characterized above. SNIP


BZZZT. Many insurance policies cover preexisting conditions. Which ones? How about your collision coverage on your automobile? Or your homeowners policy? For example, claims for damage to a body panel will be met with either a flat denial for cause or a new panel. No discount is made because the panel was scratched before the incident.

Most homeowner's insurance is an agreed-value policy. You mutually decide on the policy value usually based on the purchase price. An inspector visits to confirm dimensions and general condition. If the house suffers damage by fire, for example, everything will be made with new or as new up to the policy limit but without regard to whether the wall paper was hung in 1964 or the wall was cracked.

Isobars either lies about facts (something he vigorously debates), makes them up without a second thought or simply has no idea how anything works other than a Northwave and a failed missile defense program. He's like my uncle, who had no idea the US was exporting oil or that production was higher than at any time during Obama's predecessor's two terms. Ignorance is fine, if that's his excuse. So is being wrong. What makes him a joke is that he continues to take positions about which he knows little or nothing and refuses to acknowledge his errors.

Unless he "peeks" around his magic, front-end, plonking machine he cannot possible learn from these interactions and willfully stays ignorant. Maybe he really belongs back in the desert with the rest of the ostriches?
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Excellent points. Re: Insurance (and oil demand).

FWIW, I am not a one percenter. Apparently, I have to subtract my health insurance premiums from my income to qualify for this elite group. That, and my solar tax credits place me well outside of the minimum qualifications. :heavy sarcasm emoticon:
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feuser



Joined: 29 Oct 2002
Posts: 1395

PostPosted: Tue Mar 20, 2012 7:02 pm    Post subject: Reply with quote

isobars wrote:
Of course mandated coverage for preexisting conditions (without offsetting higher premiums) is collectivism, welfare, socialism ...
bla bla.


The very concept of insurance is collectivist, isn't it?

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mrgybe



Joined: 01 Jul 2008
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PostPosted: Tue Mar 20, 2012 7:03 pm    Post subject: Reply with quote

DanWeiss wrote:
BZZZT. Many insurance policies cover preexisting conditions. Which ones? How about your collision coverage on your automobile? Or your homeowners policy? For example, claims for damage to a body panel will be met with either a flat denial for cause or a new panel. No discount is made because the panel was scratched before the incident.


Bad example. Absolutely not true. If the insurance company can prove your vehicle was damaged before the accident they will make an appropriate deduction from any payout. If you knowingly fail to disclose the pre-existing damage, you are committing a fraud.


DanWeiss wrote:
He's like my uncle, who had no idea the US was exporting oil or that production was higher than at any time during Obama's predecessor's two terms. Ignorance is fine, if that's his excuse. So is being wrong. What makes him a joke is that he continues to take positions about which he knows little or nothing and refuses to acknowledge his errors.


Ignorance indeed. As has been clearly explained previously, current oil production levels are high in despite Obama administration policies, not because of them. They are due in part to leases granted by the Bush and Clinton administrations and in part to astonishing new technologies developed by the "flat earth" oil companies. Production on the Federal land controlled by the Obama administration is way down compared to his predecessors, as are leases granted to drill on those lands.
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pueno



Joined: 03 Mar 2007
Posts: 2747

PostPosted: Tue Mar 20, 2012 7:22 pm    Post subject: Reply with quote

mrgybe wrote:
They are due in part to leases granted by the Bush and Clinton administrations and in part to astonishing new technologies developed by the "flat earth" oil companies. Production on the Federal land controlled by the Obama administration is way down compared to his predecessors, as are leases granted to drill on those lands.

We keep hearing from the rabid righties that we can no longer blame Bush for any of the stupid crap he and President Cheney pulled --- all the employment, housing, economic, and social ills in the US are now Obama's fault because he has been president for over three years.

But it's interesting --- anything good that happens now, during the Obama era, is credited by those same rabid righties not to Obama but to the previous administration.

Everything bad is Obama's, everything good is Bush's.

How do you spell hypocrisy?
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feuser



Joined: 29 Oct 2002
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PostPosted: Tue Mar 20, 2012 7:25 pm    Post subject: Reply with quote

To the scenario in the original post:

If an insured person continues to stay with one insurer during the course of an illness and the related treatment, he/she will continue to pay the policy and the treatment will be paid for, up to the limitations set in the coverage.

If the insured person is undergoing a job loss or transition (a usually non-voluntary life event, completely unrelated to one's health), the treatment will not be paid for, regardless of accrued contributions.

It is completely understandable that a private for-profit insurer would want to exclude a condition that predates the policy. However, what happens to the accrued contributions of the now uninsured individual? Finder's keepers?

The concept of re-insurance comes in handy here - where insurers pool their risk. Since insurances have a 85% payout mandate, isn't it likely that they will use unclaimed contributions to fund a larger pool to serve as a backstop for "inherited" net-takers (versus net contributors)?

That together with the individual mandate, that virtually ensures that everyone does make contributions to their health care, should just about address the fundamental systemic failure outlines in the above scenario.

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feuser



Joined: 29 Oct 2002
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PostPosted: Tue Mar 20, 2012 7:28 pm    Post subject: Reply with quote

Yea, Dan, I don't know about that collision insurance thing... Doesn't work with Geico, or I wouldn't be paying $1500 a year in Manhattan.
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coboardhead



Joined: 26 Oct 2009
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PostPosted: Tue Mar 20, 2012 7:33 pm    Post subject: Reply with quote

Feuser wrote

Quote:
If an insured person continues to stay with one insurer during the course of an illness and the related treatment, he/she will continue to pay the policy and the treatment will be paid for, up to the limitations set in the coverage.


Except that the premiums can be increased to the point that the insured may not be able to afford them. Not a big deal if you have a group policy, since risk is spread to the group. But, it can be a problem for the self-insured.
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coboardhead



Joined: 26 Oct 2009
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PostPosted: Tue Mar 20, 2012 8:13 pm    Post subject: Reply with quote

mrgybe wrote

Quote:
Production on the Federal land controlled by the Obama administration is way down compared to his predecessors


Not true. Oil production in 2011 is down compared to 2010, but still higher than any year with the exception of 2010. I am not arguing that the Obama Administration is friendly to oil development. I agree they are not. But, those policies are not affecting the gas price increase, substantially, that we see now.

When prices drop in the fall, as they often do, that, also will not be because of the Administration's policies. However, gas prices dropping may be all many of the voters see. Kharma?
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DanWeiss



Joined: 24 Jun 2008
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PostPosted: Tue Mar 20, 2012 8:42 pm    Post subject: Reply with quote

mrgybe wrote:


Bad example. Absolutely not true. If the insurance company can prove your vehicle was damaged before the accident they will make an appropriate deduction from any payout. If you knowingly fail to disclose the pre-existing damage, you are committing a fraud.
SNIP


No, it's actually a good example because it is true. I've won treble damages based on the premise that such shenanigans represent unfair settlement practices. An insurer will set a total-loss value for a car with comprehensive coverage. It may not wish to reveal that figure when issuing the policy, but it's common knowledge that a total value threshold is less than the replacement cost and way, way less than the cost to repair to make like new. The information relating to that figure and how that figure was created is discoverable. Again, the example is not one of a total loss claim, but a less dramatic fender-bender like a soft collision caves in the front bumper cover and drives it into the radiator. The latter example was the subject of one of these two disputes, whereby the estimator concluded that the pre-existing damage to the paint from normal driving and parking, including some dings on the bumper cover and a dent in its corner, would have been so costly to repair that it superseded the insurer's obligation to replace. That, paired with revelations of fractional valuations for purposes of totaling and the insurance company's practice of forcing the policy holder to effectively sell the car to the insurer so the insurer could part out the car for profit tends to catch the attention of juries.

The insurance company has an option to inspect what it insures to satisfy its own concerns. Most do not. However, the failure to avail itself of the right to inspect may waive any right to object to a policy holder's failure to report every door ding or parking dent existing at the time of issue or throughout the policy term.

Failure of a layperson to identify latent damage is simply not a fraudulent act, and failure to disclose wear and tear damage as it occurs also is not fraud by its very definition. If a company can prove that a policy holder lied in an attempt to improve his position and that the insurance company relied on that lie, that might be fraud. Where the insurer actually inspects at policy inception but finds nothing or waives its right to inspect, fraud generally cannot be maintained as an affirmative defense absent a knowing false statement of a material fact from the insured.

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coboardhead



Joined: 26 Oct 2009
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PostPosted: Tue Mar 20, 2012 9:15 pm    Post subject: Reply with quote

Dan...and yet insurers will often not "inspect" the insured when they apply for health insurance. Instead, they will rely on the insureds to provide the assurance (no pun intended as Assurant Health is a great example of this) that no previous "conditions" exist. When a large claim is filed on a recent beneficiary all bets are off and a witch hunt insues to provide ANY method that the insurance company can use to rescind the policy.

These sorts of abuses, are one of the reasons that health insurance reform is so important.
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