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Is coverage for preexisting conditions welfare?
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DanWeiss



Joined: 24 Jun 2008
Posts: 1945
Location: Connecticut, USA

PostPosted: Tue Mar 20, 2012 10:10 pm    Post subject: Reply with quote

coboardhead wrote:
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.


So true. A slight difference remains, of course, insofar as the insurer asks the applicant a battery of questions regarding specific and categorical medical conundrums. A problem may arise when the applicant is asked whether or not she has any history of heart disease and she replies in the negative despite a childhood diagnosis of a heart murmur. Consider a question of a history of any joint disease. How can an average person understand the limits of the questions. Does my severed supraspinatus in one shoulder differ categorically from my degraded cartilage in the other shoulder? Unwittingly deny and you run the risk of being accused of insurance fraud. Answering "yes" simply tosses any future claim for that problem into uncertainty. Even pre-approved procedures can be retroactively denied.

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mrgybe



Joined: 01 Jul 2008
Posts: 2644

PostPosted: Tue Mar 20, 2012 10:36 pm    Post subject: Reply with quote

I choose my words carefully.........so I repeat, if a policyholder knowingly fails to disclose pre-existing damage when submitting a claim, he is committing a fraud.
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mrgybe



Joined: 01 Jul 2008
Posts: 2644

PostPosted: Tue Mar 20, 2012 11:12 pm    Post subject: Reply with quote

Those who doubt that fossil fuel production is down on Federal lands may choose to look at the attached government report which shows that production is the lowest since 2003 (the starting point for the report).

http://www.eia.gov/analysis/requests/federallands/pdf/eia-federallandsales.pdf

Such anti-hydrocarbon production policies absolutely do impact current gas prices. A significant part (probably 15%) of current elevated crude prices is a risk premium........the risk that producers from unstable parts of the world will cut supply. If the world's largest user of hydrocarbons gave a clear signal to the markets that we plan to aggressively develop our own resources, and to increase purchases from friendly neighbors (e.g. via Keystone), the risk of supply disruptions from unstable places becomes far less significant and the risk premium will evaporate. The mere rumor of a small release from the SPR caused crude prices to drop a couple of dollars last week. A commitment to a sustained program of increased production would have a very large impact on crude prices.
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feuser



Joined: 29 Oct 2002
Posts: 1395

PostPosted: Wed Mar 21, 2012 8:46 am    Post subject: Reply with quote

mrgybe wrote:

...
Such anti-hydrocarbon production policies absolutely do impact current gas prices. A significant part (probably 15%) of current elevated crude prices is a risk premium........the risk that producers from unstable parts of the world will cut supply. If the world's largest user of hydrocarbons gave a clear signal to the markets that we plan to aggressively develop our own resources, and to increase purchases from friendly neighbors (e.g. via Keystone), the risk of supply disruptions from unstable places becomes far less significant and the risk premium will evaporate. The mere rumor of a small release from the SPR caused crude prices to drop a couple of dollars last week. A commitment to a sustained program of increased production would have a very large impact on crude prices.


Is it fair to say that we owe the 15% risk premium in part to the Iran Warmongering and other loose talk of the Republican candidates?

Doesn't it make sense to look at the Keystone decision allowing China - Iran's biggest buyer of crude - to diversify their sources of oil and therefore reducing their dependency on Iran's exports? A situation that is very much in the geopolitical interest of the U.S.?

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isobars



Joined: 12 Dec 1999
Posts: 14163

PostPosted: Wed Mar 21, 2012 8:52 am    Post subject: Reply with quote

coboardhead wrote:
BZZZT. Many insurance policies cover preexisting conditions. Which ones? How about your collision coverage on your automobile?

Nope. I can't buy insurance FOR the wreck AFTER the wreck.

coboardhead wrote:
Or your homeowners policy?

Nope. Gotta insure the roof BEFORE the hailstorm.

coboardhead wrote:
Most homeowner's insurance is an agreed-value policy. .. An inspector visits to confirm dimensions and general condition.

Yup. And if my health is less than perfect, I pay much higher premium and/or get less coverage. Try to buy a new life ins policy with high BP, a BMI > 30, a recent diagnosis of anything worse than a common cold, etc. Ditto a leaky roof.



coboardhead wrote:
Isobars either lies about facts ... makes them up ... or simply has no idea how anything works other than ... failed missile defense program ... had no idea oil 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.


I'm baffled. I really can't tell whether these people who think buying new insurance covering preexisting conditions without paying a MUCH higher premium [mathematically, the extra costs attributable to the actuarial difference between a certain loss (p(loss)=1.0 and an uncertain loss (p<1.0)] just don't understand the concept of insurance or are just so stuck on Marxism they can't see straight ... literally.

You know but conveniently and very disingenuously omitted that >100% of our oil production bump since Jan 2009 was set in motion by specific Bush policies and actions, that Obama's influence on production has been very negative.

You can't demonstrate one lie or fabrication from me, you are obviously unaware or don't care how exceptionally well the SDI program achieved its two foremost stated goals (the media are clueless), your claim that I do not acknowledge errors is a lie if you read the dry suit thread a couple of months ago, and it took me many iterations to beat out of you your head your notion that California actually forbid you from moving out of the state rather than simply informing you that if you do, you are no longer eligible for a CA state health insurance premium handout.

What IS it with the Left and its IWANNIT mentality? Money I earn is MY GD MONEY, not yours, once I've paid for the basic public needs authorized by the Constitution ... which you repeatedly overtly reject. I can't believe you have the gall to sit in your one-percent high horse and insist that we peons subsidize your health care insurance now just because you don't want to pay for it yourself!

coboardhead wrote:
Unless he "peeks" around his magic, front-end, plonking machine he cannot possible learn from these interactions and willfully stays ignorant.

Some of the people I've plonked have much information to offer, but it's not worth the proven BS they package it in. That's their problem and their fault.

coboardhead wrote:
FWIW, I am not a one percenter.

You said your federal income taxes exceed $100,000. The last one-percenter cutoff I heard was $386,000. If you're paying $100k in taxes on <$386k, you REALLY need a better accountant.
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DanWeiss



Joined: 24 Jun 2008
Posts: 1945
Location: Connecticut, USA

PostPosted: Wed Mar 21, 2012 9:49 am    Post subject: Reply with quote

mrgybe wrote:
I choose my words carefully.........so I repeat, if a policyholder knowingly fails to disclose pre-existing damage when submitting a claim, he is committing a fraud.


mrgybe, with all due respect, I suggest you are overstating the matter. Your statement is wrong because many exceptions exist to that blanket statement. I attempted, perhaps poorly, to explain some of those exceptions with a factual example. I'll take another shot.

Your statement and my example both assume that no "fraud in the inducement" of the insurance contract is at issue.

The elements of fraud are these:

1. A false statement of a material fact;

2. Intended to induce reliance of another upon that statement;

3. Where the other actually relies on that statement; and

4 Such reliance is the proximate cause of damage thereby.

The insurer has a right to inspect every vehicle it may insure prior to issuing coverage but a policy holder has no obligation to make any statement about the condition of the car other than to declare on the title application whether it is flood damaged or a salvage. Failure to exercise that right may be a waiver of that right and serve to disconnect the reliance from the alleged damage.

Even though most policies require ongoing reporting of new accident damage, I've never experienced an insurer who can apply and enforce that reporting requirement to more mundane damage (e.g., parking lot dings, scratches, rock hits, and urban bumper-car parking damage and my example of unfair settlement practices, above).

Failure to report is distinguished from lying. While silence in the face of disclosure duties in the execution of the insurance contract (during it's ongoing term) may be a breach of the contract, silence rarely rises to the level of fraud. The option for the insurer is to deny the claim for failing to disclose. The remedy for fraud is to cancel the insurance contract ab initio.

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DanWeiss



Joined: 24 Jun 2008
Posts: 1945
Location: Connecticut, USA

PostPosted: Wed Mar 21, 2012 9:57 am    Post subject: Reply with quote

Mike, wow. My three year-old often claims that his sister "did it" when everyone in the room saw him do it. Since you read coboardhead's post (a reply to me) you know the language you quoted was mine, not his.

Iran: "Switzerland, your international aggressions in our neighborhood will not be tolerated. The Straights of Hormuz are closed to your aircraft carriers."

Six-party talks, anyone?

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coboardhead



Joined: 26 Oct 2009
Posts: 1945

PostPosted: Wed Mar 21, 2012 10:11 am    Post subject: Reply with quote

Dan...I was keeping quiet...I am not above taking credit for someone else's work! One of the ways to achieve honorary one percenter status.
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mrgybe



Joined: 01 Jul 2008
Posts: 2644

PostPosted: Wed Mar 21, 2012 10:23 am    Post subject: Reply with quote

I will happily amend my statement to read........."if a policyholder knowingly fails to disclose pre-existing damage when submitting a claim, he is in breach of the contract". Whether the insurance company has adequate motivation or the ability to detect that breach is a separate issue........the wrongful breach has still occurred. The point is that, with the exception of exotic loss portfolio transfer mechanisms, insurance is not intended to cover losses that have already taken place. So, initiating health coverage for someone who already has pancreatic cancer, and whose premiums cannot possibly cover the cost of care, may be a compassionate gesture by society, but it is a social program, not insurance.
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boggsman1



Joined: 24 Jun 2002
Posts: 3554
Location: at a computer

PostPosted: Wed Mar 21, 2012 10:29 am    Post subject: Reply with quote

what should that person do? should we just let him die?
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