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Two stories caught my interest this morning. Two stories about insurance fraud that illustrate the fraud can be perpetrated by insureds, insurers, third-parties, regulators, and just about anyone where there is money involved.

In Florida, insurer, QBE Insurance Corporation, is facing a $500 million bad faith lawsuit by a condominium association. The association’s towers were seriously damaged in a hurricane. The allegation is that the insurer, knowing the two condominium towers faced demolition and condemnation without insurance settlement money, “[took] advantage of the socioeconomic conditions of residents and the inability of residents to raise the money to make the repairs.” In other words, the insurer is accused of delaying claim settlement to force a more advantageous settlement. The association has already won a $25 million lawsuit against the insurer in February, 2009.

The Risk and Insurance Management Society (RIMS) will be broadcasting a webinar entitled “ISO 31000 and Its Implications to Risk Management” on December 10, 2009 from 1:00-2:00pm ET. The cost is $30 to non-members and free to members of RIMS.

ISO 31000 is a generic set of guidelines applicable to risk management and it can be helpful to know when establishing your organization’s risk management policy.

RIMS will also be holding a CourseCast on December 10, 2009, from 1:00-2:30pm ET, entitled “Casualty Claim Handling Techniques:
Agency Law.” Details can be found at the RIMS website.

The Occupational Safety and Health Administration (OSHA) issued some holiday specific directives last week. Employers, especially retailers, should take note of the guidelines in time for their holiday preparations.

On November 17, OSHA issued crowd control guidelines designed to lower the risk of crowd related accidents. Last year a worker was trampled to death while a mob of shoppers rushed through the doors of a large store to take advantage of an after Thanksgiving Day “Black Friday” sales event. OSHA claims in its press release that the store “was not using the kind of crowd control measures recommended in OSHA’s fact sheet.” The Fact Sheet is available online.

I had a number of health insurers contact me to point out that they also have some form of kid/young adult friendly health education and awareness campaign after my post about Aetna’s yesterday.

The one that I missed, that everyone else seemed to know, was the DocRock series of videos offered by Cigna. Dr. Mache Seibel, a.k.a. DocRock, is a real doctor with the University of Massachusetts Medical Center. He has teamed with CIGNA to launch the H1N1 Rap video at www.youtube.com/cignatv. One video “raps” for kids about 5 tips to avoid Swine Flu.

Health insurer Aetna has taken an interesting, and entertaining, approach to increasing prevention awareness for the H1N1 virus infection. The insurer has created a video featuring kids talking about prevention.

The kid advice is great. “If you cough onto someone, they can get sick. So cough into a tissue. Then throw it into the garbage and wait for the garbage truck to come.” Or this reminder: “If you sneeze into your hands and then grab the remote to change the channel, there are germs on the remote.” Bill Fried, MD, Aetna’s medical director heading the company’s pandemic flu response initiative, states, “Kids listen to other kids. Adults should listen too. We’ve all heard the advice about washing your hands and covering your cough, but sometimes kids say it best. After all, who knows more about germs than kids?”

When choosing business insurance, doing preliminary research into insurance companies is a good idea.

One resource we have looked at before are state boards of insurance. The National Association of Insurance Commissioners (NAIC) website is also an excellent resource. The Consumer Information Source on the site has links regarding AIG and any replacement insurers. It has a search feature allowing a search of filed complaints against insurers. There are a number of useful resources that allow you to compare insurers.

NAIC Consumer Information Source is a Good Resource originally appeared on About.com Business Insurance on Monday, November 16th, 2009 at 15:08:48.

Unscrupulous merchants and contractors in Florida seeking to take advantage of Hurricane/Tropical Storm victims beware! The State’s Attorney General set up a “price gouging hotline” at 1-866-9-NO-SCAM (1-866-966-7226). Florida resident are encouraged to report any storm related price gouging.

The Attorney General offered the following advice to residents to avoid scams (and these tips are good anywhere):

• Require home repair contractors to obtain all necessary government licenses and permits.
• Make sure contractors have proper occupational licenses as required by state law.
• Work only with reputable, established businesses. Take caution with “contractors” who knock on doors and offer to fix roofs and windows. Try to obtain more than one estimate for the repair work.
• Before signing a contract, check the payment terms and other provisions carefully.
• Do not pay cash to home repair contractors or tree removal services.

Price Gouging Hotline is Open in Florida originally appeared on About.com Business Insurance on Thursday, November 12th, 2009 at 11:25:59.

Given the hype surrounding the U.S. House’s passage of the Affordable Health Care for America Act (H.R. 3962 – NOTE: this is a link to the .pdf of the whole Bill and it is large) one would think the Bill is now the law of the land. It is not.

The House’s Bill does not correspond to the version prepared for debate in the U.S. Senate. The Senate may or may not pass their version, it may be subject to a filibuster, and, once passed, will need to be reconciled with the House version. In other words, passage in the House was important, and a first step, but far from being an overhaul of the U.S. health care system.

As I write this, the National Hurricane Center has issued an advisory downgrading Hurricane Ida to a Tropical Storm. Good news for businesses along the Gulf Coast as winds have weakened to 65-70 mph and further weakening is expected.

Still, Governor Jindal has declared a State of Emergency for Louisiana and there is plenty of available information for residents of Louisiana at emergency.louisiana.gov. The Louisiana Department of Insurance has many links to resources and information available on its hurricane site as well.

Today is Election Day in the U.S. and there are a number of great battles going on across the country. But, you cannot be involved unless you vote – so, get out there!

My favorite election watch today (besides Casinos for Ohio) is the New York 23rd Congressional District. There, third-party Conservative Party candidate, Doug Hoffman, after a conservative Republican revolt, is the main candidate running against the Democrat. The original Republican candidate, Assemblywoman Dede Scozzafava, has come out in support of Democrat Bill Owens and against Hoffman.