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Social Media Fears About Lack Of Coverage For Protest Injuries May Be Overblown

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3 years ago

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Thousands of protesters thronged the streets in recent days to express their anger over the killing of an African American man, George Floyd, in police custody in Minneapolis. The mostly peaceful rallies have turned violent at times, with police using batons, tear gas and rubber bullets that caused serious injuries.

That led to online social media postings that health plans might deny coverage for medical treatment of injured protesters, some suggesting it might be better for protesters not to tell providers how they got hurt.

Plans do sometimes have exclusions for coverage related to “illegal acts” that could leave people on the hook for at least part of their medical costs. But health policy experts said it’s unclear how common these clauses are or when they’re used to deny coverage.

In addition, even if a plan denies those claims, protesters would generally have strong grounds for appeal, the experts said. Success would hinge on the policy language and the circumstances around the protesters’ involvement.

“There’s a strong argument to be made that someone was participating in a civil protest, and that’s not illegal,” said Karen Pollitz, a senior fellow at KFF (the Kaiser Family Foundation). (KHN is an editorially independent program of the foundation.)

America’s Health Insurance Plans, a trade group, played down the concerns that have been mentioned on social media. “We are not aware of any blanket exclusions that would deny coverage for injuries or illnesses received during a protest,” said David Allen, a spokesperson for the group.

In general, health plans have broad leeway to exclude certain things from coverage, said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms.

For example, plans may note that they won’t cover injuries from certain dangerous activities, such as skydiving or bungee jumping. Some states allow insurers to refuse to pay claims related to drug or alcohol use.

Likewise, people who commit felonies or other illegal acts might have their claims denied. And if a lawful protest turned violent, insurers might consider it an illegal riot and deny medical coverage.

But that exclusion has to be part of the insurance contract, not something the company decides after receiving a claim.

“These exclusions need to be written down in your policy document,” Corlette said. “The plan description is supposed to outline all the things it won’t cover, in very specific language.”

Most people don’t read their policy’s fine print, but the document is generally available from insurers or employers.

Exclusion examples are not that hard to find. A sample benefits handbook for Florida Blue large group policies, for instance, specifically excludes treatment for injuries that result from “your participation in, or commission of, any act punishable by law as a misdemeanor or felony, or which constitutes riot, or rebellion.” A Cigna plan says it wouldn’t pay for care for “a Member participating in an insurrection, rebellion, or riot.”

All Florida Blue plans incorporate that exclusion language, said spokesperson Ilyssa Drumm. The company is not aware of any instances in which it has denied coverage for injuries specifically related to a riot or protest, she said.

“[We] would not apply this to someone who was injured when peacefully protesting and the actions of others led to their injury,” Drumm said.

Cigna did not reply to a request for comment.

It’s unclear the extent to which employers and insurers exclude coverage for injuries from dangerous or illegal activities or reject related claims, experts said. Researchers in at least one state have looked into this. A 2016 analysis by the Connecticut General Assembly Office of Legislative Research said the state insurance department found no coverage exclusions related to illegal acts among major medical or HMO forms filed by major carriers in the state.

The analysis noted that the National Conference of State Legislatures says that at least 18 states have laws related to coverage exclusions for “illegal acts.” Some prohibit such exclusions, while others allow them, the Connecticut study said. NCSL could not be reached to confirm the number. (State laws apply to state-regulated insurance policies, but federal laws regulate employer plans that are self-funded, meaning the company pays employee claims itself rather than buying insurance for that purpose.)

If a health plan did have an exclusion for medical services related to rioting, for example, determining how that applied to an individual policyholder’s claims would depend on specific details. How does the policy define “riot”? What does it mean to “participate” in one? Does the policy differentiate between “riot” and “protest”? Did the injured policyholder plan to attend a peaceful protest that subsequently got out of hand?

“There are probably a lot of fact-based questions that would need to be answered,” said Corlette.

Sometimes language in a policy may be very broad, allowing insurers to deny coverage for injuries sustained in the “commission of a crime,” for example, said Phyllis Borzi, a former assistant secretary of Labor who headed the Employee Benefits Security Administration and is now a consultant.

That kind of language could trip up protesters who have been arrested for offenses such as violating curfew or failing to leave the street when ordered to do so by police.

“These exclusions are designed to make sure that the plan isn’t going to be responsible if you go off and do things that are unwise and illegal and as a result you get injured,” Borzi said. “If you do get arrested, it’s just another little indicia of the fact that maybe it wasn’t just a benign activity on your part.”

Lying about how an injury occurred probably isn’t a good idea, said Borzi.

“You don’t have to volunteer the information, but if they ask you and you don’t tell them or lie, they could not just exclude the coverage but prosecute you under an insurance fraud argument,” she said.

Medicaid, the federal-state health program for low-income people, doesn’t typically have these types of provisions, said Sara Rosenbaum, professor of health law and policy at George Washington University.

Medicare, the insurance program for people age 65 and older and people with disabilities, doesn’t have these exclusions either.

The sight of crowds of protesters giving full-throated, generally unmasked, voice to their grievances has raised the specter of a resurgence of COVID-19. But insurers would be unlikely to deny coverage for treatment of the virus if someone gets sick after going to a rally, experts say.

“The employer would have to prove that the protest was the cause” of the infection, said Borzi, and given how widespread the coronavirus is, that would be practically impossible.

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By: Michelle Andrews
Title: Social Media Fears About Lack Of Coverage For Protest Injuries May Be Overblown
Sourced From: khn.org/news/social-media-fears-about-lack-of-coverage-for-protest-injuries-may-be-overblown/
Published Date: Fri, 05 Jun 2020 09:00:59 +0000

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Retirement Planning

Ends-of-the-World Every Year Since 1970

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3 years ago

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August 14, 2020

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There always has been and always will be a reason not to invest or not to stay invested. This is all the mainstream media reports to us. Below you will find a list of some of the worst global events each year since 1970. I have some commentary to follow.

1970: War: US troops invade Cambodia.
1971: Civil Unrest: Anti-war militants march on Washington.
1972: Political: Start of Watergate Scandal.
1973: Economic: OPEC raises oil prices in response to US involvement abroad.
1974: Political: Nixon resigns as President of the United States.
1975: Political: Multiple assassination attempts on President Ford.
1976: World: Ebola virus.
1977: Political: Government shutdowns.
1978: Market: U.S. Dollar plunges to record low against many European currencies.
1979: World: Iranian militants seize the U.S. embassy in Teheran and hold hostages.
1980: Economic: Inflation spiked to a high of 14.76%.
1981: Political: President Reagan assassination attempt.
1982: Economic: Recession continues in the U.S. with nationwide unemployment of 10.8%.
1983: Economic: Unemployment in the U.S. reaches 12 million.
1984: Economic: 70 U.S. banks fail during the year.
1985: World: Multiple airplane hijackings around the world.
1986: World: Chernobyl Nuclear Power Station explodes.
1987: Market: DOW drops by 22.6% on October 22.
1988: Environment: Awareness of global warming and the greenhouse effect grows.
1989: Environment: Exxon Valdez dumps 11 million gallons of crude oil into Prince William Sound.
1990: World: Persian Gulf War starts.
1991: World: Mass shooting in Killeen, TX.
1992: Human Rights: Los Angeles riots following the death of Rodney King.
1993: Terrorism: World Trade Center bombing.
1994: World: Mass genocide in Rwanda.
1995: Terrorism: Oklahoma City bombing.
1996: Terrorism: Olympic Park bombing.
1997: World: Bird flu.
1998: World: Multiple U.S. embassy bombings.
1999: World: Columbine shooting.
2000: Economic: Start of the Dotcom Market Crash.
2001: Terrorism: Terrorist Attacks in NYC, DC & PA.
2002: Economic: Nasdaq bottomed after a 76.81% drop.
2003: World: The U.S. invades Iraq.
2004: World: The U.S. launches an attack on Falluja.
2005: World: Hurricane Katrina
2006: World: Bird flu.
2007: Economic: Start of the Great Recession.
2008: Economic: Great Recession continues.
2009: Economic: S&P bottomed after a 56.8% drop.
2010: Market: Flash crash.
2011: Market: Occupy Wall Street and S&P downgrades U.S. Debt.
2012: Political: Fiscal cliff.
2013: Political: Taper tantrum.
2014: World: Ebola virus.
2015: World: Multiple mass shootings.
2016: Political: Divided U.S. Presidential election.
2017: World: North Korea testing nuclear weapons.
2018: Economic: U.S. & China trade war.
2019: Economic: Student loan debt reaches an all-time high of $1.4 trillion.
2020: World: COVID-19.

While many of these events were undoubtedly terrible (and there are certainly others not named here that were worse), most of these were broadcast as end-of-the-world events for the stock market. Despite that attention, it is worth noting that these were, for the most part, one-time events. In other words, most faded into the newspapers of history. We moved on.

Obviously, some caused monumental shifts in the way the world works. Just think about how much air travel continues to be impacted by the events of 9/11. But, outside of the resulting inconveniences (if we want to call safety protocols inconveniences) associated with air travel, flying is safer than ever before.

Take a look at just about any of the events and you will find there are many that people will hardly remember. My point here isn’t that these events are to be ignored or that they were easy to stomach at the time, but that they have become a distant memory.

I want to also make the point that we should expect these types of negative events. As investors, we know these types of crises, economic catastrophes, and global phenomena are going to happen.

But in almost all cases, here is what we can say in the next breath – this too shall pass.

Will there be legal, humanitarian, economic, or some other aid required as a result of these events? Almost certainly the answer is yes, but that doesn’t mean it they won’t eventually fade into history.

Lastly, what’s worth noting is how the market has performed over these last 50 years despite the continual advertisements of the world crashing down around us. On January 2, 1970, the Dow Jones stood at 809 and the S&P at 90 -> those are not typos. These same indexes have grown (not including dividends) to 26,387 and 3,232 respectively. Amazing, no?

Perhaps what gets overlooked more than anything else is what separates the above one-time negative events from the positive stories that go largely ignored over our lifetimes. And that is a story worth telling. See the companion post below:

Unheralded Positive Events Every Year Since 1970

Stay the Course,
Ashby

Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”

If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.

This post is not advice. Please see additional disclaimers.

The post Ends-of-the-World Every Year Since 1970 appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Ends-of-the-World Every Year Since 1970
Sourced From: retirementfieldguide.com/ends-of-the-world-every-year-since-1970/?utm_source=rss&utm_medium=rss&utm_campaign=ends-of-the-world-every-year-since-1970
Published Date: Tue, 04 Aug 2020 13:26:19 +0000

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Wildfire prone property insurance bill in California due for hearing

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3 years ago

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August 14, 2020

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The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

The bill is expected to be heard in upcoming weeks as opposing sites prepare for major battle.

A new California bill, the outcomes of which will have a lot to say about coverage for wildfire prone property in the state, will soon be headed for hearing. The hearing is expected to be a heated one as strong opposing opinions have the opportunity to be voiced.

Opponents of this bill are calling it a direct attack on consumer protections in insurance.

That said, proponents of the bill claim it is the best method for making coverage available to wildfire prone property in California. The bill in question is Assembly Bill 2167. It was written by Assemblyperson Tom Daly (D-Anaheim). If it passes,it will create the Insurance Market Action Plan (IMAP) program. The IMAP program is meant to protect residential properties.

So far, AB 2167 has progressed quickly, when taking into consideration that a chunk of the legislature has been considerably restricted by pandemic crisis precautions. It was first presented in early June and backers have been saying that it was brought forward in good timing and that it has all the momentum it needs to be passed.

That said, AB 2167 has not been without opposition. In fact, it has faced considerable opposition, having been called an attack on Proposition 103, insurance consumer protection law. California Insurance Commissioner Ricardo Lara lobbed that argument at it, calling it an “insurance industry wish list, with nothing to help consumers,” and Consumer Watchdog, whose founder, Harvey Rosenfeld, was the original author of Proposition 103.

The insurance industry strongly supports the bill, saying it will help wildfire prone property coverage.

Insurance organizations such as the American Property Casualty Insurance Association and the Personal Insurance Federation both support AB 2167. The bill also has the support of the California Association of Counties (CSAC), as well as Fire Safe Councils of California, and the CalFIRE union.

The Consumer Federation of America, another watchdog organization, has predicted that if AB 2167 passes, it will cause 40 percent increases in insurance rates. On the other hand, insurance groups claim that the bill offers owners of wildfire prone property a greater opportunity for choice and competition among insurance companies based on coverage and premiums while avoiding the limitations and high costs associated with FAIR Plan coverage.

The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

—————–

By: Marc
Title: Wildfire prone property insurance bill in California due for hearing
Sourced From: www.liveinsurancenews.com/wildfire-prone-property-insurance-bill-in-california-due-for-hearing/8549884/
Published Date: Fri, 14 Aug 2020 09:00:14 +0000

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Is this the last hurrah for bonds?

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3 years ago

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August 13, 2020

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Recently, I have written quite a bit about the long-term return expectations for investing in bonds. See here, here, here and here.

Spoiler alert: I don’t think it’s good.

But long-term bonds this year have been quite an amazing story as the COVID pandemic has caused the Fed to take historically monumental actions. As a result, we’ve watched long-term Treasuries tear the roof off the market. For instance, a 20+ Year Treasury Bond ETF (name withheld for compliance purposes) is up more than 31% YTD as of July 31st.

That is insane!

But there is a good reason for this increase shown below.

The red circle shows a decrease in the 30-year Treasury rate of almost 40% over a span of six months. That’s practically unprecedented with only two periods (2008 and 1981-1982) having similar declines over such short periods.

But this begs the question: Is this the last hurrah for bonds as a driver of any meaningful return? Below is the 30-Year Treasury rate over the last 40+ years.

For what it’s worth, people have been forecasting the end of the bond bull market since 2012 (maybe even earlier) and yet it has continued despite those predictions. But at some point, the bond party will come to an end.

The Fed has been clear that they are going to keep rates stable until at least 2022 which means this may not change for a little while longer. Or in the near term, I could even see the high returns continuing if we experience pandemic economic shutdown round two.

But, I can’t see a world where this is the case for much longer than that – most importantly over the span of a 30-year retirement.

The official end of the bond bull market depends on a recovery from the pandemic economy as well as a few other factors causing rates to rise. But when they do, it seems likely to me that this may be the last great hurrah for bonds for quite some time.

The question is when to get off that train and that undoubtedly requires a personal answer.

Stay the Course,
Ashby

Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”

If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.

This post is not advice. Please see additional disclaimers.

The post Is this the last hurrah for bonds? appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Is this the last hurrah for bonds?
Sourced From: retirementfieldguide.com/is-this-the-last-hurrah-for-bonds/?utm_source=rss&utm_medium=rss&utm_campaign=is-this-the-last-hurrah-for-bonds
Published Date: Wed, 12 Aug 2020 13:47:16 +0000

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