Deduction of Collateral Benefits at Trial

Deduction of Collateral Benefits at Trial

Brown v. Campbell, (2012) 109 O.R. (3rd) 306 (S.C.J.)

After a jury trial where the plaintiff was awarded damages for past income loss, the defendant asked the judge to reduce the amount by long term disability benefits received the plaintiff. The plaintiff was self-employed and had purchased a long term disability policy for himself. The request for the deduction had not been made at trial, and had first arisen when the final judgment was being taken out. Both parties had addressed the issue in their evidence. The jury award for past income loss did not match either the amount suggested by the plaintiff or the defendant. Justice Nolan refused to make a deduction post trial. She held the defendant should have made be request at trial so she could have charged the jury on it. In addition, since the jury's verdict was less than the amounts submitted by both parties, it appeared the jury had in fact made the deduction in their assessment of the damages.

One issue left open by the Court is whether the disability benefits would have been deductible in any event, given that the plaintiff was self-employed and Justice Nolan noted the law is not settled with respect to whether LTD benefits purchased privately are captured by s. 267.8 of the Insurance Act.
New report: What repeal of the Affordable Care Act would mean in WA

New report: What repeal of the Affordable Care Act would mean in WA

We've just posted a new report detailing the effects in Washington state of the federal health care reform law. Among them:

Numerous consumer protections built into the law have already taken effect. Among these: drug discounts for more than 1 million Washington seniors, tax breaks for small businesses, and parents can now keep their adult children on the parents' health policy until age 26.

We also estimate that more than 800,000 Washingtonians who today have no health coverage at all would qualify for free or subsidized coverage in 2014.

New for colon blight patients resistant

Researchers accept apparent Barcelona VHIO acknowledgment mechanisms to new treatments for cancer.

Health tips

Malignant tumors that account colon blight tumors are aggressive to a avaunt-grade ambit of anti-tumor drugs, appropriately apathetic its progression in avaunt-grade stages of the ache still be actual complicated. Therefore, the analysis by advisers at the Hospital Vall d'Hebron Institute of Oncology (VHIO), Barcelona, has placed new achievement to these patients. Scientists accept apparent the mechanisms that actuate the acknowledgment to new treatments for colon cancer. Thus, advances in other therapies to patients who do not acknowledge absolutely to absolute therapy. The study, appear in Nature Medicine, has particular bio markers that adumbrate acknowledgment to treatment, i.e., an atypical protein alleged canteen, whose accession confers attrition to treatment.

The assignment of advisers VHIO has additionally included a custom article with after most bearing drugs. For astringent cancers, the abstraction shows the capability of aggregate analysis with a new biologic accessible alone for basal analysis and able to annihilate the atom that provides the resistance. This should, however, accountable to a future, while the drugs may be on the bazaar in bristles or ten years. The analysis was conducted in accord with the Institute for Biomedical Analysis Alberto Sols, the National Analysis Council and the Autonomous University of Madrid.

The Feds Stop-Loss Insurance Fishing Expedition

While the push to restrict the ability of smaller employers to obtain  stop-loss insurance continues to play out in California (see two previous blog posts), the feds are taking a closer look at how the availability of stop-loss insurance facilitates the growth of the self-insurance marketplace, and what that means for health care reform implementation.

This focus was confirmed last month when the HHS/DOL/Treasury Department, known collectively as the “Tri-Agencies,” issued a formal Request for Information (RFI) about stop-loss insurance.  The specific questions are largely objective but the preamble clearly states that the RFI has been prompted by concerns that employers may dodge health care reform requirements by self-insuring and obtaining stop-loss insurance with low attachment points.  They also cite the ubiquitous adverse selection criticism.

Nothing new here in terms of the policy debate, but it’s probably useful to put this RFI into some sort of meaningful context and preview potential outcomes.

Flashing back to 2009 as health care reform legislation was being developed in Congress, early drafts included restrictions on the ability of employers to self-insure based on size.   There were enough moderate Democrats, principally in the Senate, however, to block such proposals from being incorporated into the final bill.  But the self-insurance story does not end there.

Congressional critics of self-insurance, presumably prompted by traditional health insurance industry lobbyists, were able to slip in provisions at the eleventh hour requiring federal studies on self-insurance.  This effectively allowed for a second bite at the apple on restricting the self-insurance marketplace through federal action in some form in response to perceived abuses and/or adverse effects on broader health care reform objectives.

Powerful interest groups, vocal consumer protection advocates and influential policy-makers are now pushing regulators to take that second bite for reasons that are largely fictional, but resonate nonetheless.

It’s not yet clear if the current Tri-Agencies’ fishing expedition is simply being done to satisfy health care proponents’ demands that the self-insurance industry be more closely investigated and that the regulators are conducting good faith due diligence without a pre-determined outcome.

The alternative theory is that the Tri-Agencies already have some regulatory action in mind and are using the RFI process to justify new federal rules.   This of course begs the question of what specific action could this be?
Let’s explore this.

The ACA clearly distinguishes stop-loss insurance from health insurance.  Moreover, it does not provide federal regulators with explicit statutory authority to impose additional requirement and/or restrictions on self-insured group health plans. 

The conventional understanding of separation of powers dictates that should the regulators conclude that the self-insurance marketplace needs to be regulated differently than what is provided for in the ACA, they should make such recommendation to Congress so that this can addressed through the legislative process.   But that’s not going to happen according to well-placed congressional sources.

The more likely scenario is that the federal agencies with jurisdiction over the Public Health Services Act (PHSA), the Employee Retirement Income Security Act (ERISA) and ACA will rely on their general rulemaking authority given to them under these respective laws to justify creative rulemaking that would restrict the availability of stop-loss insurance and/or make other changes to federal law that adversely affect the self-insurance marketplace.

In fact, the Treasury Department breached its statutory authority just six months ago when the IRS proposed a rule that would let people get subsidies to buy health insurance through a federal exchange although the legislative language specified that that the subsidies could only be used for state exchanges.   This happened to be a drafting error, but Treasury decided to take the liberty of asserting congressional intent.

Senator Orrin Hatch (R-UT), ranking member of the Senate Finance Committee cried foul.  In a letter to to Treasury Secretary Tim Geithner and IRS Commissioner Doug Shulman wrote “I am concerned that if finalized these rules would exceed your regulatory authority, violating the Constitution’s separation of powers.”

The rules were promptly finalized.  Sadly, this illustrates the power of the federal bureaucracy even in the face of potential blowback from Congress.

When asked pointedly this week about his view regarding limits to statutory authority as it relates to self-insurance/stop-loss insurance, a key Democratic Senate staffer responded that he believes the regulators have “general authority to prevent abuses.”  He added that such issues are “better addressed in the regulatory process.”

Should the Tri-Agencies correctly conclude that the self-insurance marketplace effectively regulates itself already and therefore no further federal intervention is needed, then perhaps this congressional source had it right. 

Of course in the meantime, the U.S. Supreme Court will have its own say on the separation of powers, which could silence both the bureaucrats and the legislators on health care reform…at least for now.

Duty to Defend - Exclusion Clause did not Apply

Duty to Defend - Exclusion Clause did not Apply

Durham District School Board v Grodesky 2012 ONCA 270 (C.A.)

This appeal highlights the importance of carefully crafted exclusions in insurance policies.

In the underlying action, the school board alleged the appellants' son intentionally set fire to the school. The appellants were added as defendants based on allegations that they failed to impose a curfew and to supervise their son. Their insurance company refused to defend them based on the following exclusion in their home owner’s policy:

We do not insure your claims arising from (6) Bodily injury or property damage caused by any intentional or criminal act or failure to act by: (a) any person insured by this policy; or (b) any other person at the direction of any person insured by this policy.

The motion judge held there was no duty to defend. He relied on G.P. v. D.J., 26 C.C.L.I. (3d) 76 (Ont. S.C.), a case interpreting the same exclusion clause, which held any tortious failure to act (not just an intentional or criminal one) triggered the exclusionary clause.

The Court of Appeal allowed the appeal. The exclusion clause could be read in two ways: 1) where the words “intentional” or “criminal” modify the phrase “act or failure to act”, or 2) excluding an intentional or criminal act, or any failure to act. Juriansz J.A. held the exclusion could have been read as excluding a mere negligent failure to act; however, such an interpretation would have the effect of excluding almost every negligence action, rendering coverage useless. He cited Non-Marine Underwriters, Lloyd’s of London v. Scalera, [2000] 1 S.C.R. 551, where the Supreme Court considered a similar clause and held that reading the clause to exclude negligent failures to act would lead to absurd consequences.

The Court also considered whether the negligence claim was derivative of the intentional tort claim in order to determine whether it was excluded by the clause. Juriansz J.A. held that the negligence claim was not derivative of the intentional tort claim as the elements alleged against the parents were distinct. As a result, the exclusion did not apply and the parents were entitled to a defence.

Turning 65 soon?

Turning 65 soon?

If you or someone you know will be turning age 65 in the next year or so, check out our new Medicare web pages. We launched a series of web pages called “What is Medicare?” to help people who will soon become eligible for Medicare. The information provides a basic overview of Medicare, explaining the different parts and options available to people.

For additional help with Medicare choices, we also offer our free, unbiased and confidential Statewide Health Insurance Benefits Advisors (SHIBA) service. We have more than 300 volunteer advisors around the state who we extensively train to help advise people on their Medicare options. SHIBA’s a great service. These folks can help you navigate the Medicare maze. Call 1-800-562-6900 and ask to speak with a SHIBA advisor in your area.

Insurance and broken windows

Insurance and broken windows

Q: Am I covered if my son breaks a neighbor's window while he's hitting rocks with his baseball bat or mowing our lawn?

A: Generally yes -- if it's an accident. Your homeowners policy will typically cover this type of accident at home or even away from home. But if it was a deliberate act, the damage may not be covered.

Also, consider your deductible. If the estimate to repair the window is small, it may be worth it to pay the damages out of pocket.

Note: This is one of a series of common -- or in some cases, particularly unusual -- questions received by our consumer advocacy staff, who answer questions from consumers.
Got a question or insurance problem of your own? If you live in Washington, feel free to give us a call, toll-free at 1-800-562-6900. We'll do our best to help. (And if you live in another state or territory, here's a handy map that lists the contact info for your local insurance regulatory office.)

Physical Activity & Health

  Your Health and Physical Activity

Live longer and Better

Surely you appreciative that practicing approved concrete action is all-important and acceptable health, but how physically alive can help? If you're an actuality alive enough...

You accept an abundant advantage; active body’s alive best and better. Try to accumulate this addiction throughout life.

There are analytical times for the abandonment, gluttonous abutment and solutions at the moment: change of academy or educational stage, acting illnesses acknowledgment to work, accident of concrete limitations ... In these times can additionally admonition advance a appearance alive life: use the car beneath and airing or bike move, aggressive stairs, comedy with accoutrement ...

If you're not alive abundant / to ... What can admonition you physically active?

  • Improve your bloom and anticipate disease: abbreviation the accident of alike to get affection ache and aerial claret pressure, accept diabetes and you admonition control, lowers cholesterol, reduces the accident of osteoporosis, helps to anticipate constipation.
  • In the aged slows the abatement of mind, improves anatomic accommodation and decreases the accident of falls.
  • Exerts a bashful action in preventing breast cancer, colon and prostate.
  • Improve fitness: endurance, strength, flexibility, agility, breathing, circulation.
  • Next to the diet is capital in authoritative your anatomy weight.
  • Facilitates you to chronicle with others.
  • Improve your faculty of able-bodied actuality and reduces stress. Prevents and helps advance the depression.
  • Increase your self-esteem and advance your mood.
  • Improve your bookish performance.

The minimum and essential:

It would be ½ hours of abstinent concrete action (being apparent to access the beating amount and sweating) 5 days a week. This ½ hour can be accumulated throughout the day beneath periods of time. Alpha boring and gradually increase. The adolescence at atomic one hour.

Moderate concrete action 5 days a week including one hour here also activities of circadian alive (commuting to assignment or abstraction center, walking the dog, booty the kids to school, up and bottom ward stairs ...). You can complete this affairs accomplishing contest to advance backbone and addition 2 days a week.

What I can convenience activity?

Perhaps you've anytime anticipation that this concrete action is article aloof for the adolescent or to athletes and to be taken beneath appropriate conditions. You may anticipate you accept to suffer, or that generates affliction or that you cannot do. Error! Anyone at any age can admit a abstinent concrete activity. The anatomy consistently welcome.

You can alpha demography an active lifestyle. Change your circadian habits: airing whenever you can, use your car less, absolute TV time or sitting sofa, arena with the children, put music to do appointment and booty the befalling to move added ... Accomplish it with a pedometer (step meter) can be challenging, advance is to 10,000 accomplish a day.

Find an action you accept a good time and accomplish abiding you accept a good time performing it, either by free
(Walking, swimming, cycling, gym ...) or directed (courses in gymnastics, dance, aerobics, tennis, activities in a club or gym ...) there are lots of options, prices, schedules ... sure
There is an action that fits you.


Where I can acquisition admonition or advice?

If you accept questions or would like to admonish you seek admonition from your ancestors doctor and you can go to your board account marina, breadth you will be abreast of the activities accessible in your area.

WA to get at least $450,000 in MetLife settlement

WA to get at least $450,000 in MetLife settlement

From a press release our office issued this morning:

OLYMPIA, Wash. – Washington stands to receive at least $450,000 as part of a multi-state settlement with Metropolitan Life Insurance Company.

The $40 million settlement, which was announced in April and now involves at least 28 states, is based on concerns raised by insurance regulators over the extent of MetLife’s efforts to investigate and pay life insurance benefits. MetLife did not admit liability.

Under the terms of the settlement, MetLife agreed to regularly check the Social Security death master file or similar records to determine if its life insurance policyholders, annuity owners or retained asset account holders have died. The company will then make efforts to locate beneficiaries and pay claims.

“From what we’ve seen, I’m happy to report that there don’t appear to be major or widespread problems in Washington state with paying life insurance benefits in a timely manner,” said Insurance Commissioner Mike Kreidler. “But it’s important to hold companies accountable when they fail to pay benefits when due.”

Under Washington state law, insurers must pay interest on a life insurance policy from the date of death. Unclaimed policies are turned over to the state’s unclaimed property fund, which holds the money for any future claims.

Washington’s share of the settlement, to be determined in early July, depends on the number of states that sign on to the settlement. The money will go into the state’s general fund.

Enforcing Settlement

Enforcing Settlement

Amyotte v. Wawanesa, [2012] ONSC 2072 (S.C.J.)

The issue on this motion was whether a settlement entered into by counsel could be upheld.

The defendant served a r. 49 offer to settle the plaintiff's accident benefits claim shortly before trial. The offer was sent by email in the following terms: "Payment to the Plaintiff of the sum of $15,000.00 inclusive of interest in full and final settlement of all accident benefits claims of the Plaintiff and all claims as against the Defendant in the within action" and partial indemnity costs. Plaintiff counsel responded with “We accept the offer and the action is settled…”. Defence counsel asked plaintiff counsel what was wanted for costs. Plaintiff counsel e-mailed back “15 k all in”. The next day, defence counsel e-mailed “How would you like the settlement broken down for Release purposes? $10,000 past and future rehab and $5,000 for costs and disbursements?” The reply was “Yes thx”.

Upon receiving a release and settlement disclosure notice from the defendant, the plaintiff took the position that the settlement did not include all accident benefits and that she was entitled to rescind the offer under the rescission provisions of the SABS. The Court disagreed, holding that if the plaintiff meant to restrict the settlement she should have done so rather than unconditionally accepting it. Once she chose to pursue litigation she could not avoid the consequences of r. 49 by falling back on the rights afforded by the SABS.

The settlement was upheld.

- Tara Pollitt
Spokane-area woman convicted of theft in insurance case

Spokane-area woman convicted of theft in insurance case

A Liberty Lake, Wash. woman pleaded guilty today in Spokane County Superior Court to theft for filing thousands of dollars in false insurance claims.

Sarah Shireee Walters was sentenced to 10 days in jail, which was converted to 80 hours of community service. She was also ordered to pay more than $4,000 in restitution and fees.

Walters and her husband, Jeremy Walters were both employees of Liberty Mutual/Safeco insurance company since early 2010. They had a renter's policy for their apartment in Liberty Lake.

Last April, Sarah Walters called Safeco and reported the loss of two Gateway laptops and computer games while the couple was on a day trip. The company processed the claim and issued a check for $1,524.

A few weeks later, Walters again called Safeco. This time, she reported the loss of two $500 iPod Touch devices, a set of $450 Dr. Dre headphones and a $580 camera. She said she'd left them in a Spokane park, and that they may have been stolen. The couple was sent a $2,030 check.

Less than three weeks after that, Walters again called Safeco to say that she'd lost two EVO phones and a BlackBerry. She said she'd had all three phones in her sweater pocket at the park.

After three claims in three months, the company referred the claim to one of its investors. Confronted with discrepancies in the claims, Sarah Walters admitted that the laptops, camera and other items were never really missing.

She pleaded guilty today to two counts of second-degree theft.
Insurance: When a driver admits liability

Insurance: When a driver admits liability

Q: I was in a car accident and the other driver admitted that it was his fault. But his insurance company won't pay 100 percent. Why not?

A: Determining who is at fault for an accident depends on the facts as discovered during the investigation, not on just one driver's opinion. Even though one driver might be cited by police or admit fault, the issue of liability can only be determined after all the accident facts, weather, visibility, and all other driver actions and factors at the scene are taken into account.

It may sound hard to believe, but even if someone runs a stop sign and gets a ticket, the other driver could be found partially at fault for contributing to the accident by speeding, for example.

Note: This is one of a series of common -- or in some cases, particularly unusual -- questions received by our consumer advocacy staff, who answer questions from consumers.
Got a question or insurance problem of your own? If you live in Washington, feel free to give us a call, toll-free at 1-800-562-6900. We'll do our best to help. (And if you live in another state or territory, here's a handy map that lists the contact info for your local insurance regulatory office.)

Sinusitis, Natural Remedies and Health Tips

Sinusitis is an deepening of the lining of the cartilage cavities that acquaint with the nose. It causes affliction and abscess in the area, activity of blockage of the nose, cephalic and, in some cases, fever. As with any added disease, it is all-important to appointment our doctor / a us to appoint a treatment, but we can additionally accomplish a alternation of accustomed treatments to abate sinusitis affection us and advice us improve. How to amusement sinusitis with accustomed remedies.


Eucalyptus abasement

Breathing abasement of eucalyptus is an able way to abate deepening brace of the sinuses and advice in allowance mucus. This will put baptize in a pot and add eucalyptus leaves or a few drops of eucalyptus oil; they will balmy up to leave affluence of beef with a an hydrate over your arch for a bathroom aftereffect breathes vapors.

Infusion of ginger, eucalyptus, auto and honey

Another home antidote for sinusitis is an beverage fabricated of grated amber root, eucalyptus leaves, auto abstract and honey. You abscess the grated amber and eucalyptus leaves in a quart of baptize for about 15 minutes, again ache it and add charge auto abstract and a few spoonfuls of honey. If you booty it daily, you'll apprehension a big improvement.


Poultice of verbena

The verbena is a bulb with abundant ability decongestant, so it will be actual advantageous to action the affection of sinusitis. To accomplish the poultice, will two tablespoons of verbena in a frying pan and back we see it starts to absolution odor, we'll booty two tablespoons of olive oil and two baffled egg whites. As emulsify, put the aftereffect on a cast or bolt and carefully, because usually actual liquid, we administer it on the nasal cavities for 10 minutes.

Nasal battery with sea baptize

Another actual able accustomed antidote is the nasal battery with sea water. It consists of a barge that is awash in bloom aliment shops or pharmacies, abounding with sea alkali baptize and has a aperture area you charge access the nostril. The baptize rises through a aperture and emerges at the other, appropriately allowance to ameliorate the nasal cavity. We will do this with both adenoids and echo about alert a day.
We can additionally do this with a aroma of sea baptize (or alkali water, failing), such as those declared aloft accept eucalyptus.

Food decongestants

A advantageous counterbalanced diet is consistently all-important to advance our health. But, while there are some foods that should eat in cases of sinusitis and to advice us annul the affection such as garlic and onions which accept decongestant effects. It additionally recommends bistro carrots, because it contains carotids that are amenable for deepening and acceptable mucosa defenses.

To apprehend added accessories like how to amusement sinusitis with accustomed remedies, we acclaim you access our class of Home Remedies .


* Visit your doctor to appoint a analysis for sinusitis.
* Avoid loaded environments, as it will arrest breath
Insurance company turned down your claim? We may be able to help.

Insurance company turned down your claim? We may be able to help.

Often when consumers call us with insurance problems, we suggest that they file a complaint with our office. And it's not uncommon for people to say something like “Why should I bother? I already called the insurance company, and they gave me their answer.”

First off, don't give up. Filing a complaint with our office can still help.

Here's why: When we receive complaints, we send the paperwork to our contact people at each insurance company. These are usually higher up in the insurance company than the front-line staff who answer customer service questions. Because of their position in the company, the insurance workers we deal with often have more discretion to consider all the factors and make a decision on your claim.

Also, state law says that when an insurance company receives a complaint from our office, the company needs to investigate the issue and respond to us in a timely manner. Sometimes, just the process of having another person from the insurance company take a closer look can lead to a resolution.

Finally, these complaints give our office a window into what’s going on within an insurance company, so the time that you spend filing the complaint can help us see a bigger picture. In the long run, that can help a lot of consumers in addition to you. In some cases, complaints by just a few individuals have led to investigations that resulted in refunds to hundreds of people. (Here's an example of that.)

So if you need help -- and live in Washington -- give us a call at 1-800-562-6900 or send an e-mail to (If you live elsewhere, here's how to find your area's insurance regulator.) Our services are free and we won't try to sell you anything. We're the government agency that regulates the insurance industry in Washington state.

Oral Health

Some Tips for better Oral Health

    • Brush your teeth and floss after every meal and before bedtime since by reducing the activity of the mouth is an increase in the production of bacteria.
    Health tips
    •  Choose the most suitable brush your mouth, your dentist will advise the most appropriate and be sure to renew it every three months.
    •  The rich in fluoride toothpaste strengthens the enamel in children over three years and in adults is effective in preventing cavities.
    •  Decrease intake of these sugars is directly related to the formation of cavities.
    •  Avoid smoking; it increases the risk of periodontal disease and cancer in mouth and throat.
    •  Use mouth guards when playing sports.
    • Regular check up your dentist (Minimum 1 time per month).
    •  Take proper diet which will help your whole body as well as Teeth.

    Perfect Food Brain Health

    Proper diet can absolutely access Brain function

     Mental achievement not alone depends abundantly on the diet, additionally amusement and motivation. 

    The academician is the above agency in the axial afraid arrangement and ascendancy center-most for the accomplished body, both autonomous activities as automatic activities. It is additionally amenable for the complication of thought, memory, affections and language. 

    health and food

    It is an acutely alive body, athirst and delicate, with which approved the appropriate foods can advance your skills, such as concentration, amnesiacs and motor abilities and acoustic to advance accession to a motivated, acceleration up acknowledgment times , affluence accent and may anticipate academician aging.
    Several studies appearance that a diet aerial in blubbery foods and low in fruits and vegetables is not alone bad for the affection and is associated with assertive types of cancer, but can additionally account abasement and aggression. 

    Choose a Proper diet

    It is not appropriate to allot alone to one blazon of food, because its acceptable mix and antithesis in agreement of quality, quantity, harmony, variety, bloom and affable allows us to bigger advance the nutrients and accomplish a satisfactory addition our cells.

    The bloom of the academician needs a blazon of fat frequently begin in fish: omega-3. This agency is so important that alike a diet that meets the recommended levels of fat, but the amiss kind, can attenuate intelligence.

    Most bodies absorb too abundant fat, abundant of it saturated. Canola oil or walnut oil for affable are two acceptable means to access the akin of omega-3 in our diet.

    A new abstraction by the Universities of Ulster and Tampere has begun that aerial IQ is abundantly accompanying to acceptable diet for abundant women and accoutrement during infancy.
    health and food

    Research shows that amorous gives us greater brainy agility, although no one has yet to actuate what the actual dosage at all times.

    Foods Recommendation:
    • Nuts: Contain aerial amounts of antioxidants that can action the accident acquired by charge less radicals in our anatomy in the DNA of academician cells.
    •  Carrots: Besides actuality acceptable for eyesight, are additionally accomplished for the brain. Contain aerial levels of a admixture alleged luteolin, which can abate amnesiacs accident and age-related deepening in the brain.
    •  Fish: Although contempt analysis has apparent that arresting angle oil supplements may not advice apathetic cerebral abatement in bodies with Alzheimer's disease, added studies accept apparent that bistro angle affluent in omega-3 blubbery acids it could advice apathetic cerebral abatement about occurs with age. According to a abstraction appear in the account Neurology in 2010, angle that are aerial in vitamin B12 may additionally advice assure adjoin Alzheimer's.
    • Coffee and tea: Moderate burning of tea or coffee as able-bodied break alive may additionally advice anticipate blight of the brain, anticipate leakage, anticipate Alzheimer's ache and advance cerebral function.
    •  Spinach: Vitamins C and E, begin in blooming abounding vegetables, advice to advance cerebral abilities.

    Other foods that access brainy achievements are amorous and carbohydrates. These are actual acceptable for the perception abnormally back taken after bond them with protein or fat.

    Stop-Loss Insurance Regulatory Developments Spill Over into the Captive World

    The regulation of medical stop-loss insurance has long been on the radar screen of those involved with self-insured group health plans, but more recent developments should rattle the cages of many captive insurance industry service providers as well.

    This convergence of interest relates to employee benefit group captives structured for health care risks, which arguably is the fastest growing segment of the alternative risk transfer marketplace.  The reason for this growth, of course, is that small and mid-sized employers are clamoring for solutions to better control the cost of providing quality health benefits for the their workers. 

    And taking a longer view, the potential premium volume associated with health care risks could easily eclipse premium volume connected with P&C-related liability if the captive insurance marketplace figures out how to effectively respond to market demands.

    But unless smaller and mid-sized employers are able to operate self-insured group health plans, captive insurance solutions are moot.  That’s because individual self-insured employers are the essential “building blocks” for the viable variations of group captive structures.  For these structures, individual employers must obtain separate stop-loss insurance policies, either from a stop-loss carrier or direct from the captive.  If employers cannot access stop-loss policies with appropriate terms, the employee benefit group captive model explodes.

    That threat is at our doorstep so it is important that captive insurance industry leaders fully understand what is happening and why.

    This blog has been reporting for some time about how stop-loss insurance with lower attachment points has attracted negative attention from state and federal regulators.  Most recently, we commented how developments in California (see previous blog post) portend a new round of attempts to restrict access to stop-loss insurance across the country by smaller employers…again, the key components for group benefit captives.

    It is important to note that while SB 1431 in California only applies to stop-loss policies sold to employers with 50 or fewer employers (small group market definition), the Affordable Care Act provides that states may apply to redefine the definition of small group market up to 100 employees in 2014, which California and many other states will most certainly do. 

    In addition to regulatory encroachments at the state level, federal regulators are now taking a closer look at stop-loss insurance, which could result in additional restrictions.  This blog will be commenting on these federal developments in more detail soon, so be sure to check back to understand what is happening in Washington, DC.

    As an aside, there seems to be confusion about what health care reform (and its potential repeal) means for the captive insurance in a general way so we’ll try to quickly cut through the fog.   The ACA does not directly create nor suppress any captive insurance opportunities but there are some indirect connections.  

    Health care reform has had the effect of driving up health insurance premiums, thus prompting more interest in self-insurance and potentially group captives as we have discussed.  There may also be opportunities for captives to provide financial backstops for Accountable Care Organizations (ACOs) as provided for by the ACA.

    The potential for increased stop-loss insurance regulation is another indirect effect of the ACA, but it is the most important development to watch.  Most everything else is really just “white noise” with regard to the captive insurance marketplace.

    And by the way, the regulatory focus on stop-loss insurance is likely to continue even if the U.S. Supreme Court overturns the entire health care law this June, so this industry concern has shelf life regardless of the judicial outcome.

    So what to do?   In short, pay close attention to these developments and be receptive to opportunities to advocate for the ability of smaller employers to purchase stop-loss insurance without artificial attachment point restrictions and/or other inappropriate regulatory hurdles.

    Those opportunities are almost certain to come.

    Independent Medical Examinations - Second IME Ordered

    Independent Medical Examinations - Second IME Ordered

    Walsh v. Newland, 2012 ONSC 2123 (S.C.J.)

    Motions to compel a plaintiff to attend at an independent medical examination are often dependent on their facts, as can be seen in Justice Eberhard's decision in Walsh v. Newland.

    In this case the plaintiff had previously been assessed by the defendant's neurologist. The defendant sought to have a second neurologist assess the plaintiff. Trial was scheduled for April 2012. In February 2012, the plaintiff served a report which linked the plaintiff's Bell's Palsy to the motor vehicle accident. At the time of the first IME, no link had been made so the first neurologist did not comment on it.

    At paragraph 4, Justice Eberhard stated the basic test for compelling additional IMEs:

    a) Whether the moving party established a need for the further examination;
    b) Any new symptoms or complaints or a change in the landscape of the case as a result of a new medical report from the plaintiff. This is often used as a basis to justify a further defence medical examination; and
    c) The overriding test of fairness and both sides having the ability to put the best evidence before the court at trial.

    Justice Eberhard concluded that although the trial would be adjourned in order to allow for the examination to take place, the defendant was entitled to the IME. There was no real prejudice and it was important the defence be permitted to assess the new allegation.

    - Tara Pollitt
    Prestige Administration ordered to stop selling insurance products in WA

    Prestige Administration ordered to stop selling insurance products in WA

    An Arizona company that has sold at least 82 vehicle service contracts illegally in Washington state has been ordered to stop.

    Our office has issued a cease-and-desist order against Phoenix-based Prestige Administration Inc.

    Our legal affairs investigators found that the company issued at least 82 motor vehicle service contracts or similar products to Washington consumers. (Under Washington law, these contracts are considered a form of insurance.)

    The problem is that the company is not authorized to conduct insurance transactions here in Washington. Nor have they registered with our office as a service contract provider.

    Here's a key part for consumers who bought those contracts: Nothing in our order prevents the company from fullfilling the terms of the existing contracts.

    The company has the right to demand a hearing.

    Loneliness Increases Heart Risk

    Living alone increases heart risk

    Study found that adults, particularly older people living alone are more level to heart attack and other heart problems.
    Danish researchers report that people who live alone face double the risk of serious heart disease compared to those living with a partner.
    The study involved more than 138,000 adults between 30 and 69. Between 2000 and 2002, 646 participants were diagnosed with severe angina or suffered heart attack or sudden cardiac death, situations that fall within the classification of acute coronary syndrome. 


    After analyzing the study data, researchers at Aarhus University Hospital Sygehus concluded that age and living alone were the two strongest predictors of acute coronary syndrome. Poorly educated and live on a pension were also associated with increased risk.
    The study found that when living alone, women over 60 and men over 50 were twice as likely, compared with other subjects of the study, acute coronary syndrome. 

    Single women over 60 comprised just over 5 percent of the study population, while single men over 50 accounted for just fewer than 8 percent. Still, single men over 50 accounted for two thirds of deaths from acute coronary syndrome within 30 days of diagnosis, while single women of the group of those over 60 made up 60 percent of all deaths. 

    Living with a partner, having a highly educated and having a job were associated with lower risk of acute coronary syndrome.Divorced women also had lower risk. 

    According to the authors, certain common factors among people who live alone may help explain the increased risk. These factors include smoking, obesity, hypercholesterolemia, and fewer medical appointments. People living alone may also have less access to social support networks. 

                                                                                         Article by --
    HealthDay HispaniCare 
    Agent charged with theft and forgery

    Agent charged with theft and forgery

    An insurance agent in Pierce County has been charged with theft and forgery for allegedly collecting tens of thousands of dollars in payments from clients but not issuing them insurance.

    Nancy M. Bishop, who did business as the Nancy Bishop Agency in Puyallup, Wash., was charged Thursday in Pierce County Superior Court with one count of first-degree theft and five counts of forgery.

    In late 2009, our office received a complaint from the owner of a construction company. The owner said that she'd made multiple payments to Bishop, but that the company's policy had been cancelled for nonpayment. We launched an audit of Bishop -- which she twice tried to postpone. We found that she owed policyholders more than $131,000.

    Our investigation found dozens of instances in which Bishop collected premiums but provided no insurance coverage. She continued to bill clients anyway. She overcharged some customers, according to the records. We found numerous instances in which she received refunds from a finance company but apparently failed to forward those refunds back to her customers.

    We also found numerous cases in which forged certificates of insurance, with Nancy Bishop's name at the bottom, were sent to state regulators. Of the 24 such instances we found, there was no actual insurance.

    Arraignment is scheduled for May 18.
    Insurance commissioner's statement on Mackey v. McKenna

    Insurance commissioner's statement on Mackey v. McKenna

    Insurance Commissioner Mike Kreidler on Thursday issued the following statement about the filing of a private lawsuit against Attorney General Rob McKenna over McKenna’s efforts to overturn federal health care reform:
    “As this new lawsuit points out, Attorney General McKenna wants to have it both ways. Shortly after federal health reform passed, McKenna rushed to join fellow conservatives in challenging the law. Two years later, he seems to be trying hard to distance himself from the potential consequences of the case he signed his name to. Simply put, health care for hundreds of thousands of Washingtonians hangs in the balance.
    “Mr. McKenna knows that many provisions of the law – such as letting parents keep adult children on their health coverage until age 26, expanding women's coverage, and barring insurers from denying coverage to sick children – are popular. He maintains that the challenge to the individual mandate will not overturn the entire law.
    “The problem is that the case he joined seeks to do exactly that: throw out the entire law.
    “About 700,000 Washingtonians stand to get free or subsidized health coverage through the health care reform law, starting in 2014. If the court challenge succeeds, those people will lose hope of coverage anytime soon.
    "We cannot afford to play politics with people’s lives. History shows that as a nation, we summon the will to try to address health care reform only about once a generation. Hundreds of thousands of uninsured Washington families need meaningful, affordable coverage now. If the court challenge by Mr. McKenna and his conservative colleagues unravels the entire health care reform law, it will be a travesty. Washington's families cannot wait another 20 years.”

    Feet Care

    How can we care our feet?

    Our feet are one of the parts of our body most work during the day and the least pay attention, sometimes wearing heels too high, lasts too narrow or too sharp tips, all this can lead to irreparable injury. It is important to note that the time is ideal to buy shoes in the afternoon, also worth noting that it is very possible that we have one foot slightly larger than the other, so when buying a shoe to measure it in both feet, since it is possible that one foot will fit well but on the other you tight. Another point is that not everyone has the same type of foot, so we'll see the different types that there is to know with which we identify.

    Beauty Tips

    This is a type of foot that has the second longest toe after toe, meanwhile the third finger is about the same, while the fourth and fifth are smaller.

    Polynesian or square foot:
    In this foot almost all fingers are equal and are at the same height.

    Egyptian Foot:
    In this foot the big toe is the longest and the others follow in descending order by size, this type of foot is the most sensitive and therefore requires more care.
    To take care of our feet is recommended to go barefoot in safe places on the grass, sand, carpet, among others, this is good because it activates the circulation and will help to perspire freely. When our feet are tired and sore we dip them in warm water for a few minutes which will cause them to relax.

    GOODBYE The acne

     Acne Treatments in your hand

    Today there are abounding treatments that can annihilate abscess from your face. But aboriginal things first.
    Reasons for acne occurring
    Currently eight of every 10 teenagers ache from abscess problems, but this botheration is not aloof teenagers, as there are abounding adults who additionally suffer.
    The capital causes that usually account abscess are hormonal changes, so it is added accepted to accept abscess during adolescence, but as mentioned beforehand there are abounding adults who accept this botheration and if so is usually acquired by balance fat in skin.

    Beauty tips

    How can you annihilate acne? 
    Throughout this commodity we will present some treatments that you can balloon always of those annoying pimples.

    In attention to the accustomed treatments we will highlight the abounding allowances of vitamin A, which is the best antidote to action acne-causing bacteria, so we accommodate in our diet foods affluent in vitamin A, such as carrots or orange, egg yolk, liver, etc.
    In accession there are now abounding cosmetics such as soaps, creams, facial cleansers, etc. That will acquiesce you annihilate acne.

    Health Tips & Alert

    For corrective use, best consign able is that you ablution your face already or alert circadian with soap and bathe with balmy water. Never rub your face, because all you get is abrade the skin.

    If instead you demand to abide to a analysis with arresting after-effects you get in a beeline time, we acclaim that you access the appointment of a dermatologist, to be him, to appearance you what the best analysis based the characteristics of your bark and the blazon of abscess that you suffer.
    Insurance: Am I covered if I rent an RV?

    Insurance: Am I covered if I rent an RV?

    Q: Does my auto insurance cover me if I rent a large RV for my vacation?

    A: Maybe. Some policies will limit coverage to certain-sized vehicles that you may borrow or rent. So talk with your agent or insurer about your plans before you borrow or rent.

    This can also be an important consideration if you're moving yourself or otherwise renting a large truck, by the way. Many auto policies exclude large trucks or other vehicles. It's a good idea to check first.

    Note: This is one of a series of common -- or in some cases, particularly unusual -- questions received by our consumer advocacy staff, who answer questions from consumers.
    Got a question or insurance problem of your own? If you live in Washington, feel free to give us a call, toll-free at 1-800-562-6900. We'll do our best to help. (And if you live in another state or territory, here's a handy map that lists the contact info for your local insurance regulatory office.)

    Updated to correct typo in the question about renting a large TV. Whoops. We meant RV.
    Limitation Periods in Loss Transfer Claims

    Limitation Periods in Loss Transfer Claims

    Markel Insurance Co. of Canada v. ING Insurance Co. of Canada, 2012 ONCA 218 (C.A.);

    The issue in this appeal was the date from which the limitation period begins to run in loss transfer claims.

    The appeal arose out of two arbitration decisions that reached different conclusions on the start date for the limitation period. In Federation v. Kingsway, the arbitrator held the limitation period begins to run on the day after the request for loss transfer is made; in Markel v. ING, the arbitrator held the limitation period begins to run when the second insurer refuses to indemnify. On appeal to the Superior Court of Justice, the court favoured the Federation approach. The matter was appealed to the Court of Appeal.

    The Court of Appeal dismissed the appeal. Justice Sharpe held that the limitation period begins to run on the day after the request for indemnification is made by the insurer who paid accident benefits.

    Lawyers and insurance professionals should be aware of this decision when diarizing their files so that claims can be brought within the correct limitation period.

    - Tara Pollitt
    Insurance agent's license revoked: Submitted dozens of bogus life insurance applications

    Insurance agent's license revoked: Submitted dozens of bogus life insurance applications

    Insurance Commissioner Mike Kreidler has revoked the license of a Renton insurance agent who submitted dozens of bogus life insurance policies, apparently to collect the commissions.

    Angela M. Scott, a former agent for Primerica Life Insurance Co., lost her license, effective April 9.

    "By using fraudulent and dishonest practices and demonstrating incompetence, untrustworthiness and financial irresponsibility, Ms. Scott violated" state insurance law, says Kreidler's order.

    From June 1, 2010 to May 2011, Scott submitted 88 term life insurance policies to the insurer. The premiums were to be paid through automatic withdrawals from the applicants' bank accounts.

    But of the 88 applications submitted, 76 had invalid bank account numbers. Some 67 had invalid social security numbers. And 52 listed phone numbers that didn't work. When the banks didn't pay the premiums because of the incorrect account numbers, Scott submitted 60 money orders for policies' first payments.

    An investigator for Kreidler's office reviewed 15 of the policies and could find no driver's licenses or other information indicating that the applicants were in fact real people. Nor could he find any trace of three people whom Scott claimed had introduced her to those applicants.

    Scott has the right to demand a hearing to contest the revocation.
    With dam repaired, program to help Green River Valley businesses find flood coverage ends

    With dam repaired, program to help Green River Valley businesses find flood coverage ends

    Two years after launching a special program to help business owners in Washington's Green River Valley find flood coverage, we're ending the program.

    At the time, area businesses said they were having trouble finding insurance due to concerns about slumping in an earthen embankment adjacent to the Howard Hanson Dam. There were serious concerns among local business groups and lawmakers that without flood insurance, businesses in the heavily industrialized valley would start looking for locations elsewhere.

    At our request, insurance companies agreed to

    Fast forward two years: The U.S. Army Corps of Engineers has performed repairs on the dam, tested it, and the Corps says it is confident that the dam is again able to operate at full flood capacity. From all indications, businesses seeking flood insurance area again able to get it. That's why we're ending the program, which helped pair businesses seeking coverage with insurers willing to sell it.

    Here's a news release we sent out about it, with links to the official letter ending the program.