Monday, December 31, 2012


Insurance statistics in Washington state

Each year, the Insurance Information Institute, an industry-backed research group, compiles data on the insurance industry in each state.

From this year's Washington edition:
  • Number of people working in the insurance industry in Washington state: 49,445.
  • Their payroll: $3.2 billion.
  • Premium taxes paid: $406 million
  • Premiums: About $19 billion.
The report includes a lot of other information, including details about which companies write the most insurance, losses incurred, etc.

Thursday, December 27, 2012


365 Tips for Healthy Living

Table of Contents
Intro

Tip 1. Colour Therapy, A Basic Guide to Putting Colour in Your Health
Tip 2. Recognize the Problem with Conventional Therapies
Tip 3. Use the Recovery Diet
Tip 4. Anti-Aging Therapies
Tip 5. Basic Nutritional Principles
Tip 6. Basic Dietary Treatment Principles
Tip 7. Basic Vegetarianism
Tip 8. Get to Know Healthy Kitchen Practices
Tip 9. Control Inflammation with Cold
Tip 10. Control Pain with Heat
Tip 11. Fasting Is a Time of Rest
Tip 12. Hydrotherapy, the treatment of disease with the bath
Tip 13. A simple nature cure for inflammatory conditions is the cold footbath.
Tip 14. The cold hipbath is a routine treatment in most diseases.
Tip 15. The Epsom salt bath is useful in many conditions.
Tip 16. A simple nature cure is the hot footbath.
Tip 17. A hot hipbath relieves conditions “below the belt.”
Tip 18. The hot immersion bath is a surprising cure for obesity.
Tip 19. Use the mud bath to remove impurities.
Tip 20. Enhance beauty with the mudpack.



Aetna fined $1 million for insurance violations

A Connecticut insurance company has been fined $1 million by Washington State Insurance Commissioner Mike Kreidler for multiple violations over several years.

Aetna Life Insurance Company has agreed to pay the fine. The violations include issuing unapproved insurance policies, failing to file legally-required documents with the state and charging unapproved rates.

“All insurers must comply with state law, and most of them do,” said Kreidler. “I hope that this fine and compliance plan resolves these problems with Aetna.”

Among the violations:

• Starting in 2005, Aetna issued health, disability or life insurance policies to more than 4,400 people that did not comply with state law. Among the violations: The policies had not been filed for approval with Washington state.

• Also starting in 2005, the company issued health policies that did not include all Washington state health care mandates. Nor did they describe Washington’s appeals and grievance process, as required by law.

• For more than three years, Aetna continued to sell a health policy that had been disapproved.

• Starting in 2009, Aetna issued other health, disability and life policies that had not been filed with the state. Some of those health policies that did not include all Washington state mandates. Nor did the company have an approved appeals and grievance process for those plans.

• In 2010 and 2011, Aetna issued medical and dental plans for more than 100 Nordstrom retirees that had not been approved by Kreidler’s office, as required by law.

The company has also agreed to a compliance plan designed to prevent similar problems in the future.

Fines issued by Kreidler’s office do not go to the insurance commissioner’s office. The money collected goes to the state’s general fund.

Yak insurance vs. yakking about insurance

Nepalese herders, tired of losing their livestock to snow leopards, have come up with an insurance plan to compensate them when a leopard kills a yak.

The herders pay about $1.50 a year to cover each yak, and are paid about $50 if the yak is killed by a snow leopard.

(On a side note, we're betting that this story is driving a significant amount of traffic to insuranceyak.com, which is a blog devoted not to yak insurance, but to yakking about insurance.)

Monday, December 24, 2012


Order approving Amerigroup WA acquisition by WellPoint


We've gotten a number of calls from analysts about this: Here's the final order approving acquisition of Amerigroup Washington Inc. by WellPoint, Inc.

For the full history and the rest of the documents, see this page and scroll down to "Amerigroup Washington Inc."


Happy Holidays

Happy holidays from the Ontario Insurance Law Blog.  We'll be back in January with our weekly posts.  We wish you all the best in 2013.

Wednesday, December 19, 2012


When Has FSCO Mediation Failed - Part 2

Last week, we blogged on the Court of Appeal`s decision in Hurst v. Aviva, which held that insureds may proceed to bring court actions or arbitration proceedings if 60 days have passed since an application for mediation at FSCO has been filed and no mediation has taken place.

The Court released its decision in Younis v. State Farm Insurance Company, 2012 ONCA 836 (C.A.) concurrently with Hurst.  In the Hurst actions, the 60 day period had elapsed prior to the insured filing a court action.  In Younis, however, the claimant applied for mediation on July 14, 2011 and filed a court action a few days later. State Farm`s motion to stay the action took place well after the 60 day period had elapsed.  Justice Sloan refused to stay the action. 

The Court of Appeal allowed the appeal.  The Court held that the insured commenced his action in contravention of the statutory requirement by not waiting 60 days.  Since Younis had not waited until mediation had failed, his action was barred.  To allow otherwise would permit insured person to immediately commence civil actions and the statute did not permit this tactic.

Sunday, December 16, 2012


High wind warning in south Puget Sound -- gusts up to 60 mph Sun and Mon

The National Weather Service has issued a high wind warning for the south Puget Sound area, including south Tacoma, Olympia, the southern part of Hood Canal, Montesano, Chehalis and Centralia.

A "southerly wind 15 to 30 mph will develop late this evening (Sunday)...then switch to southwest wind 30 to 40 mph with gusts to 60 mph late tonight and Monday morning," the NWS said. "Winds will slowly ease Monday afternoon."

High winds -- especially when soils are soaked, as they are now -- can topple trees, cut power lines, etc. After winter storms, we often get a flurry of calls from folks wondering what their homeowners and auto insurance covers. Here are some of the most common questions we get, along with the answers.

Update: (10 a.m. Monday) The winds have died down, although we might get a bit of snow tonight.

Friday, December 14, 2012


Hole-in-one golf insurer extradited to face felony charges in WA

From a news release we sent out today:
OLYMPIA, Wash. – A Connecticut businessman who insures golf tournament hole-in-one prizes but has a history of failing to pay has been extradited to Washington to face charges.

Kevin Kolenda, 55, of Norwalk, Conn., was flown from Connecticut to Washington under guard Thursday. He has been booked into the King County Jail. He’s expected to be arraigned Monday at King County Superior Court in Seattle.

“It’s rare that we have to go to these extremes to rein in a scammer,” said Washington Insurance Commissioner Mike Kreidler. “But Mr. Kolenda’s been thumbing his nose at regulators for years. Arresting him seems to be the only way to get his attention.”

In August, Kolenda was charged in King County Superior Court with five counts of transacting insurance without a license, a class B felony. His arraignment was slated for Sept. 5, but he failed to show up. A judge issued a bench warrant for Kolenda’s arrest.

In addition to failing to show up in court, Kolenda also ignored a Washington cease-and-desist order in 2004 and a $125,000 fine in 2008.

On Sept. 26, Kolenda was arrested on the Washington bench warrant by police in Norwalk. He has been held since then in jail in Connecticut, pending extradition. His transfer to Washington was approved in November by Connecticut Gov. Dannel Malloy.

“I’m very grateful to everyone who’s helped us get Mr. Kolenda here to Washington to face justice,” said Kreidler. “He has a long history of selling illegal insurance and refusing to pay prize winners.”
In some cases, charities have had to come up with the prize money that Kolenda refused to pay. In others, the prize winners agreed to forgo a prize.

Kolenda in 1995 started a business called Golf Marketing, working out of a home his parents owned in Norwalk. Since then, the business’ name has changed several times, including: Golf Marketing Worldwide LLC, Golf Marketing Inc., Hole-in-Won.com, and currently Hole-in-Won.com Worldwide. The company also has a regional office in Rye, N.Y.

Kolenda has repeatedly failed to pay winning golfers in Washington. Among them:

• In 2003, Kolenda illegally sold insurance for a tournament in Bremerton. But when a golfer got a hole in one and tried to claim the $10,000 prize, Kolenda wouldn’t pay.

• In 2004, Kolenda sold insurance for a Vancouver tournament. Again, a golfer got a hole in one. Kolenda refused to pay the $50,000 prize. After a hearing at which Kolenda failed to appear, he was ordered in 2008 to pay a $125,000 fine. He never did.

• In 2010, Kolenda sold coverage to pay $25,000 for a hole in one during a golf tournament in Snohomish. A player got a hole in one. His golf partners signed notarized forms attesting to the hole in one. The prize remains unpaid, despite numerous calls and emails from the partners and tournament officials.

Similar allegations have been made against Mr. Kolenda and/or his business in numerous other states, including Montana, Ohio, Georgia, California, New York, Hawaii, Alabama, Massachusetts, Florida, Connecticut and North Carolina.

Thursday, December 13, 2012


Job opening: .NET developer


We're recruiting to fill a position for an information technology specialist 4 (.NET developer) in our operations division in Tumwater, Wash.

The successful applicant's duties will include software development of mission-critical agency systems, systems analysis, as well as software unit and quality assurance testing.

For more specifics, duties, salary, timeline, etc., please see the full job listing.

Guilty plea from man who hit car, then bought insurance


A Blaine man who rear-ended another driver, rushed to buy insurance, then claimed that the crash happened afterward has pleaded guilty to insurance fraud.

Mark Traxler, 51, let his auto insurance lapse in January because he didn't pay the premium.

Two weeks after his coverage ended, he hit a car in Bellingham, causing more than $5,000 in damage.

He immediately went to his insurance agent and paid for new coverage. By nightfall, the other driver had made a claim against his policy.

The problem: Traxler said that the accident happened after he'd bought the coverage, when a 9-1-1 call placed by the other driver indicated that it happened before.

Traxler today pleaded guilty in Whatcom County Superior Court. He was sentenced to 364 days in jail, but 354 were suspended on the conditions that he do 80 hours of community service, pay a $250 crime victim penalty assessment, a $200 filing fee and a $500 fine.

Wednesday, December 12, 2012


When Has FSCO Mediation Failed - Part 1

We previously blogged on the decision in Cornie v. State Farm, in which Justice Sloan held that insureds may commence claims against their accident benefits carriers if 60 days have elapsed since an application for mediation has been filed, even if mediation itself has not occurred.  The Court of Appeal has now released its appeal decision in Hurst v. Aviva, 2012 ONCA 837 (C.A.).

Section 281(2) of the Insurance Act prevents insured persons from commencing court actions or arbitrations against their insurers unless they first seek mediation and mediation has failed.  The claimants waited 60 days after applying for mediation and when no mediation had taken place, they commenced actions.  FSCO`s position was that the prescribed 60 day time limit for conducting mediation did not begin to run until an application for mediation had been assessed by FSCO and found to be complete.  FSCO refused to issue a report declaring the mediations had failed.  The insurers in four actions brought motions to have the actions stayed on the basis that they were barred by s. 281(2) as mediation had not taken place.  Justice Sloan dismissed the motions and the insurers appealed. 

The Court of Appeal dismissed the appeals.  The Court concluded that the process is intended to be completed with 60 days after an application for mediation has been filed; however, if mediation has not taken place within 60 days, insured persons are free to pursue either court action or arbitration. 

The Court rejected the insurers` arguments that the cost to the industry could be $83 million as a result of the interpretation of the Act that does not require mediation to actually take place.  The insurers submitted statistics that 75% of claims are resolved by mediation at FSCO.  One has to expect a flood of court proceedings as a result of this decision, along with significant costs to insurers.

Tuesday, December 11, 2012


Job opening: Market analyst

We're recruiting to fill one permanent position for a market analyst in our Tumwater, Wash. building.

The person will be responsible for conducting market analysis of regulated entities (e.g. insurance companies) under the direction of our chief market analyst. We provide regulatory oversight of market interactions between consumers and companies, in order to protect consumers and promote a healthy business environment.

Please see the full job listing for a description of the job duties, salary, benefits, etc.

Monday, December 10, 2012


Coming soon: Our revamped website

For more than a year now, we've been working hard behind the scenes developing an easier-to-use website. While insurance industry professionals -- agents, brokers and insurers -- are familiar with navigating our site, testing showed that consumers could only complete site-related tasks about a third of the time. That's a problem, obviously, when a key part of our mission is informing and protecting consumers.

So we've revised the navigational structure of the site to make it a lot more intuitive. For years, for example, much of the navigational structure on the site simply mirrored the agency's organizational chart, rather than putting things where average users would expect them to be.

Along the way, we've repeatedly tested the changes on both consumers and industry professionals to make sure that we really are improving things, rather than just changing them.

The upshot: Successful task completion on the website for consumers, which is about 33 percent on our current website, rises to nearly 80 percent on our new prototype website, pictured below.

We're also changing the look and feel of the site to update it. The site isn't live yet, but we're expecting to make the change in mid-January.

There will inevitably be some hiccups and things we'll need to fix, but we think you'll like the new site better. And we know it will be easier to use.

Wednesday, December 5, 2012


20,000 Washingtonians potentially affected by data breach at Nationwide Insurance

An October data breach in a Nationwide Insurance computer network resulted in personal information for thousands of Washingtonians being stolen, according to company officials.

"On October 3, 2012, a portion of our computer network that is used by Nationwide Insurance and Allied Insurance was criminally intruded upon by an unidentified perpetrator. We discovered the attack that day, and took immediate steps to contain the intrusion," Nationwide attorney Samuel Lee notified our office recently.

The company has said that more than 1.1 million people's personal information may have been affected. Some of them are not Nationwide customers. Apparently, some people who might have just gotten quotes, etc. are on the list of those who may have been affected. We've been contacted by some of these people, and since they're not Nationwide customers, they initially think the letter is some kind of scam or sales pitch for ID theft services.

"Although we are still investigating the incident, our initial analysis has indicated that the compromised information included individuals’ name and some combination of their Social Security number, driver’s license number and/or their date of birth and possibly their marital status, gender, and occupation, and the name and address of their employer," Lee wrote.

The attack was reported to law enforcement, including the FBI, who are investigating. Nationwide is sending notification letters to 20,916 people whose personal information may have been compromised. The company says it is tightening network security. It is also offering a year of free credit monitoring and identity theft protection services to those 20,916 people.

In the letter being sent out, the company apologizes for the data breach and says "we are not aware of any misuse of your information at this time."

Nationwide customers should watch for a letter in the mail, or they can call a special hotline the company has set up: 1-800-760-1125.

The state attorney general's office also maintains an excellent page with detailed tips on preventing and dealing with identity theft.

Appellate Jurisdiction

Under the Courts of Justice Act, appeals relating to amounts greater than $50,000 must be made to the Court of Appeal.  Appeals of judgments relating to amounts under $50,000 are to the Divisional Court.  Where only a portion of a judgment is appealed, does the jurisdiction change?

In Grammatico v. Chambers, 2012 ONSC 6518 (Div. Ct.), the parties disagreed on whether the proper court to hear an appeal was the Divisional Court or the Court of Appeal.  The substantive judgment involved sums greater than $50,000, the threshold imposed by s. 19(1.2) of the Courts of Justice Act for appeals to the Court of Appeal. The defendant argued that it sought to appeal an interest component relating to costs, rather than the substantive judgment.  Since the amount would be less than $50,000 the defendant's position was that the appeal was to the Divisional Court.

Justice Eberhard held that the appeal was to the Court of Appeal.  The jurisdiction for appeal must be determined by the aggregate of the sums awarded.  The fact that only one part of the decision was under appeal did not determine jurisdiction.

Tuesday, December 4, 2012


Think you have flood insurance? Make sure.

Again, we can't say it enough: Homeowners and businesses in flood-prone areas should make sure they have adequate flood coverage.

“Standard homeowners or business policies do not cover flooding,” said Insurance Commissioner Mike Kreidler. “It’s tragic when people don’t discover that until it’s too late.”

The federally-run National Flood Insurance Program (www.floodsmart.gov) is the first stop for most people seeking flood coverage. The program was created by Congress in 1968. It offers flood insurance to homeowners, renters and business owners in communities that have taken certain steps to help reduce the risk of flooding. There is a 30-day waiting period for most policies, so it’s important not to delay.

Many insurance agents offer National Flood Insurance Program policies. The average NFIP policy costs about $600 a year.

“Renters should also strongly consider flood coverage for their belongings,” Kreidler said. “That coverage, which starts at $49 a year, is inexpensive. Replacing your stuff is not.”

Mortgage lenders in flood-prone areas typically require flood coverage. But homeowners often later let that coverage lapse.

The National Flood Insurance Program website has online tools to estimate the flood risk at a particular address, as well as damage estimates from different flood levels.