Friday, February 26, 2010

Auto glass installer sentenced, must repay $100,000

A Battle Ground auto glass installer who overbilled an insurance company for years will have to pay back $100,000 in inflated billings.

Robert T. Wooster, doing business as Dr. Bob’s Auto Glass and DRB Enterprises Auto Glass, pleaded guilty earlier this year to a felony charge of first-degree theft. He was sentenced to 1 year's probation and $100,000 in restitution on Thursday.

Washington state Insurance Commissioner Mike Kreidler's Special Investigations Unit served a search warrant on Wooster’s business in late 2007, seizing dozens of fraudulent invoices.

The investigation found that Wooster had two schemes for illegally billing the insurer:

-He would replaced chipped or cracked windshields, but bill the company for more-expensive side- or back windows. The insurance commissioner’s office is aware of more than 100 cases in which customers had windshields replaced, but where the records showed that Wooster had billed for side- or back glass.

-He would submit bogus invoices, cutting and pasting photocopied dealer invoices to make it look like his costs for the glass were much higher than they really were. He also fabricated false invoices for parts that were never actually installed, such as new window moldings.

Wednesday, February 24, 2010

West Seattle man pleads guilty to first-degree theft in insurance fraud case

Edward Charles Bailey, 59, of West Seattle, has pleaded guilty in King County Superior Court to first degree theft for committing insurance fraud.

Bailey, who reported an on-the-job back injury to his employer in 2006, was placed on temporary total disability and received disability pay from his employer’s insurer, Alaska National Insurance. Doctors subsequently ruled him unable to return to work.

Five weeks after the injury, investigators working for the insurance company videotaped Bailey working vigorously on his sailboat at a Seattle marina. The sanding, painting, climbing and moving of machinery were all contrary to the physical restrictions imposed by Bailey’s doctors, according to the Washington insurance commissioner’s Special Investigations Unit.

When shown the video, the independent medical examination doctors who had originally seen Mr. Bailey reversed their original opinion as to his ability to work.

According to the charges, Bailey was paid more than $26,000 in unnecessary medical expenses and disability benefits that he wasn’t entitled to.

Bailey's sentencing is slated for early next month.

Meanwhile, in Virginia...

An amendment has been introduced in the Virginia state legislature to ban insurers from requiring their customers:

" have an identification/tracking device or mark implanted or permanently or semi-permanently incorporated into the body, skin, teeth, hair, or nails of such person to track, or to aid in tracking such person."

Violations would be subject to a fine of $500, payable to that state's Literary Fund.

For the record, we here in Washington are unaware of any insurer planning to implant anything in your hair, fingernails, or anywhere else. The closest thing we've seen is a proposal from some auto insurers to allow their customers to voluntarily have devices installed in their cars to monitor how they drive (jackrabbit starts, speeding, etc.), for the purpose of giving good drivers a discount.

Thursday, February 18, 2010

New online tool calculates your risks of car wrecks, burglary, wind damage, etc.

A company called Virtual Insurance Advisor has built an interesting online tool that allows you to type in a few variables (age, gender, state) to get a ballpark estimate of the risks in your life.

Example: A 35-year-old man in Washington state, according to the tool, has:

-a 1 in 43 risk of dying within 10 years
-a 1 in 15 chance of having an auto collision claim this year
-a 1 in 1023 chance of having a house fire this year
-a 1 in 250 chance of suffering major wind damage to the home
-a 1 in 1064 chance of a home burglary

and so forth. All told, there are nearly three dozen situations listed.

(Lastly, this post comes with our usual disclaimer: As Washington state's insurance regulator, we do NOT endorse any company, agent, etc. Mentioning a company's website, study, press release, etc. does not mean we're endorsing them or their products. But you knew that already.)

Wednesday, February 17, 2010

Insurance news: Oregon opens health insurer rate filings, new legislation re: autism coverage, and Allstate says teen girl drivers "more distracted" than boys

Health insurers filing rate requests with the state of Oregon will no longer be able to keep those requests secret, the Oregonian reports today.

In Missouri, lawmakers in the House have approved a bill to require insurers to cover treatment for autistic children. The same thing happened in the Virginia state senate.

The Wall Street Journal has an interesting story about insurers getting involved on cancer treatments for their members. Headline: Insurer Plays Judge on Cancer Care.

And the Chicago Tribune reports on an Allstate study that concludes that, as the article puts it, "Differences between the sexes are becoming less noticeable when it comes to teenage driving. In what seems like a role reversal, girls are expressing a new need for speed, while aggressive driving and speeding by boys is down."
Here's the story, and here's the link to the study.

Percentage of uninsured motorists, by state

It's a question that our office gets periodically: What percentage of Washington drivers have no insurance?

The short answer is that we're not sure. Our office regulates insurers, agents and brokers, but not the consumers who actually buy the coverage.

But the Pennsylvania-based Insurance Research Council did an estimate, based on data collected from nine major auto insurers representing about half the private passenger auto market in the United States.

(Editor's note (2/7/2012): This post continues to get high hits, but you can find updated numbers here. Now back to the original post...)

The states with the highest percentages, the IRC estimates, are in the South. The lowest states are about evenly split between the Midwest, intermountain West and the Northeast.

The most recent report uses 2007 data. Washington came in fairly high, with an estimated 18 16 percent of drivers -- about one in six -- uninsured. Oregon and Idaho were much lower: 11 percent and 9 percent, respectively. The top two spots were Mississippi, with 28 percent, and New Mexico, with 29 percent.

Here is the IRC's breakdown of states, by percentage of uninsured drivers:

Alabama = 26%

Alaska = 13%

Arizona = 18%

Arkansas = 15%

California = 18%

Colorado = 15%

Connecticut = 9%

D.C. = 15%

Delaware = 10%

Florida = 23%

Georgia = 12%

Hawaii = 12%

Idaho = 9%

Illinois = 15%

Indiana = 14%

Iowa = 12%

Kansas = 10%

Kentucky = 16%

Louisiana = 12%

Maine = 4%

Maryland = 12%

Massachusetts = 1%

Michigan = 17%

Minnesota = 12%

Mississippi = 28%

Missouri = 14%

Montana = 15%

Nebraska = 8%

Nevada = 15%

New Hampshire = 11%

New Jersey = 8%

New Mexico = 29%

New York = 5%

North Carolina = 12%

North Dakota = 5%

Ohio = 16%

Oklahoma = 24%

Oregon = 11%

Pennsylvania = 7%

Rhode Island = 14%

South Carolina = 9%

South Dakota = 7%

Tennessee = 20%

Texas = 15%

Utah = 8%

Vermont = 6%

Virginia = 9%

Washington = 16%

West Virginia = 8%

Wisconsin = 15%

Wyoming = 9%

Note: This post was updated to correct Washington's percentage.

Friday, February 12, 2010

Washington state fined insurers more than $400,000 last year

Washington state insurance commissioner Mike Kreidler issued more than $400,000 in fines in 2009, as well as revoking the licenses of several insurance agents.

“Most insurers and agents work hard to follow the rules, but when they drop the ball, they’re held accountable,” said Kreidler, the state’s top insurance regulator.

Kreidler’s office collected a total of $407,600 in fines in 2009. That’s considerably lower than the previous year, when the state fined insurers more than $1.2 million.

“Hopefully, it’s a sign that companies are getting better at following the rules,” said Kreidler. “The whole point of fines is to ensure that the consumer protections in state law are followed.”

Fines collected by the state insurance commissioner’s office do not go to the agency. The money is deposited in the state’s general fund to pay for other state services.

The enforcement orders are posted on the Office of the Insurance Commissioner website at Here are some of the major ones:

 Pacificare of Washington Inc., Pacificare Life Assurance Co., and Unitedhealthcare Insurance Co., all of Mercer Island, were fined $100,000 with $60,000 suspended for failing to file health care provider contracts and changes with the state.

 Farmers Insurance Company of Washington was fined $40,000 for issuing policies that weren’t in accordance with the documents they’d filed with the state.

 Nationwide Life Insurance Co. of Minneapolis, Minn. was fined $20,000 for issuing insurance documents that had not been filed with the state, among other violations.
 Kawasaki Motors Corp. of Wilmington, Del. was fined $20,000 for selling service contracts before they had been registered in Washington.

Thursday, February 11, 2010

What to do if your health care claim is denied

Last week, an article in the New York Times highlighted the plight many consumers face when their health insurance claims are denied. The article gives some good general consumer tips, but Washington state consumers have extra rights.

First, you should always check your policy and follow your health plan's review process. But if that fails, you have the Patient Bill of Rights which, in part, guarantees that health care decisions providers make are based on medical standards and gives you the right to an independent third-party review of your claim. Learn more

Tuesday, February 9, 2010

WA Senate approves "joint underwriting association" bill to help businesses in flood plain get insurance

The Washington state Senate on Tuesday approved legislation to help businesses located below a weakened dam find flood insurance.

“This is a critical bill to protect businesses in King County’s Green River Valley,” said Insurance Commissioner Mike Kreidler, who requested the legislation.

“This valley is a vital area of the state’s economy, and it’s difficult if not impossible for some businesses to find enough flood coverage there right now,” Kreidler said. “We don’t want employers leaving because they can’t protect themselves against this risk.”

Senate Bill 6240 would allow the insurance commissioner’s office to set up a “joint underwriting association” or JUA. The association, made up of insurance companies, would serve as an insurer of last resort for businesses that cannot find flood coverage.

The bill passed the Senate, 30 to 18. A similar bill, House Bill 2560, is currently in the state House of Representatives.

According to the U.S. Army Corps of Engineers, a weakened abutment adjacent to the Howard Hanson Dam means that the dam cannot hold back as much water as usual. Corps officials have said that the need to release that extra water means that the flood risk below the dam is about 1 in 33.

The heightened flood risk has apparently led to a sharp contraction in the local insurance market, Kreidler said. Federal flood coverage is still widely available for both homes and businesses, but only covers up to $500,000 in commercial property and $500,000 in contents.

For many businesses in the heavily industrialized valley, that’s not enough coverage. Nor does the federal flood program offer business-interruption coverage, which is critical in a major manufacturing and distribution area like the valley.

“It’s important to note that this insurance isn’t a giveaway,” said Kreidler. “JUAs are designed to be self-supporting. The coverage wouldn’t be cheap. But at least it would be available.”

The state already has a JUA set up to provide insurance for midwives. Lawmakers approved another one for day care programs, but it was never used. The regular insurance market rebounded before it was needed.

At least 24 other states have passed similar legislation.

Thursday, February 4, 2010

Insurance news: Fraud's up, fire depts are billing homeowners for putting out fires, and insurance office bomber captured

Lots of insurance news today, some of it a bit odd.

Business Week reports that lawmakers in Maine are considering removing annual and lifetime caps on health coverage.

The Huffington Post and numerous other news sites report that public health care spending is on track to exceed private insurance spending (on health care) next year.

Here in Washington, several news outlets reported on a cease and desist order issued by our office against an auto service contract company. Here's a link to one of the stories, this one in the Puget Sound Business Journal.

ABC News says that some fire departments are billing homeowners for the cost of putting out fires. Among the reported justifications: "Hey, don't worry, it's going to go to insurance."

The LA Times covers a controversial decision by Oklahoma State University to take out $10 million life insurance policies on 27 donors, naming the school as beneficiary. Name of program: the "Gift of a Lifetime."

The Wall Street Journal reports that Metlife shares dropped on worries over potential AIG aquisition, and that Hanover Insurance's profit was up 68 percent on investment gains.

Also in the Journal: A leading anti-insurance-fraud group says that "questionable" claims rose 14 percent last year. says that online searches for life insurance are up 15 percent.

Lastly, the Bizarre Insurance Story of the Day: police in Darwin, Australia have nabbed a man who allegedly bombed an insurance office. He's a 45-year-old man who apparently goes by the name "Bird."

Wednesday, February 3, 2010

Planning a Super Bowl party?

Designating a driver should be at the top of your party-planning list -- This is a really good reminder from the Insurance Information Institute. Millions of Americans will drive to a friend or family member's house to watch the Indianapolis Colts play the New Orleans Saints (go Saints!) making Sunday's event a treacherous time to be on the road.

“Those throwing a party where alcohol is served have both a legal and moral responsibility to make sure that their guests are capable of driving safely,” said Jeanne M. Salvatore, senior vice president and consumer spokesperson for the I.I.I.

“You don’t want to allow anyone who has been drinking to drive a vehicle or ride a motorcycle while impaired. Not only do your guests risk injury or death to themselves or others, but you may be held financially responsible.”

Tuesday, February 2, 2010

Kreidler orders California company to stop selling illegal vehicle service contracts

Washington state Insurance Commissioner Mike Kreidler has ordered a California-based warranty company to stop selling unauthorized vehicle service contracts in Washington.

Consumer Direct Warranty Services, Inc., of Redding, Calif. was ordered to cease and desist “engaging in or transacting the unauthorized business of insurance in the state of Washington,” including advertising.

Kreidler’s office has received complaints about vehicle service contracts sold by the company, which has not registered as a motor vehicle service contract provider in the state. Neither the company nor any of the other parties listed in the order are licensed to sell insurance products in Washington.

The order also names three other companies and four individuals believed to be affiliated with Consumer Direct Warranty Services, including:

 Warranty Administration Services, Inc.

 Warranty Administration Solutions, Inc.

 SafeData Management Services, Inc. and

 Robert L. Chapman, James C. Sletner, Jennifer Shaw and Tamara Berbena.

All are based in Redding, except Berbena, who lives in Red Bluff, Calif.

The companies were also ordered to turn over a complete list of their Washington service-contract customers, and to notify those customers about the order.

Under Washington state law, the order notes, anyone selling unauthorized insurance in the state remains “individually liable for the performance of the contract and for the full amount of any loss sustained by an insured under such contract.”

Monday, February 1, 2010

Insurance news and lots of it: MA will allow insurance appeals for some Toyota drivers, Iowa looks at credit scoring, and Indiana balks at climate survey for insurers

Insurance Journal: MA insurance regulators will allow some Toyota drivers who were involved in accidents linked to unintended acceleration to appeal insurance surcharges assessed by their carriers. Click here.

AMedNews: WA issues cease and desist orders to five companies allegedly selling illegal health insurance.
NY Times: Lawmakers on Thursday announced legislation designed to protect people hit by a family death or other life event that can cause their credit scores to drop and insurance rates to soar. (A death, serious illness, military deployment, identity theft or natural disaster can hurt credit score, says legislator.)

NY Times: With plans to pass sweeping healthcare reform stalled in Congress, the White House is targeting smaller efforts to improve the nation’s healthcare system, such as increasing use of cheaper, generic medicines and boosting electronic medical records.

NY Times: Indiana officials will not impose climate regulations on insurance companies, making it the first state to abandon the landmark measure before it goes into effect nationwide this spring. Medical inflation continues to exceed inflation. (e.g.:Hospital charges rose 7.1 percent)
Denver Westword news blog: Jurors explain stunning $37 million verdict against Assurant Health: Story about rescissions and the largest bad-faith insurance verdict in Colorado history.

Insurance and winter storms: What's covered, what's not, and what to do now...

If a tree limb falls on your car, is it covered by insurance? How about the food in your freezer during a power outage, or your TV when a power surge wrecks it? And what about the cleanup costs for all those wind-damaged branches and storm debris in your yard?

Here's our list of tips about insurance and winter storms.