Keeping the faith.As the nation reeled in shock at the horror Hurricane Katrina Experts expect the industry will be able to handle the losses, but the road to meeting commitments may be particularly difficult. Disputes and lawsuits are predicted to arise over whether policyholders whose homes were destroyed should be paid the full face value of their homeowners policies when hurricane damage was caused by flooding. Also, after all payments are made, high-risk insurance pools in Alabama, Louisiana and Mississippi will likely levy assessments on all property insurers in their respective states. Full coverage of Hurricane Katrina's impact on the industry begins on page 10. Our other cover story, this month looks at new faces of an old problem. Health insurance fraud has existed as long as health insurance, but today's thieves are finding innovative ways to seam seam (sem) a line of union. osteoid seam on the surface of a bone, the narrow region of newly formed organic matrix not yet mineralized. the industry. "We're now starting to see some unique kinds of schemes, like 'rent-a-patient,' developed in South California," said Louis Saccoccio, executive director of the National Health Care Anti-Fraud Association. Pharmaceutical fraud is growing rapidly, involving pharmacists This is a list of notable pharmacists.
Other new schemes involve identity theft, in which a thief steals "patient information and generates lists to bill from for services never rendered," Saccoccio said. "We're also starting to see organized crime groups knowing money is out there in health care and developing schemes to defraud To make a Misrepresentation of an existing material fact, knowing it to be false or making it recklessly without regard to whether it is true or false, intending for someone to rely on the misrepresentation and under circumstances in which such person does rely on it to his or the system," he said. "Fighting on New Fronts" on page 30 explores these latest seams and what insurers are doing to fight back. Sally Whitney is editor. You may reach her at (908) 439-2200, Ext. 5340, by writing to A.M. Best Co., Ambest Road, Oldwick, NJ 08858, or by e-mail at sally.whitney@ambest.com. The e-mail address See Internet address. e-mail address - electronic mail address for Best's Review is bestreview@ambest.com. |
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