Police have arrested and charged more than 100 people with filing millions of dollars in fake auto insurance claims in Lawrence, in the largest investigation into auto insurance fraud in the state's history.
More than a year after the arrests began, the investigation is far from over: Authorities expect as many as 100 more arrests in the next year.
''It's a culture," said Daniel J. Johnston, executive director of the Insurance Fraud Bureau of Massachusetts, which has three investigators devoted to the Lawrence fraud cases. ''We have so many other cases that we're still investigating that clearly the expanse of this is dramatic."
The sheer number of insurance claims from Lawrence in recent years has raised police suspicion. Across the state, according to 2002 statistics, for every 100 vehicle accidents, 43 people say they were injured, Johnston said. But in Lawrence, he said, the same number of accidents produce 141 people reporting injuries.
Authorities launched the task force after a 65-year-old grandmother, Altagracia Arias, was killed in an allegedly staged accident last year. Arias had paid $200 for a seat in a ''bullet car," the name schemers use for the vehicle that causes the accident by ramming into another vehicle, police said. She died when her car slammed into a telephone pole.
Arias had solicited friends at Lawrence Senior Center to buy seats in the two cars, allowing them to claim injuries and sue their insurance companies for amounts averaging between $2,000 and $3,000, police said at the time. Two drivers in the accident were charged with manslaughter in Arias's death.
There is no single group that ran the Lawrence fraud ring, authorities said. At the height of the scam, police say, at least a dozen people known as ''runners" oversaw the planning of each false accident and claim, Lawrence Police Chief John Romero said. Some of the runners have been arrested.
''It's not any one organization," he said. ''It's a number of people."
Police are still seeking Joel Vega, a 26-year-old alleged runner who police say coordinated several false claims.
The accidents were typically staged with well-choreographed precision. The runners would direct two vehicles to a certain street at a certain time, where they would hit each other with enough force to damage both vehicles. The passengers crammed into the vehicles would later complain that the collision had strained their necks and injured their backs.
Some chiropractors were allegedly involved in the fraud ring, collecting payments from insurance companies. And some lawyers have been arrested for their alleged role in helping their clients file fake claims.
In September, 16 people, including three lawyers and four chiropractors, were indicted by an Essex County grand jury on various charges, including conspiracy to commit insurance fraud. The lawyers indicted lived in Salem and Andover; the chiropractors lived in Weston and New Jersey. Continued...
Monday, December 13, 2004
Many Alaskans go without Health Coverage
Associated Press
KENAI -- The percentage of Alaska adults without health insurance ranks among the highest in the nation, according to a report.
Alaska, like the rest of the country, also faces rising costs for long-term care, child care, Medicaid and prescription drugs, according to the study funded by the Pew Charitable trust.
The study was conducted by Governing Magazine and the University of Richmond. It found 22 percent of adults between 21 and 65 had no health insurance. Only eight states had higher rates.
Alaska did somewhat better when it came to covering children under 18, where between 10 and 15 percent were uninsured. That put the state 35th among states.
The study found that state-run health care systems were largely unable to deliver improvements in medicine fairly and consistently to many of their citizens, in part because rising costs were overwhelming state budgets.
Alaska is unique in that its annual budgets are tied directly to the production and price of oil. If prices remain at their current levels, at least $400 million to $450 million of additional revenue could allow state lawmakers to reverse at least some of the budget-cutting trends of the past several years, including within the budget of the Department of Health and Social Services.
The department's budget has risen even as the department has meshed some programs, zeroed funding to others, eliminated positions, consolidated grants and contract functions and made other changes.
Earlier this year, a retiring Homer public health nurse with 25 years of experience said reduced travel budgets had affected local health services.
Among other things, nurse Donna Fenske said there was a need for maternal and child-care education outreach programs. Fenske said she has seen programs come and go as they were affected by political choice or lack of funds.
Health and Social Services Commissioner Joel Gilbertson said the department is considering budget requests that would take into account the unexpected oil revenues. But he said he wouldn't couch any increases in terms of reversing trends.
Past changes to department programs, he said, were the result of analyzing their effectiveness and taking appropriate steps that, while made with the budget in mind, were not driven entirely by the bottom line.
"If programs were not working, we stopped funding them and directed the money to those that were," he said.
At $1.7 billion in fiscal year 2005, Health and Social Services represents the largest segment of the state's operating budget. Nearly $1 billion of that is associated with Medicaid. The increasing cost of long-term care, home health programs, prescription drugs and the like are straining available state and federal dollars.
Today, 145,000 Alaskans hold a Medicaid card. More than 120,000 of them used it in the past year. That number will grow as the population ages, Gilbertson said.
"We are getting close to a quarter of the population using the system," he said. "That's a tremendous financial burden."
KENAI -- The percentage of Alaska adults without health insurance ranks among the highest in the nation, according to a report.
Alaska, like the rest of the country, also faces rising costs for long-term care, child care, Medicaid and prescription drugs, according to the study funded by the Pew Charitable trust.
The study was conducted by Governing Magazine and the University of Richmond. It found 22 percent of adults between 21 and 65 had no health insurance. Only eight states had higher rates.
Alaska did somewhat better when it came to covering children under 18, where between 10 and 15 percent were uninsured. That put the state 35th among states.
The study found that state-run health care systems were largely unable to deliver improvements in medicine fairly and consistently to many of their citizens, in part because rising costs were overwhelming state budgets.
Alaska is unique in that its annual budgets are tied directly to the production and price of oil. If prices remain at their current levels, at least $400 million to $450 million of additional revenue could allow state lawmakers to reverse at least some of the budget-cutting trends of the past several years, including within the budget of the Department of Health and Social Services.
The department's budget has risen even as the department has meshed some programs, zeroed funding to others, eliminated positions, consolidated grants and contract functions and made other changes.
Earlier this year, a retiring Homer public health nurse with 25 years of experience said reduced travel budgets had affected local health services.
Among other things, nurse Donna Fenske said there was a need for maternal and child-care education outreach programs. Fenske said she has seen programs come and go as they were affected by political choice or lack of funds.
Health and Social Services Commissioner Joel Gilbertson said the department is considering budget requests that would take into account the unexpected oil revenues. But he said he wouldn't couch any increases in terms of reversing trends.
Past changes to department programs, he said, were the result of analyzing their effectiveness and taking appropriate steps that, while made with the budget in mind, were not driven entirely by the bottom line.
"If programs were not working, we stopped funding them and directed the money to those that were," he said.
At $1.7 billion in fiscal year 2005, Health and Social Services represents the largest segment of the state's operating budget. Nearly $1 billion of that is associated with Medicaid. The increasing cost of long-term care, home health programs, prescription drugs and the like are straining available state and federal dollars.
Today, 145,000 Alaskans hold a Medicaid card. More than 120,000 of them used it in the past year. That number will grow as the population ages, Gilbertson said.
"We are getting close to a quarter of the population using the system," he said. "That's a tremendous financial burden."
Health Insurance partnerhip gets funding
Associated Press
MILWAUKEE - A statewide health insurance cooperative plan is expected to receive $2 million in federal money to kick it off.
President Bush is expected to sign the appropriation bill giving the Wisconsin Federation of Cooperatives the money to help underwrite the insurance risk of farmers and other co-op members.
Many of the anticipated members of the regional health care cooperative have not had health insurance for years and insurers consider them high risks.
The fund will serve as a reserve pool of money to pay medical costs that total $30,000 to $100,000 a person. Without the reserve, insurers would have to pick up the entire expense of such high-cost claims and pass on the costs to members with higher premiums.
Bill Oemichen, the federation's president and CEO, said he expects the first regional health care cooperative, which will be mostly for farmers, to operate in northwestern Wisconsin by early summer.
The next regional co-op is planned for north-central Wisconsin.
Eventually the group hopes to have five regional health care cooperatives throughout the state for small businesses, self-employed people and employees of nonprofit organizations.
Oemichen said Sen. Herb Kohl, D-Wis., and Congressmen Dave Obey, D-Wis., and Mark Green, R-Wis., helped get the appropriation included in a congressional bill.
"We want to ensure that our family farms in Wisconsin succeed, and that they have the tools they need to compete. This will give them some clout in getting health insurance," Green said.
The Legislature approved creating five regional health care purchasing alliances last year, but did not provide any funding.
MILWAUKEE - A statewide health insurance cooperative plan is expected to receive $2 million in federal money to kick it off.
President Bush is expected to sign the appropriation bill giving the Wisconsin Federation of Cooperatives the money to help underwrite the insurance risk of farmers and other co-op members.
Many of the anticipated members of the regional health care cooperative have not had health insurance for years and insurers consider them high risks.
The fund will serve as a reserve pool of money to pay medical costs that total $30,000 to $100,000 a person. Without the reserve, insurers would have to pick up the entire expense of such high-cost claims and pass on the costs to members with higher premiums.
Bill Oemichen, the federation's president and CEO, said he expects the first regional health care cooperative, which will be mostly for farmers, to operate in northwestern Wisconsin by early summer.
The next regional co-op is planned for north-central Wisconsin.
Eventually the group hopes to have five regional health care cooperatives throughout the state for small businesses, self-employed people and employees of nonprofit organizations.
Oemichen said Sen. Herb Kohl, D-Wis., and Congressmen Dave Obey, D-Wis., and Mark Green, R-Wis., helped get the appropriation included in a congressional bill.
"We want to ensure that our family farms in Wisconsin succeed, and that they have the tools they need to compete. This will give them some clout in getting health insurance," Green said.
The Legislature approved creating five regional health care purchasing alliances last year, but did not provide any funding.
Saturday, December 11, 2004
Humana spurs job growth
By Richard Ryman
rryman@greenbaypressgazette.com
Humana Inc.’s success in individual health insurance sales means more jobs in Green Bay.
Membership in HumanaOne has topped 100,000 nationwide, and that means about 100 jobs in Green Bay dedicated to servicing those policies. As sales grow, so will the number of jobs needed to support the business.
All administrative functions for HumanaOne are in the Feld Building in downtown Green Bay, including customer service, claims processing and operations.
Humana has other offices for its individual plan in Waukesha, Madison and San Antonio where about 500 people work in product development, sales, telemarketing and underwriting.
“Once the policy is sold, we get involved with the customer on a very close basis,” said Jan Battiola, director of service operations for the Wisconsin Service Center in Green Bay.
“They are footing the entire bill. Their purchasing decisions are different than in the group world. They pay attention. They want to know.”
Humana started selling its individual policies in May 2002 in Illinois. Growth has been steady. The policies are now available in 15 states, with plans to expand to around a dozen more in 2005, said Tod Zacharias, vice president of the Small Group Division in De Pere. About 8,000 plan members live in Wisconsin.
Brown County is home to Louisville, Ky.-based Humana’s Small Group Division and HumanaDental.
“As we looked at the marketplace we serve … the individual market seemed to be a marketplace we were missing,” Zacharias said.
Zacharias said that in coming years purchases by self-employed individuals are expected to increase, while the number of small employers offering coverage to their workers is expected to decrease.
Humana felt it had some advantages going in, including strong nationwide health plan networks and advanced technology. For instance, applications for individual plans are taken over the telephone and some coverage is activated the same day. Individual-plan members have access to a secure Web site with personalized health insurance information, including benefit details, claims information and health reference materials.
The extensive networks allow individual plans to take advantage of discounts and make the plan portable anywhere in the country.
There are four deductible levels ranging from $500 to $5,000, and options are available for prescription drug coverage and Health Savings Accounts.
Early indications are the individual business can be profitable, Zacharias said. “It’s breaking even already this year.”
rryman@greenbaypressgazette.com
Humana Inc.’s success in individual health insurance sales means more jobs in Green Bay.
Membership in HumanaOne has topped 100,000 nationwide, and that means about 100 jobs in Green Bay dedicated to servicing those policies. As sales grow, so will the number of jobs needed to support the business.
All administrative functions for HumanaOne are in the Feld Building in downtown Green Bay, including customer service, claims processing and operations.
Humana has other offices for its individual plan in Waukesha, Madison and San Antonio where about 500 people work in product development, sales, telemarketing and underwriting.
“Once the policy is sold, we get involved with the customer on a very close basis,” said Jan Battiola, director of service operations for the Wisconsin Service Center in Green Bay.
“They are footing the entire bill. Their purchasing decisions are different than in the group world. They pay attention. They want to know.”
Humana started selling its individual policies in May 2002 in Illinois. Growth has been steady. The policies are now available in 15 states, with plans to expand to around a dozen more in 2005, said Tod Zacharias, vice president of the Small Group Division in De Pere. About 8,000 plan members live in Wisconsin.
Brown County is home to Louisville, Ky.-based Humana’s Small Group Division and HumanaDental.
“As we looked at the marketplace we serve … the individual market seemed to be a marketplace we were missing,” Zacharias said.
Zacharias said that in coming years purchases by self-employed individuals are expected to increase, while the number of small employers offering coverage to their workers is expected to decrease.
Humana felt it had some advantages going in, including strong nationwide health plan networks and advanced technology. For instance, applications for individual plans are taken over the telephone and some coverage is activated the same day. Individual-plan members have access to a secure Web site with personalized health insurance information, including benefit details, claims information and health reference materials.
The extensive networks allow individual plans to take advantage of discounts and make the plan portable anywhere in the country.
There are four deductible levels ranging from $500 to $5,000, and options are available for prescription drug coverage and Health Savings Accounts.
Early indications are the individual business can be profitable, Zacharias said. “It’s breaking even already this year.”
Texas keeps eye on State Farm
The Texas Department of Insurance says State Farm must continue to get prior approval before changing rates for homeowners. But State Farm spokeswoman Sophie Harbert says its rates are "competitive, fair and justified" and haven't changed since June of 2003. She says the company is still evaluating this week's state order. So State Farm becomes the only insurance company in Texas that must get prior approval from regulators on what it charges for homeowners policies. Texas previously made the same prior approval requirement of all homeowner policy rates. But as of December first, regulators moved companies to a file-and-use system, which allows them to charge new rates while they're under review. State Farm by January 14th must file its rates with the state. An insurance department spokesman says State Farm is overcharging.
Friday, December 10, 2004
MetLife introduces human value calculator
NEW YORK--(BUSINESS WIRE)--Dec. 9, 2004
MetLife today announced the launch of a new Human Life Value Calculator, available on its Web site at www.metlife.com/lifevaluecalculator, designed to help individuals measure their full-economic value and purchase adequate life insurance protection. MetLife has been challenging the industry to move away from rules-of-thumb when it comes to helping consumers understand their life insurance needs.
"We don't use rules-of-thumb when we purchase car or homeowners insurance," said Joe Jordan, MetLife senior vice president. "Why should we use imprecise rules to value our lives? Similar to the way you can look up the book value of your car, with MetLife's Human Life Value Calculator, you can determine the economic value of your life."
It's no secret that Americans as a group are grossly underinsured. According to LIMRA the average life insurance coverage is less than three times income. MetLife believes that part of the under-insurance problem is the focus on methods that compute life insurance without consideration of an individual's full economic value.
Under the Human Life Value approach, a person's actual financial contribution to his or her household is determined. Income, projected pay raises, cost of household services and fringe benefits such as health insurance are calculated, minus personal consumption. Taxes and the time value of money are also part of the equation.
Human Life Value is not new to the insurance industry. Dr. Solomon S. Huebner--who also founded The American College--developed this scientific method in the early twentieth century. And many courts have recognized the Human Life Value approach as an appropriate way to measure the economic value of a person's lifetime contributions to his or her family.
"The calculator is the first step," added Jordan. "The purchase of life insurance should be determined by needs and goals. At MetLife we believe that face-to-face interaction is still critical. You can plug numbers into the calculator but you can't ask the calculator questions."
MetLife today announced the launch of a new Human Life Value Calculator, available on its Web site at www.metlife.com/lifevaluecalculator, designed to help individuals measure their full-economic value and purchase adequate life insurance protection. MetLife has been challenging the industry to move away from rules-of-thumb when it comes to helping consumers understand their life insurance needs.
"We don't use rules-of-thumb when we purchase car or homeowners insurance," said Joe Jordan, MetLife senior vice president. "Why should we use imprecise rules to value our lives? Similar to the way you can look up the book value of your car, with MetLife's Human Life Value Calculator, you can determine the economic value of your life."
It's no secret that Americans as a group are grossly underinsured. According to LIMRA the average life insurance coverage is less than three times income. MetLife believes that part of the under-insurance problem is the focus on methods that compute life insurance without consideration of an individual's full economic value.
Under the Human Life Value approach, a person's actual financial contribution to his or her household is determined. Income, projected pay raises, cost of household services and fringe benefits such as health insurance are calculated, minus personal consumption. Taxes and the time value of money are also part of the equation.
Human Life Value is not new to the insurance industry. Dr. Solomon S. Huebner--who also founded The American College--developed this scientific method in the early twentieth century. And many courts have recognized the Human Life Value approach as an appropriate way to measure the economic value of a person's lifetime contributions to his or her family.
"The calculator is the first step," added Jordan. "The purchase of life insurance should be determined by needs and goals. At MetLife we believe that face-to-face interaction is still critical. You can plug numbers into the calculator but you can't ask the calculator questions."
Progressive November income falls
Progressive Insurance company on Thursday reported a decline in November net income as the amount of premiums written and earned grew, but its ratio of losses and expenses rose. The company said income fell 6 percent to $93.8 million, or 46 cent cents per share, down from $99.5 million, or 45 cents per share, a year ago. Net premiums written rose 7 percent to $937 million from $875.5 million, while premiums earned rose 8 percent to $1.02 billion from $939.5 million. Progressive's combined ratio of losses and expenses rose to 89.6 from 86.7. The company said growth continued to slow in its personal lines and commercial auto businesses, but auto growth in November benefited from a lower inventory of unprocessed applications. Progressive shares roes 53 cents to close at $91.20 on the New York Stock Exchange.
Subscribe to:
Posts (Atom)
:.
