Not All Water Is Created Equally

Let’s take a step back for a moment to understand homeowners insurance basics. All homeowners insurance losses are directly caused by something. A “Peril” is a direct cause of loss. However, there may be indirect causes of loss that caused the actual damage for a particular claim. When you think about water damage losses this way, it makes understanding how water damage claims get paid a lot easier for homeowners.

Types of Water Damage

Now let’s break down the four most common types of water damage claims a homeowner can have:

Rain Water Damage

Suppose there is a heavy thunderstorm right above your home. The high wind from the storm rips off a section of your roof. Since it was still raining at the time you were saying goodbye to your roof, the rain water poured into your home causing water damage. The direct cause of water damage in this case was wind. The indirect cause of water damage in this case was rain water, which entered through the damaged section of roofing.

Backing Up of Sewers and Drains

If the main trap in your sewer waste line gets clogged, waste water that drains into the waste line will back up and flood into your home. The direct cause of water damage in this case is a clogged sewer drain. The indirect cause of water damage in this case was waste water backing up into your home from the clogged sewer drain.

Broken Water Pipes

If a water pipe breaks in your house, running water will flood out your home. The direct cause of water damage in this case is the broken water pipe. The indirect cause of water damage in this case is running water leaking from the broken water pipe.

Flooding of Surface Waters

Suppose there is a hurricane in your area and you live near tidal waters (for example, less than 1 mile from the South Shore of Long Island). Due to the storm surge created by the hurricane, coastal waters near your home rises by 8 feet. Since your home is at sea level and you are in a flood-prone area (you don’t necessarily need to be in a flood zone mind you), tidal waters now begins to flow into your home causing severe damage. The direct cause of water damage in this case is flooding of surface water.

How to Cover Yourself Against Water Damage Losses

Now that you have a good understanding about water damage losses and how they are caused, it’s time for you to select and obtain the right policies and endorsements to protect you against water damage exposures:

Homeowners Insurance

Homeowners insurance by default, protect insured’s against water damage caused by broken water pipes in the home. It also covers you from damage due to rain water entering your home from losing a section of roofing, a window breaking, or a wall collapsing due to a windstorm.

Water & Sewer Backup

Available via endorsement on a homeowners policy, Water and Sewer Backup coverage protects insured’s against losses caused by the backing up of sewers or drains. Most of the time, you must request this additional coverage be added to your homeowners policy. Ask your insurance broker about this optional coverage endorsement.

Flood Insurance

Homeowners insurance does not cover you for losses caused by tidal/surface flood waters. For these types of perils, you must obtain a separate flood insurance policy. Flood insurance is written through the Federal Emergency Management Agency (or FEMA). Some states require you to apply for this type of policy directly through FEMA. Other states (such as New York) allow you to obtain this coverage through your insurance broker. Bear in mind, the maximum limit a flood insurance policy offers on residential dwellings is $250,000 as determined by FEMA.

*Note* Just because your home is not officially in a flood zone doesn’t mean your home is not at risk of flooding due to tidal/surface waters.

High Value Homes Have Specialized Options

For homes that are valued at $1 million or more in replacement cost, these high value homeowners insurance policies get written by specialty carriers such as Chartis, Chubb, and Fireman’s Fund. In most cases, these high risk policies will include basic flood and water & sewer backup coverage by default, with the option to endorse excess flood insurance directly onto the homeowners policy due to the higher replacement cost value of the home. Talk to your high value homeowners insurance broker for more information about these programs.

There are fines associated with an employer’s failure to provide this packet, but until now they have been generally unenforced by the Board. However, we have been advised that the Board may start enforcing this requirement and fining employers who do not provide the packets to claimants. It is important for employers to understand: Insurance carriers will not pay this fine.

Many insurance carriers in New York automatically send the claimant a packet once the claim is set up – but some do not (most noteworthy – the New York State Insurance Fund or “NYSIF”). To avoid fines, those employers that have their Worker’s Compensation Insurance through the NYSIF should make certain that Claimant Information Packets are promptly distributed to newly injured employees.

Oxford – ER Visits vs Urgent Care Visits

In addition, Oxford also has an “On Call” phone number for subscribers to use if they are unsure as to what medical setting they should pick for a medical need they are experiencing. The phone number is 800-201-4911.

Remember, emergency room (ER) costs are incredibly inflated and can have a negative effect on large group premium rates. As a result, employers and subscribers should choose where they should receive care wisely as to avoid reduced coverage and higher premiums in the future. Oxford has a large amount of Urgent Care Facilities in their network. If employees use them, they can get quicker access to care while controlling claim costs in non-emergency situations.

For more information regarding Oxford Health Plans, contact a New York insurance broker.

The 5 percent discount is now available to new policyholders with electric vehicles in Alabama, Arizona, California, Illinois, Kansas, Minnesota, Oklahoma, and Texas and will be available nationwide by the end of 2012. Current policyholders with electric vehicles will receive the 5 percent discount at renewal.

For more information regarding The Hartford auto insurance program, contact a New York insurance broker.

Article source: Business Wire

oxfordhealth.com mobile

Oxford Health Mobile provides streamlined and instant access to many subscriber services such as:

-Finding doctors, hospitals, urgent care, and convenient care clinics
-Viewing health plan ID cards
-Checking recent claims
-Updating user profile settings

Easy Access

Using oxfordhealth.com on a smartphone is easy and allows its subscribers to view important benefit information when convenient. Subscribers just need to enter the same username and password they use when they access oxfordhealth.com from their computers.

Oxford Health – Mobile Access Flyer

For more information about Oxford Health Plans and subscriber benefits, contact a New York insurance broker.

Letters will be going out to Emblem small groups and its members shortly regarding the changes. Sample letters can be found below:

Emblem Health – Small Group Drug Formulary – Group Notice Letter – March 2012
Emblem Health – Small Group Drug Formulary – Member Notice Letter – March 2012

Below is the new Emblem Health small group drug formulary:

Emblem Health – New Small Group Drug Formulary Pharmacy – March 2012

For more information regarding these changes, contact a New York insurance broker or your Emblem Health representative.

Strong northwesterly winds, low humidity, and a continued lack of rain for the Tri-State area has led to another Red Flag warning for much of southern New England today. Affected areas include northern New Jersey, the Catskills and Hudson Valley areas of New York State, NYC, Long Island, and Connecticut. As a result… any fires that start may quickly spread. Outdoor burning is not recommended.

Look for fire warnings to continue for the NYC metro area so long as our area remains precipitation-free.

The Hartford – Spectrum

As of this writing, The Hartford is targeting the following classes of small businesses for Spectrum insurance coverage:

Technology

Application Service Providers
Computer Consultants
Computer Data Processing
Computer Facilities Management
Computer Systems Integration Services
Custom Computer Programming & Application Services
Internet Search & Indexing Tool Provider
Prepackaged Software
Software & Internet Design Services
Technology Service Provider
Website Design & Development Services

Financial Services

Banks, Savings & Loan Institutions
Charitable Foundation
Commodity Broker
Credit Unions
Finance Companies
Financial Planners
Insurance Agencies
Insurance Companies
Investment Companies
Mortgage Banker
Mortgage Broker
Stock Broker
Trust Companies

Professional Services

Accounting & Auditing Services
Animal Hospitals
Architects & Auditing Services
Bookkeepers
Dental Lab
Draftsmen
Engineers & Engineering Services
Laser Eye Surgery Centers
Lawyers & Law Firms
Medical Billing Services
Medical Offices
Other Professional Offices
Radiology Labs
Tax Preparers
Veterinarian

Business & Professional Services

Actuarial Services
Advertising Agencies
Art Conservators
Art, Dance, Drama & Music Schools
Art Galleries & Studios
Answering Service
Appraisers
Authors
Business, Computer & Secretarial Schools
Claim Adjusters
Consultants
Court Reporters
Crematories
Embroidery Operations
Employment Agencies
Funeral Directors
General Offices
Graphic Artists & Designers
Interior Decorators
Interpreter or Translators
Language & Reading Learning Centers
Locksmith Shops
Manufacturer’s Representative Excluding Product
Market Research Firms
Media Duplication
Non-Profit Associations
Notary Public
Patent Agents
Photo Finishing Labs
Photography Studios
Post Production Studios
Public Speaker
Publishers
Real Estate Agencies
Religious Reading Rooms
Repair Shops
Stenographic & Secretarial Services
Taxidermists
Telemarketing Firms
Title Agencies
Travel Agencies
Vacuum Cleaner Sales & Service
Videography Services
Storefront Window Decorators

A Myriad of Coverage Solutions

Below are some of the key ways The Hartford can help mitigate your company’s liability exposure:

-Bodily Injury and Property Damage Liability
-Personal and Advertising Injuries
-Medical Payments
-Damage to Premises Rented to You
-Employment Practices Liability
-Additional Insured
-Building and Business Personal Property
-Computers and Media
-Computer Fraud
-Cyber Liability
-Accounts Receivable
-Property in Transit
-Tenant Obligations
-Off-Premises Utility Services—Business Income

The Hartford Insurance Company’s greater New York City and Long Island coverage area includes Nassau, Suffolk, The Bronx, Queens, Brooklyn, Manhattan, Staten Island, Richmond, and Kings County. Businesses listed above that are domiciled in these areas are eligible to apply for Spectrum BOP coverage with the Hartford at special pricing.

For more information on how to protect your business with extraordinary liability coverage at affordable prices, contact a New York insurance broker.

Attached is a 2012 break down of Flexible Spending Accounts, Health Reimbursement Arrangements, and Health Savings Accounts. All of these are designed to help fight rising health insurance premiums for small and large businesses.

FSA HRA HSA Breakdown – 2012

As you can see, each of these options are different in nature…all of which offer ways to help businesses with premium cost control. For more information about these IRS options, contact a New York health insurance broker.

Oxford Health Plans – Hospital Listing – 022112