In managing the claims handling function, insurers seek to balance the elements of customer satisfaction, administrative handling expenses, and claims overpayment leakages. As part of this balancing act, fraudulent insurance practices are a major business risk that must be managed and overcome. Disputes between insurers and insureds over the validity of claims or claims handling practices occasionally escalate into litigation (see insurance bad faith).
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Accidental loss: The event that constitutes the trigger of a claim should be fortuitous, or at least outside the control of the beneficiary of the insurance. The loss should be pure, in the sense that it results from an event for which there is only the opportunity for cost. Events that contain speculative elements such as ordinary business risks or even purchasing a lottery ticket are generally not considered insurable.
Middle Income: If your income is above the threshold of $45,960 (adjusted), you will not qualify for subsidized health insurance. Those above the poverty rate can still shop for insurance via an exchange but will not benefit from subsidies. However, income thresholds change depending on household size, so it is worth finding out if you qualify. Individuals can also shop for insurance through one of the major carriers, including those listed in this review, such as Humana, Kaiser Permanente or Blue Cross Blue Shield (BCBS), depending on what is available in your area. In most cases you can expect to pay about $300 to $600 per month in premiums for individual insurance. If you don't know if your income qualifies for subsidies, you can use one of the exchange calculators to help you figure that out. Another option for healthy mid-income individuals is high-deductible health plans. These plans have a deductible of up to $6,600, but will have a lower monthly premium and will help you pay major expenses.
In the United States, the underwriting loss of property and casualty insurance companies was $142.3 billion in the five years ending 2003. But overall profit for the same period was $68.4 billion, as the result of float. Some insurance industry insiders, most notably Hank Greenberg, do not believe that it is forever possible to sustain a profit from float without an underwriting profit as well, but this opinion is not universally held. Reliance on float for profit has led some industry experts to call insurance companies "investment companies that raise the money for their investments by selling insurance."
If you decide to opt out instead of acquiring compliant health insurance, you do have a few options. These options probably won't qualify to relieve you of having to pay the shared responsibility payment, but they can still lower your health care costs. Many insurance companies offer short-term insurance plans that might help you between coverage periods or after losing insurance. Catastrophic insurance usually has a high deductible, but can help if you need expensive treatment. Another option is Direct Primary Care (DPC) or "concierge medicine." These are not standard insurance models but involve a direct payment to the provider as an annual fee or retainer for services. This type of arrangement is not common, but it's an option for some. Boutique offices are becoming increasingly popular as well. These medical practices do not bother with insurance and simply make cash-price arrangements with patients. Many offer quite competitive rates for routine services. However, keep in mind that this alternative option does not satisfy the requirement to have minimal compliant health insurance and that you may need to pay the fine unless you are somehow otherwise exempt.
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