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.
In determining premiums and premium rate structures, insurers consider quantifiable factors, including location, credit scores, gender, occupation, marital status, and education level. However, the use of such factors is often considered to be unfair or unlawfully discriminatory, and the reaction against this practice has in some instances led to political disputes about the ways in which insurers determine premiums and regulatory intervention to limit the factors used.
Insurers will often use insurance agents to initially market or underwrite their customers. Agents can be captive, meaning they write only for one company, or independent, meaning that they can issue policies from several companies. The existence and success of companies using insurance agents is likely due to improved and personalized service. Companies also use Broking firms, Banks and other corporate entities (like Self Help Groups, Microfinance Institutions, NGOs, etc.) to market their products.[30]
The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insurer will compensate the insured. The amount of money charged by the insurer to the Policyholder for the coverage set forth in the insurance policy is called the premium. If the insured experiences a loss which is potentially covered by the insurance policy, the insured submits a claim to the insurer for processing by a claims adjuster. The insurer may hedge its own risk by taking out reinsurance, whereby another insurance company agrees to carry some of the risk, especially if the primary insurer deems the risk too large for it to carry.
Additional living expenses, or loss-of-use coverage is typically a fixed amount – 20% of your dwelling coverage. However, if you live in an area prone to wildfires or hurricanes, it's worth checking with your insurer to see if they offer higher coverage limits in the event a catastrophe forces you from your home for an extended period. Additional living expenses can add up, so it may be worth the added peace of mind to increase this coverage component.
USAA maintains a strong financial standing and ranked the highest of our top picks with Consumer Reports and J.D. Power. This means you won’t have to worry about settling up financially with the company, and you’ll likely have a decent time maneuvering through its claims process. If you or anyone in your immediate family is an active or retired service member, you should definitely give USAA a call and get a quote.
Affordable premium: If the likelihood of an insured event is so high, or the cost of the event so large, that the resulting premium is large relative to the amount of protection offered, then it is not likely that the insurance will be purchased, even if on offer. Furthermore, as the accounting profession formally recognizes in financial accounting standards, the premium cannot be so large that there is not a reasonable chance of a significant loss to the insurer. If there is no such chance of loss, then the transaction may have the form of insurance, but not the substance (see the U.S. Financial Accounting Standards Board pronouncement number 113: "Accounting and Reporting for Reinsurance of Short-Duration and Long-Duration Contracts").
It might be the most difficult thing you’ll ever do, but it’s important to advocate for yourself during an emergency room visit. If possible, ask all the questions you can think of and make sure to get answers before agreeing to have any procedures done. And just because you’re at an in-network facility doesn’t mean you’ll always be treated by an in-network doctor, so make sure to talk to whoever is providing the care if you can. Obviously this isn’t possible if you’re incapacitated, but if you can, you should make clear what your health insurance does and does not cover. This can help you avoid an unexpectedly large bill later. If you do end up with a huge emergency room bill even though you have insurance, contact your provider and ask if there are any programs available for bill reduction.
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