Am I Covered?

Paul Morrone |


By Tom Morrone, CFP ®, CPA, Principal

Over the years I have been involved in countless conversations with clients, family and friends about insurance claims. These discussions have covered the spectrum including health, long term care, disability, homeowners and auto. The only claim that has absolute certainty is a death claim. After all, you either have life insurance or not and you are alive or not. That one is simple. All other claims can have some level of complexity that can be absolutely frustrating.

Back in the mid 80's I worked for Blue Cross Blue Shield and had some responsibilities to test for fraudulent claims. There were some interesting cases that were examined but those were for people attempting to abuse the system. Of course many totally legitimate claims were reviewed that placed a level of assurance that the claims process was functioning correctly. Nonetheless, it was still a pretty straight forward process. Fast forward to today and introduce the Affordable Care Act and it is an entirely different story. The changes are astonishing regarding the complexity of obtaining health insurance for companies, the self-employed and just the average family. The claims process is just as complicated with so many exclusions, exceptions, deductibles, co pays and co-insurance. I personally do not see an end in sight to simplify the health insurance process. There will always be problems of some type that will affect certain demographics of the population.

Long term care (LTC) is another story all together. Data that was not available just a few years ago has forced some insurance companies to no longer offer LTC. In other instances, the carriers have raised the LTC premiums to such a level that it is unaffordable. Fewer insurance companies are offering more expensive policies. This is not good for consumers. No end in sight here either.

The same complexities carry to the other insurance lines including home and auto. There is also flood and wind insurance, if applicable, that can add another layer of confusion and of course costs. Many insurance policies are complex and you should have discussions with an insurance professional to clarify policy costs, exclusions, etc. when shopping for these or any types of insurance.

Due diligence for insurance is vital. You do not want to be wondering when a situation for a claim arises and you say to yourself, "Am I Covered?"

Until The Next Tom's Take…