Don't forget flood coverage

We can't stress this enough: many people assume that their homeowners policy includes flood coverage.

It doesn't. Standard homeowners-, renters- and business policies do not cover flood damage. If your property is in a flood prone area, you should strongly consider buying flood coverage.

How do you know if you're in a risky flood area? Type your address into the red box on the home page for the federally run National Flood Insurance Program. That's where most people buy their flood coverage. Many local insurance agents sell these policies.

And if you think a few inches of water wouldn't cause much damage, you might be surprised. The NFIP put together an interesting interactive simulator that details -- item by item -- the costs of different levels of flooding in a typical home. See the link above.



Data.table rocks! Data manipulation the fast way in R

I really should make it a habit of using data.table. The speed and simplicity of this R package are astonishing.

Here is a simple example: I have a data frame showing incremental claims development by line of business and origin year. Now I would like add a column with the cumulative claims position for each line of business and each origin year along the development years.

It's one line with data.table! Here it is:
myData[order(dev), cvalue:=cumsum(value), by=list(origin, lob)]
It is even easy to read! Notice also that I don't have to copy the data. The operator ':=' works by reference and is one of the reasons why data.table is so fast.


And it is getting even better. Suppose you want to get the latest claims development position for each line of business and origin year. Again, it is only one line: Read more »

It's Novermber and Everybody's Busy (Too Busy to Talk)

The days before Thanksgiving are a time of unrelenting activity. Some people are finalizing the big meal for Thursday. Others are preparing for the December holidays. In fact, I’ve been told that there are even elves working overtime somewhere near the North Pole. Thanks to climate change they are wearing Hawaiian shirts, but they are still working hard.

Speaking of working hard, the folks at the Department of Health and Human Services (HHS) have been very busy this week. On Tuesday, November 20, 2012, our busy elves at HHS released a new set of rules and regulations designed to flesh out the Patient Protection and Affordable Care Act (PPACA).

Tuesday’s new rules and regs cover a host of areas from defining the benefits to creating the framework for future premiums and options. You can find the public relations version of all of this at healthcare.gov. Don’t worry about going to the government’s website. This will all be coming to you – on TV, on billboards, and door-to-door solicitation, if necessary – thanks to a special campaign.
The new rules reaffirm the definition of the Essential Health Benefits (EHB). The PPACA demands that all policies offered for individuals and small groups provide coverage for a “core package of items and services known as Essential Health Benefits. EHB must include items and services within at least the following 10 categories”:
    1. Ambulatory patient services
    2. Emergency services
    3. Hospitalization
    4. Maternity and newborn care
    5. Mental health and substance use disorder services, including behavioral health treatment
    6. Prescription Drugs
    7. Rehabilitative and habilitative services and devices
    8. Laboratory services
    9. Preventive and wellness services and chronic disease management
    10. Pediatric services, including oral and vision care
    Most of this looks pretty reasonable. Though you may wonder how much that maternity benefit will add to the cost of a woman’s policy. And if that woman can’t have children, how much is she wasting?

    Employer sponsored group health policies have included maternity “covered as any other illness” for years. We know how to evaluate the risk and how much each policyholder needs to pay. That is, after all, the concept of insurance – evaluate risk and share the cost. What happens when the risk is open-ended? How do we share an unknown cost?
    #7, above, is coverage for rehabilitative and habilitative services and devices. We are all familiar with rehabilitative care such as physical therapy which is designed to restore the patient to his/her former state of health and previous level of skills. The current fight over rehabilitative care is about the number of treatments. Today’s policies cover 15, 20, or maybe 25 visits to the physical therapist. We don’t know if future policies will be allowed to have such limitations. But rehabilitative coverage is much easier to assess than habilitative.

    Habilitative therapies create skills. Teaching an autistic child to interact with his/her peer group is a wonderful thing. In fact, improving social skills and communication is life-changing for the children and adults touched by autism and certain forms of mental illnesses. Those suffering from other illnesses or conditions, such as cerebral palsy, have had their lives improved through habilitative care. Much of this has been open-ended, where patients weren’t actually cured, just made better. So as long as someone was willing to pay for services, another appointment was warranted.

    Both the government, through Medicare and Medicaid, and the insurance industry have fought habilitative care for decades. The insurance industry lives by black and white. Habilitative therapies exist in a grey area. The industry has avoided paying for much of these services by labeling them experimental or educational. That may end soon.

    Do you care? Is this good? As always, the answer is Yes and No.

    Please don’t get distracted by the pictures of your neighbor’s autistic child. This has very little to do with her. It is important to remember that the healthcare debate has very little to do with health. With the possible exception of someone personally touched by a particular condition, this is, and always has been, a discussion of how we compensate doctors and hospitals. Who gets paid from the deep pockets and who doesn’t.

    The insurance industry is still trying to retain the right to offer a stripped down contract that will exclude some of the open-ended coverages. It is far easier to price a policy that has fewer gray areas. A policy that doesn’t cover habilitative services; a policy that doesn’t pay for infertility treatments; a policy that included some limitations for rehab, would be significantly less than the federally mandated coverage. My guess is that we won’t have that option for long, if ever.

    Seeing how much these other benefits add to the cost of coverage would force us to finally have a national discussion about our priorities. What are we willing to pay for? It still appears that no one in Washington, Democrat or Republican, wants to have that discussion.

    And who can blame them? It’s November and everybody’s busy. Way too busy to talk.

    Job opening: Senior market analyst

    We're looking for a senior market analyst in our Tumwater office. Here's the job description, including salary, responsibilities, and timeline. The deadline for applying  is just before 5 p.m. on Monday, Dec. 3.*

    Also, we still have an opening for an Information Technology Specialist 4 (.NET developer).

    *Update: The deadline has now been extended to Dec. 17, 2012.

    One computer, one camera, fake invoices...and four different insurance claims

    A Renton man has been sentenced to jail plus community service after submitting thousands of dollars in bogus claims for a $4,900 laptop, and a $3,200 camera.

    Between December 2010 and September 2011, Michael Tran Lai, 32, filed multiple claims with four different insurance companies claiming the loss of the MacBook Pro laptop and Nikon camera. He claimed they were stolen from a car, or lost in luggage while travelling, or stolen from his hotel room. The invoices turned out to be fake.

    He also filed multiple claims for the same accident damage to his Lexus.

    Laid was sentenced Nov. 16 to 10 days in jail, 160 hours of community service, and $854 in court fees and costs. A restitution hearing is also pending.

    Tips to avoid a turkey-fryer fire...because here's what that looks like

    The turkey-fryer disaster video is a YouTube holiday staple, and it's not surprising. Oil burns really well. Turkeys are big.
    The biggest mistake seems to be this: overfilling the pot and plunging a big turkey in while the flame is lit, causing a lot of oil to splash over the sides and, yup, ignite.
    Bigtime.

      
    And sometimes, this happens on a deck or close to a house.

    So if you must fry your turkey, here are some key tips:
    • Fry outside, away from the house.
    • Do not overfill the pot with oil.
    • Properly thaw the turkey.
    • Turn off the flame before adding the turkey.
    • Use the grappling-hook thing to lower the turkey in carefully (and not splash oil).
    • Be careful of oil splattering on your arms. Splashed boiling oil can cause horrible burns.
    • And -- if in doubt, review video No. 2 above -- keep a grease-approved fire extinguisher handy.
    Bonus round: Actual turkey-fryer-mishap-victim William Shatner reviews these points in his cautionary video "Eat, Fry, Love."

    Claims reserving in R: ChainLadder 0.1.5-4 released

    Last week we released version 0.1.5-4 of the ChainLadder package on CRAN. The R package provides methods which are typically used in insurance claims reserving. If you are new to R or insurance check out my recent talk on Using R in Insurance.

    The chain-ladder method which is a popular method in the insurance industry to forecast future claims payments gave the package its name. However, the ChainLadder package has many other reserving methods and models implemented as well, such as the bootstrap model demonstrated below. It is a great starting point to learn more about stochastic reserving.

    Since we published version 0.1.5-2 in March 2012 additional functionality has been added to the package, see the change log, but in particular the vignette has come a long way.

    Many thanks to my co-authors Dan Murphy and Wayne Zhang.
    Read more »

    Flood warning update

    Flood warnings remain in effect in the following counties: Grays Harbor, Lewis, Mason and Thurston, with some gale warnings and small craft advisories offshore.

    Here's the complete list from the National Weather Service office in Seattle.

    Flood, high wind and storm warnings in WA

    The National Weather Service has issued a long list of flood-, wind- and storm warnings, watches and advisories today. Here's a roundup:

    A flood warning has been issued for the Chehalis River at Centralia (in Lewis County) and the Chehalis River near Grand Mound (in Thurston County). Moderate flooding is expected, and the weather service is warning motorists not to try driving through flooded areas -- the most common cause of flood-related deaths in Washington.

    In Lewis County, the flood warning will be in effect from Tuesday morning to Wednesday evening, with the river expected to hit flood stage around 9 a.m. Tuesday and crest 4 feet over flood stage around 4 p.m. Tuesday.

    What's that mean? At four feet over flood stage, the weather service says, "The Chehalis River in Lewis County will flood some residential and commercial areas with water encroaching upon the first floor of some homes and businesses. Swift flood waters will cover some roads.

    At Grand Mound, the river's expected to hit flood stage around 7 a.m. Tuesday and crest about 2 1/2 feet over flood stage around 4 a.m. Wednesday. Flooding of several roads in Independence Valley is expected, including SR 12 and James-, Independence-, Moon- and Anderson roads. Flood waters are expected to cut off access to and from Chehalis Reservation and inundate nearby farmland.

    Minor to moderate flooding is also predicted the the Chehalis River near Doty (Lewis County), the Newaukum near Chehalis (Lewis), the Satsop River near Satsop (Grays Harbor County) and the Skokomish River near Potlatch (Mason). There's a flood advisory -- meaning minor flooding is possible -- for a dozen western Washington counties, as well as western Kittitas, Klickitat and Yakima counties.

    A high wind warning is in effect for Seattle and the central coast areas, with the strongest winds occurring as we post this, with the warning lasting until 3 p.m. South winds of 25-35 miles an hour have been reported, with gusts near 60 miles an hour.

    A winter storm warning has been issued for the Cascade mountains above 4,500 feet, with periods of heavy snow expected to persist through evening. An additional 1-2 feet of snow is likely, especially over the North Cascades, the weather service says.

    Similarly, a winter weather advisory is in effect for the Olympic mountains above 5,000 feet, with 6-11 inches of snow expected, but tapering off late today.

    Fraud charges for man who hit car, then bought insurance

    A Blaine man who rear-ended another driver, rushed to buy insurance, then claimed that the crash happened afterward has been charged with insurance fraud.

    Mark Traxler, 51, let his auto insurance lapse in January because he didn't pay the premium.

    Two weeks after his coverage ended, he hit a car in Bellingham, causing more than $5,000 in damage.

    He immediately went to his insurance agent and paid for new coverage. By nightfall, the other driver had made a claim against his policy.

    The problem: Traxler said that the accident happened after he'd bought the coverage, when a 9-1-1 call placed by the other driver indicated that it happened before.

    Traxler has been charged in Whatcom County Superior Court with insurance fraud.

    The search for Big Daddy: barbecue case leads to insurance fraud charges

    In the summer of 2011, a Renton man named Cassk Thomas, Jr. filed a claim with his insurer, saying that someone had stolen his his 26-foot, 8,500-pound, two-tank, three-grill barbecue smoker, dubbed "Big Daddy."

    The barbecue had been stored behind a locked fence, he told police. Two screws on a hinge had been removed. The smoker, as well as the double-tandem-axle trailer it was mounted on, was gone. Thomas provided his insurance adjuster with an invoice from a Spokane company, totalling $32,343, for the trailer and smoker.

    Thomas' insurer, American Family Insurance, paid Thomas $30,474 for the lost barbecue, as well as $24,668 for lost income while he sought a replacement barbecue.

    Upon investigation, it turned out that the trailer was actually purchased from a company in Texas for less than a third of what Thomas claimed. A former business partner said it cost $9,470, and she provided paperwork showing that.

    The company Thomas had named as the manufacturer in Spokane apparently does not exist. It's not listed with the state departments of licensing or revenue, not on the Internet, the business address is a residence and, in repeated attempts, no one answered the phone there. A company official named by Thomas turned out to be an old roomate of his.

    Thomas has been charged in King County Superior Court with 1st degree theft and insurance fraud, both of which are felonies.

    Sorry, You're Screwed

    The letter came from The State of Ohio, The Ohio Department of Insurance, and Medical Mutual. Good news never comes with that many names on the top of the letter.


    We are sorry to inform you that your Ohio High Risk Pool coverage will be canceled at the end of the day on November 30, 2012.

    The letter was dated November 12, 2012.

    Some of the unhealthiest residents of the State of Ohio were being tossed off their insurance policy, the Ohio High Risk Pool. In less than three weeks they would no longer be insured. And nobody is standing in line to cover them. How could this happen?

    The Ohio High Risk Pool is part of the Patient Protection and Affordable Care Act (PPACA). A stop gap measure, the states were charged with the duty of offering coverage for the chronically uninsured suffering from significant preexisting conditions. The federal government also provided five billion dollars of which Ohio received $152,000,000 for the four year program.

    To qualify for the Ohio High Risk Pool you must prove:
    1. Citizenship
    2. That you have not been credible insurance coverage for at least six months
    3. That you have been declined by two insurers within the last six months
    4. You may skip #3 if your medical records show that you have a major illness that would have gotten you declined
    You can not have had credible insurance coverage in the six months leading up to your application for coverage under the Ohio High Risk Pool. This is a federal requirement. Neither the State of Ohio nor Medical Mutual of Ohio, the insurer running our plan, has anything to do with this rule. Some people who are not easily insured have purchased supplements, a better than nothing option. If something happened while they were attempting to find real insurance or qualify for an affordable program, these responsible people were trying to do what they could.

    My friend Dave is a conscientious insurance agent. He took a letter from American Medical and Life Insurance Company (AMLI) to the Ohio High Risk Pool. The letter, dated February 11, 2011 was sent to clients to advise them that their policy was no longer HIPAA credible coverage. Dave verified that since the AMLI CoreValue policy was no longer credible coverage, his clients, including family members, could retain this minimum semblance of coverage until they had six months of no real insurance and could enter the Ohio High Risk Pool. NO PROBLEM.

    It is those people, those responsible people who attempted to have some coverage, no matter what, who are being kicked to the curb. The letter from the State specifically notes:

    Our records indicate you were enrolled in an AMLI policy in the six months prior to enrolling in the Ohio High Risk Pool Program. Therefore, CMS directed us to cancel your coverage because you are not eligible for this program.

    The PPACA is a poorly written law. We know that. Worse, the rules and regulations are being written on the fly. What complies one day is non-compliant the next. We went through this with the grandfathering rules. The costs, both human and financial, can’t possibly be calculated.

    The Ohioans being kicked out of the High Risk Pool did nothing wrong. They followed the rules of that moment. We are talking about individuals who are gravely ill. What do they do now? 

    DAVE
    www.bcandb.com

    Simulating neurons or how to solve delay differential equations in R

    I discussed earlier how the action potential of a neuron can be modelled via the Hodgkin-Huxely equations. Here I will present a simple model that describes how action potentials can be generated and propagated across neurons. The tricky bit here is that I use delay differential equations (DDE) to take into account the propagation time of the signal across the network.

    My model is based on the paper: Epileptiform activity in a neocortical network: a mathematical model by F. Giannakopoulos, U. Bihler, C. Hauptmann and H. J. Luhmann. The article presents a flexible and efficient modelling framework for:
    • large populations with arbitrary geometry
    • different synaptic connections with individual dynamic characteristics
    • cell specific axonal dynamics
    Read more »

    A hard lesson for victims with flooded houses: standard homeowners policies don't cover flooding


    The New York Times has a nuts-and-bolts story about insurance concerns in the wake of Hurricane Sandy, and all of the lessons apply here in Washington.

    The biggest one -- and something that we repeat often -- is that a standard homeowners policy does not cover flooding. For that coverage, people typically buy a policy from the federally-run National Flood Insurance Program.

    The problem is that unless required to by their lender, many homeowners simply don't get flood coverage. (And even those whose mortgage requires it often later let it lapse.)

    The article covers things like who pays for tree removal, will you be reimbursed for living costs if your home is uninhabitable, and will an insurer cover the cost of ruined food when the power fails.

    25 free apps


    The U.S. Department of Health and Human Services has compiled a list of free health-related applications, created by the feds, regarding health. They include apps for the iPhone, iPad, Android and iPod Touch.

    The apps include:

    Find a Health Center: Created by the Health Resources and Services Administration, this map-linked app helps you find the nearest federally funded health center, which will care for you even if you have no health insurance. Based on your income, you pay what you can afford.

    The popular BMI calculator, which helps determine your body mass index.

    Brrd Brawl: A mobile game developed to give jittery quitting smokers something to do with their hands.

    52 Weeks of Women's Health: Info on 52 health topics, ranging from eye health to contraception. Also helps track medications, allergies, etc.

    Other apps include help triaging injuries in the field, treating radiation injuries, quitting smoking, tracking the flu in your area, tracking a pregnancy and reuniting after a disaster.

    Job opening: .NET developer

    We're recruiting to fill a position for an information technology specialist 4 (.NET developer) in our operations division in Tumwater, Wash.

    The successful applicant's duties will include software development of mission-critical agency systems, systems analysis, as well as software unit and quality assurance testing.

    For more specifics, duties, salary, timeline, etc., please see the full job listing.

    Three companies fined $605,000

    Insurance Commissioner Mike Kreidler is fining three companies a total of $605,000 for violating Washington insurance laws.

    “Our insurance laws protect consumers and maintain a level playing field in the insurance market,” said Kreidler. “Break the law and you’ll face the consequences.”

    The fines were as follows:

    PacifiCare of Washington (now known as UnitedHealthcare of Washington, Inc.) has agreed to pay a $400,000 fine for what state financial examiners concluded were improper royalties paid to an affiliated company. The company contended that the payments were administrative fees, but acknowledged that it had failed to annually reconcile the payments with actual costs to show that the company wasn’t overpaying.

    In addition to the fine, the company has recovered the $72.9 million it paid between 1999 and late 2006.

    STA Travel Inc., based in Texas, agreed to pay $115,000 for allowing unlicensed staffers to sell insurance policies in Washington. The company is a travel agency specializing in international college student travel. It sells travel insurance as part of its travel services.

    Although the company’s office manager was a licensed insurance agent, under Washington law, all staff selling travel policies needed to be licensed. Policies were sold by unlicensed staffers from 2005 to 2011.

    Lenovo (United States) Inc., incorporated in Delaware, has agreed to pay $90,000 for improperly selling 1,327 service contracts in Washington. The company failed to register as a service contract provider, as required by state law. The service contracts were sold from mid-2008 through mid-2012.

    Fines collected by the insurance commissioner's office do not go to the agency. The money is deposited in the state's general fund to pay for other state services.

    Time for an old classic game: Moon-buggy

    I discovered an old classic game of mine again: Moon-buggy by Jochen Voss, based on the even older Moon Patrol, which celebrates its 30th birthday his year.

    Read more »

    googleVis 0.3.3 is released and on its way to CRAN

    I am very grateful to all who provided feedback over the last two weeks and tested the previous versions 0.3.1 and 0.3.2, which were not released on CRAN.

    So, what changed since version 0.3.2?


    Not much, but plot.gvis didn't open a browser window when options(gvis.plot.tag) were not set to NULL, but the user explicitly called plot.gvis with tag NULL. Thanks to Sebastian Kranz for reporting this bug. Additionally the vignette has been updated and includes an extended section on knitr.

    As usual, you can download the most recent version from our project site. It will take a few days before version 0.3.3 will be available on CRAN for all operating systems.
    Read more »

    License revocation for insurance agent who allegedly faked own death

    Washington Insurance Commissioner Mike Kreidler has issued an order to revoke the license of an Enumclaw insurance agent who allegedly faked his own death as part of a $2 million scam.

    Aaron Travis Beaird, manager of Team Financial Services LLC, "knowingly devised a scheme and artifice to defraud consumers and to obtain money and property by means of false and fraudulent pretenses," according to the order.

    Beaird would recomment to his clients that they liquidate one investment and transfer the money into another investment or insurance policy, making the checks out to his business.

    The problem: Beaird didn't actually invest the money or buy a policy. Instead, according to the license revocation order, he'd take the money for "his own use and benefit." To cover things up, he would provide his clients with fake account statements.

    Beaird was arrested in early July on federal charges of wire fraud and mail fraud. Investigators said he left a fake suicide note in his car, which was found parked near a bridge on June 23rd.

    He pleaded guilty in federal district court Aug. 28th. He admitted to defrauding at least 11 people out of more than $1 million. He is currently incarcerated, awaiting sentencing,  at the SeaTac Federal Detention Center.

    Beaird has the right to demand a hearing to contest the order.

    Update: (Nov. 20) The revocation has taken effect.