In most states, legislation requires rating manuals and rating plans that must be filed for approval by the regulatory authority before they are put into application. Insurers are permitted to cooperate in the gathering and sharing of data for rating purposes in the preparation of these manuals and plans. These rating organizations are licensed and supervised by the individual states. (more…)

The Unfair Claim Settlement Practices Act provides that no insurer may engage in unfair claim settlement practices. Examples of unfair claim settlement practices are:

• The intentional misrepresentation to a claimant any pertinent facts or policy provisions which relate to the coverage at issue (more…)

The insurance functions of Blue Cross and Blue Shield plans were pretty simple in their early years. The plans engaged in community rating. This simply meant that all of the subscribers of a plan were in one large risk pool. Insurance premiums were determined essentially by projecting the growth of insurance claims and dividing by the number of subscribers. Commercial insurers began to challenge this in the 1950s through experience rating, and by the 1960s, experience rating had driven out community rating. (more…)

Automobile, as one of the most widely owned major assets by United States people, is also the prime source of personal liability. Every year more than 18,3 million accidents occurred on US roads and highway. These involving in excess of 30 million vehicles, injuring almost 3 millions and killing more than 50 thousands. This statistics is also including auto liability claims settlement both claimants and defendant drivers. Due to this big number of accident, auto liability claims settlement decisions are far reaching. There are various factors which influenced auto liability claim settlement such as the extent of the claimants’ body injury, claimant’s degree of fault in causing the accident, the rules of state negligence, and attorney involvement. (more…)