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Shopping For Insurance

H.E.L.P. is working with two other non-profit service groups to provide consumers with even-handed information about shopping for health, Medicare supplemental and long-term care insurance. That effort has produced the following information items:
Tips on Shopping for Insurance
Information and Complaints
Checking the Ratings

The effort has also produced what we believe to be a first-of-its-kind Pledge of Conduct for insurance professionals. We'd like your feedback on any of these efforts - e-mail us at: question@help4srs.org

 

Tips on Shopping for Insurance

DO

Know that you are the customer. You can select the time, place and length of your meeting with an insurance professional.
Check the financial ratings of the insurance companies you are considering (see "Checking the Ratings" below).
Shop carefully; obtain comparables and take your time.
Obtain and review a summary plan description / outline of coverage.
Check references and experience of the professional. How many claims has the professional has handled? Note: some professionals represent multiple insurance companies, others represent only one.
Contact the California Department of Insurance to check the current status of the professional's license and complaint history.
Fully divulge your medical history and medications to the professional, and complete the application carefully.

DON'T

Don't buy strictly on lowest premium cost. Terms of coverage and credit-worthiness of the insurance company are very important.
Don't replace an existing policy with another unless: you can't afford the existing policy, or the existing policy no longer meets your needs, or the new policy improves your coverage in a meaningful way.
Don't buy a policy until you are comfortable that your questions have been answered.

ALMOST READY TO BUY, BUT...

Before committing, review the summary plan description / outline of coverage thoroughly.
Be clear about possible future premium increases.
Get a second opinion from HICAP (see below) or other knowledgeable resource.
Find out about any "free look" (cancel your purchase) period.
Don't pay with cash -- make your check or money order for the first month's premium only -- payable to the insurance company.

NOW THAT YOU'VE BOUGHT A POLICY

Double check the policy you receive (check the exclusions and limitations, make sure the policy agrees with the information you received earlier).
Raise questions promptly -- resolve within any "free look" period.

Information and Complaints

The California Department of Insurance produces brochures on many types of insurance, and provides information to consumers. The Department also handles inquiries and complaints about insurance agents and companies. Telephone hotline hours are 8 to 5, Monday through Friday.

Telephone hotline: 800-927-4357
General telephone: 213-897-8921
Fax: 213-897-5961
Internet web site: http://www.insurance.ca.gov/

In Los Angeles County, Health Insurance Counseling and Advocacy Program (HICAP) of the Center for Health Care Rights provides answers to questions on Medicare, HMO's, supplemental (Medi-gap) insurance and long-term care insurance.

Telephone: 800-824-0780

The National Insurance Consumer Helpline represents insurance companies, and provides information on policies and technical language.

Telephone: 800-942-4242

Complaints may also be made directly to the management of an insurance professional's employer, and to any insurance company involved in the situation.

 

Checking the Ratings

Several rating agencies grade the ability of insurance companies to meet their financial obligations. Agencies vary in the rating scales and methods they use to rate insurers, and agencies may not rate the same insurers. Although the same letter ratings may be used by several agencies, they do not necessarily have the same meanings. Most agencies classify the letter ratings of insurers (from A+ to F) under the broader designations of "secure" or "vulnerable." Agencies may rate insurers according to both their claims-paying ability and financial solvency.

Rating Agencies
Name Phone Charges
A.M. Best Company (900) 420-0400 Based on phone time
Demotech, Inc. (614) 761-8602 Selected companies
Fitch Ratings Desk 1(800) 893-4824 Five free ratings
Moody's Investor Service (212) 553-1653 Five free ratings
Standard & Poor's Corp. (212) 208-1527 Five free ratings
Weiss Research, Inc. (800) 289-9222 $15 per rating
* A copy of the 1994 report Comparison of Private Agency Ratings for Life / Health Insurers can be obtained by writing the U.S. General Accounting Office, P.O. Box 6015, Gaithersburg, MD 20884-6015. Request Report #GAOGGD-94-204BR.

 

Pledge of Conduct (Insurance Professionals)

Loyalty

My first duty is to the Client. I will always provide service based on the Client’s best interest, even if this conflicts with my interests or the interest of others.

Confidentiality

I will disclose Client information to others only with the Client’s prior permission or if I am required by law to make that disclosure.

Honesty

I will deal with all in an honest manner, and will avoid exaggeration, misrepresentation or concealment of pertinent facts relating to the transaction. I will present a true picture in my advertising and representations to the public.

"Ask First!"

I will provide to each new Client a fully and accurately completed copy of the "Ask First!" form, at the beginning of the relationship with that Client.

Referrals to Others

I will refer my Clients only to services and organizations I believe to be appropriate. I will not accept (directly or indirectly) referral fees or similar compensation in any transaction, even if permitted by law, without prior disclosure to the Client.

Comparables

Before selling any product to a Client, I will provide to the Client a written description of what I consider to be the best products or approaches for the Client’s needs, together with the advantages and disadvantages of each.

Compensation

If requested by the Client, I will include in the written description of products and approaches the amount of compensation I would receive under each product or approach.

Qualifications and Competency

I will maintain full certification, qualification and licensing in my profession to provide each of the services I undertake to provide. The services I provide will conform to the standards of practice and competence which are reasonably expected in the disciplines in which I engage.

Non-Discrimination

I will not deny equal professional services to any person for reasons of race, color, religion, sex, handicap, familial status, or national origin.



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