Understanding the Florida No-Fault Law

Understanding the Florida No-Fault Law

What is No-Fault Law?

The Florida No-Fault Motor Vehicle Law requires drivers to carry Personal Injury Protection coverage as part of their auto insurance; this No-Fault coverage pays the insured’s bills, regardless of fault, up to the limit of the insurance (minimum limit is $10,000). For example, after an accident, one’s No-Fault coverage would pay $10,000 towards personal recovery. Personal Injury Protection pays 80% of medical bills, 60% of lost wages, and 100% of replacement services costs (any service needed because of a loss of ability caused by the accident); also, PIP contains a $5,000 death benefit, should the driver die due to injuries sustained in the accident (Note that PIP claims must be made within 14 days of the accident). This law was passed with the intention of lowering the number of tort (civil wrongs, usually caused by negligence) lawsuits in relation to car accidents. So, instead of immediately suing each other, the two parties in the accident now have their own Personal Injury Protection, regardless of fault, with which to pay personal bills incurred by the accident. It is important to note that PIP is not liability insurance and it benefits the insured only. This coverage follows the individual around the state of Florida, whether driving an owned, borrowed, or rented vehicle.

What is Covered in my Auto Insurance Policy?

A personal auto policy contains sections on liability coverage, medical payments coverage, uninsured motorist coverage, and other sections with general information regarding the policy (duties after an accident, general provisions, damage to your auto, endorsements, etc.). Typical liability limits are split into three categories: bodily injury per person, bodily injury per accident, and property damage per accident. The minimum limit in Florida is 10/20/10—this means that the insured would receive $10,000 of bodily injury coverage per person, with no more than $20,000 paid per accident, and $10,000 of property damage coverage per accident. Medical Payment limits apply per person per accident and act as primary coverage when the insured is driving an owned auto and secondary when the insured is driving a non-owned auto; typical limits are $500, $1,000, $2,000, and $5,000. Uninsured motorist coverage protects the insured if he is not at fault in an accident with an uninsured or under-insured driver; UM limits cannot be greater than standard liability limits.

Where does No-Fault Coverage fit into my Auto Insurance Policy?

Personal Injury Protection (No-Fault Coverage) is a required endorsement (added coverage) to auto policies in the state of Florida and takes priority in paying the insured after an accident, regardless of fault. If a driver holds basic PIP, $5,000 of Medical Payments coverage, PIP would cover 80% of medical bills up to $10,000, and then his Medical Payment coverage would pay the remaining costs, up to $5,000. Suppose that this driver incurred $25,000 in medical losses—the first $15,000 would be paid by his policy and the at-fault driver would be liable for the remaining $10,000 of medical bills. If the at-fault driver was carrying the required liability limits of 10/20/10, the at-fault driver’s policy would pay the insured the remaining $10,000. If the at-fault driver was not carrying the required limits, the insured driver is in need of Uninsured Motorist coverage for the remaining $10,000. Without UM, he could have to pay the remaining $10,000 of medical bills out of pocket—this is the benefit of Uninsured Motorist coverage. Uninsured Motorist coverage exists to pay the insured should his policy limits be exhausted and the at-fault driver be uninsured or under-insured; it serves as a precautionary measure to ensure that the driver is insured and covered should the other party not be.
Overall, No-Fault coverage protects and pays for the insured’s expenses in any accident; after No-Fault coverage is exhausted, the insured can turn to Medical Payments coverage; after Medical Payments coverage is exhausted and if not at fault, the insured can look to the other party’s liability insurance; and finally, should the opposing party’s limits be exhausted or nonexistent, Uninsured Motorist coverage can, within its limits, cover the rest.

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120 Day Rule: The Workers’ Compensation Obstacle Course

120 Day Rule: The Workers’ Compensation Obstacle CourseIt seems every time you turn around there is another opinion issued by a Judge of Compensation Claims (JCC) or First District Court of Appeals and unfortunately, it is almost never in favor of the employer/carrier.  Each new opinion brings with it the likeliness of another hurdle or obstacle a workers’ compensation adjuster must deal with.

In May of this year the First District of Appeals rendered an opinion regarding major contributing cause (MCC) and 120 day rule.

The 120-day rule allows a carrier to delay the decision to deny an obligation to pay benefits for 120 days as long as the carrier pays for the requested benefits during the investigation period.

In this particular case the treating physician had attributed the claimant’s medical issues to be 60% pre-existing and 40% work-related.  Consequently, the carrier denied the claim entirely due to the major contributing cause for the need for treatment is over 50% pre-existing and there was never a compensable injury.  Even though the carrier had denied the claim, the claimant requested his one- time free change in physician.  The claimant’s attorney requested the (JCC) to determine if the claimant was entitled to the one time change in physicians even if the claim had been denied or basically asking the JCC to determine if a claimant can receive a one-time change in physician if there is no compensable injury. The JCC ruled in favor of the employer carrier stating the claimant is not entitled to benefits if there is no compensable injury.

However, the First DCA reversed the JCC ruling by stating the carrier did not notify the claimant in writing of the intent to investigate under the 120 day rule.

In the event one of your employees has a claim denied or the adjuster is investigating for possible denial, it is imperative to be sure the adjuster send the employee the 120-day letter to reserve those rights.

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Breast Cancer Awareness and Your Employees

Breast Cancer Awareness and W3 Employees.

Breast Cancer Awareness and W3 Employees.

National Breast Cancer Awareness Month is all about spreading one simple, powerful message: detection and prevention can save lives. Talk to your employees and post articles such as this and help to bring awareness.

Early breast cancer detection and prompt treatment is vital to a successful outcome.

The size of breast cancer and how far it has spread are two of the most important factors in determining the prognosis, or the chances for survival. Early screening is critical to catching the cancer when it’s more likely to be smaller and contained in the breast.

Early Screening Recommendations

The American Cancer Society recommends that women have:

  • Clinical breast exams every 3 years in their 20s and 30s, and every year after 40
  • Annual mammograms starting at age 40
  • Awareness of how their breasts normally look and feel, so they can report any changes to their doctor for further examination

Lower your risk of breast cancer with these five behaviors.

Reach and maintain a healthy weight. Being overweight or obese can increase your breast cancer risk. Extra weight can increase you insulin levels which are linked to some cancers.

Exercise regularly. A study from Women’s Health Initiative showed an 18% reduction in risk with only 1.5 hours per week of brisk walking. The American Cancer Society recommends a weekly minimum of 150 minutes of moderate-intensity activity or 75 minutes of high-intensity, or a mixture of both. Make sure to spread the workouts throughout the week for the most benefit.

Don’t sit too long. “Sitting is the new smoking.”  Studies have shown sitting for more than 60 minutes at a time without stretching or standing can cause irreversible health concerns. One of these concerns is the likelihood of developing cancer, especially in women. The risks increase if you sit more than 6 hours a day.

Limit alcohol. Studies have shown 2-5 alcoholic drinks a day have shown higher risks of developing cancer than those women who have one drink a day. Some research even shows as little as 3-6 glasses of wine a week can slightly increase your chance of developing breast cancer.

Avoid or limit hormone replacement therapy. Many postmenopausal women consider this therapy to ease their symptoms such as night sweats, hot flashes, etc. Research has revealed that women that take a blend of estrogen and progestin may be more likely to increase their chance of breast cancer. Discuss this with your physician and the options to control your menopausal symptoms and if you decide to use HRT to use a minimal dosage and for the shortest amount of time necessary.

 

Voyages to Cuba Bring Uncertainty

Map of Cuba

Florida boaters should be cautious before making plans to navigate to Cuba.

On September 18, 2015, The U.S. Department of the Treasury released new rules surrounding U.S. travel to Cuba. The administration lifted the prohibition on boating to Cuba and Cuban waters. While the intrigue is enormous, Florida boaters should be cautious before making plans for such a Caribbean voyage. Although the U.S. government has liberalized the rules, there are many unique conditions that should be considered; political risk, crime, navigational limits available on current insurance policies, just to name a few.

The new regulations bring the marine insurance industry into uncharted territory. Insurance companies are not yet offering coverage extensions for destination Cuba. The reasons that the carriers may be slow to respond are as follows:

  • Conflicting laws and regulations between U.S. agencies
  • Lack of familiarity with Cuban laws which may govern in civil and criminal matters
  • Lack of knowledge and limited opportunities for subrogation
  • Additional expense of sending marine surveyors and claims adjustors
  • Unknown/adequate repair facilities
  • Access to repair parts
  • Towing charges if the vessel had to be repatriated for repair
  • Technical complications associated with endorsing in force policies
  • No underwriting data to base rates on

It is uncertain when insurance companies will offer this coverage to the recreational boater. In the meantime, boaters are reminded that property and liability coverage only applies to claims which occur within the navigational limits stated in the boater’s policy. Wallace Welch & Willingham will stay attuned to this situation and will continue to post updates.

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Are Your Employees Getting their Flu Shots?

 

Employee with Flu ShotFacts About the Flu and Flu Vaccine

Healthy adults can spread the flu virus the day before they feel sick. On average, each year more than 200,000 people are hospitalized with flu related complications. Prevention is the main defense to minimizing the risk of spreading the flu virus. Help fight the flu for yourself, your family and those around you.

Prevention Suggestions:

· Get the flu vaccine.
· Wash your hands often with soap and water.
· Cover your nose and mouth with a tissue when you sneeze.
· Stay home if you are sick to avoid spreading the flu to others. The CDC recommends staying home 24 hours after the fever is gone.
· If you get the flu, antiviral drugs can treat your illness. These drugs can make the illness milder and shorten the time you are sick, but it suggested starting this treatment within the first two days of symptoms.

Where can you get the flu shot?

Your employees can go to participating network doctors or participating retail locations. This is a covered benefit for most groups; just remind them to show their insurance card. Check your insurance website for participating pharmacies or contact your wellness coordinator for assistance with plan information.

Keeping employees healthy and happy is important to your company.

 

6 Reasons Why “Technology-Backed” Trumps “Technology-Based” Employee Benefits

What do you expect from your broker when offering employee benefits? 

Employee BenefitsAre you looking for a trusted advisor who offers the expert help and service needed for you to choose the best employee benefits for your company? Or are you looking for a way to streamline paperwork and ease the administrative burden on HR? Either way, an independent insurance agency, like Wallace Welch & Willingham, is always going to be your best bet.

An independent agency gives you the expert guidance that makes the benefits selection, implementation, and analysis a smooth process. We use technology to offer you a variety of tools and resources that make the benefits administration process virtually painless.

If you are considering moving your HR tasks to a platform like Zenefits or Gusto you must take a look at the bigger picture. These companies can give you HR software, with benefits thrown into the mix, but they are, first and foremost, technology-based and technology-focused. You will not receive the benefits support and personalized service that a local agent provides.

Check out what Wallace Welch & Willingham can offer compared to these new technology-based companies.

1.) Industry Focused

We are focused on your needs and have the expertise necessary to guide you through the plan-choosing process. We’re here to answer questions, provide guidance, and support your HR needs with our HR tools: MillsonJames and the Seay HR Hotline. We’re here to serve you, and we have the personalized service, backed by technology, to help you succeed.

Technology-based companies are focused on providing you with HR software. Once they lure you in with free basic HR technology, they encourage you to switch to them for your benefits—helping  you with benefits is a concern secondary to the software.

2.) Local Presence

Wallace Welch & Willingham is located near you, and we’re proud members of this community. We understand what’s happening in the benefits marketplace, both locally and nationally, and we understand your business. If you want to communicate on the phone or over email, we’ll respond promptly. We’ll be there to sit down face-to-face and guide you through the benefits selection and strategic planning process. When you need us, we’re here for you.

Technology-based companies are headquartered in other states, working in virtual clouds. Zenefits, for instance, is based out of California. Their representatives rarely, if ever, meet with clients and they lack a local presence and understanding. If you enroll in benefits through them, you forfeit the ability to have personalized, face-to-face meetings to help you achieve your goals.

3.) Knowledge & Experience

We help you choose the best benefits, guide you through the open enrollment process, run health claims diagnostics, and sit down with you to develop strategic plans for lowering costs due to health claims. We understand that benefits are more than just benefits—they are an important recruitment and retention tool and choosing the right ones will help you keep your employees happy. We also provide you with compliance information and employee communications, so you are never left to struggle on your own. W3 has been in the insurance industry for over 90 years. We have the knowledge behind our products to offer the best solutions to our clients.

Technology-based companies will automate what they can, but, unfortunately, expert insight and advice cannot be obtained from a computer. Their sales people have were hired (recently) with one objective; to sell their product. Their ability to compete with local insurance agencies based on product knowledge is extremely limited.

4.) Service & Year-Round Support 

We are here for you year-round, and you never have to wonder if you’ll be able to reach someone. While open enrollment is often the most challenging time of the year, we don’t abandon our clients the other 11 months of the year. When you work with us, you’ll personally know who you’re talking to.  We bring an understanding of your business and a solid history of past exchanges to each new conversation. We provide consistent, prompt communication and guidance, and we are ready to serve you.

Zenefits is massive, but its size can be a disadvantage for clients who want to know who they are speaking to. You also want to know that your broker has a contextual and institutional understanding behind each new question or concern.

5.) Pricing Transparency

We are upfront with you about costs. If we are ever going to charge you a fee for an added service, we’ll let you know in a clear and timely manner so you can make an informed decision. We promise never to say “free” if we don’t mean it.

Technology-based companies claim to be free.  That statement is true for their “core features, ” however, beyond those basics, clients run into extra costs. These costs often include a monthly fee per-employee for certain features and even a per-employee charge for delaying implementation of core features.

6.) Compliance and Content

We provide our clients with content to meet business and employees’ needs.  We give you access to W3 Client Connect, a content portal, where you can target the information you need if you want to self-serve. Need help with compliance? Want employee newsletters? Need articles explaining benefits or related topics? Thinking about starting a wellness program? Want to make benefits education fun with short videos for employees? Whatever you’re looking for, we can deliver customized content and training for you.

These new technology-based companies don’t have a content library, employee educational articles, videos or newsletters, or wellness staff and program materials.

Technology-backed or Technology-based? 

When you are faced with a choice between Wallace Welch & Willingham and a technology-based company, consider what makes us different. Are you looking for a trusted advisor who can offer assistance while being backed by technology to make the process easier? Or are you looking for a technology-based solution that kicks service and expertise to the curb?

If you’re looking for a benefits expert who is technology-backed to meet your needs, contact Wallace Welch & Willingham today.

 

How Much Life Insurance Do I Need?

shutterstock_71485084Several factors go into knowing how much life insurance is right for you and your family. The goal is to keep your family living in their current lifestyle. Some things to look at include current debt, expenses, retirement savings, and current/future income.

Since there are many things to take into consideration, let’s break them down into three sections.

Family Needs – There would be immediate financial obligations should you pass away. These include final expenses, any unpaid medical expenses, outstanding mortgage and other debts. Next, you will need to determine how much income is needed to sustain your family on a monthly basis. What are your current monthly expenses? If you or your spouse is a stay-at-home parent, you may have extra expenses to accommodate for. Did you know that, according to  Salary.com, the average estimated salary of a stay at home mother was $118,905 in 2014. This is just something to think about when reviewing expenses. Daycare, cleaning, food and other expenses would likely increase to accommodate that change.

Future Obligations – You must also think of any future financial obligations. College tuition and fees for your children is an important cost to factor into your planning. Perhaps you planned on paying for your daughter’s wedding. Maybe you would like to contribute to your spouse’s retirement and make sure that he or she is able to retire once your income has ceased.

Available Resources – Take a look at your current accounts. Do you have savings accounts, 401ks, IRAs, 529 college plans, etc? The value in these accounts all factor into the amount of life insurance that you would need.

This can all seem pretty overwhelming. Luckily, LifeHappens.org has a great online calculator that can help you determine how much life insurance to purchase. This is a great starting point on determining how much life insurance is needed.

Once you have gone through the online calculator to help determine the amount of insurance needed, your life advisor can help you find the most cost-effective life insurance program to cover your needs. Contact Abbey at 727-522-7777 x150 today for a life insurance quote.

Ready for your personalized quote?

Children’s Life Insurance: Insuring Their Insurability

Children's Life InsuranceParents all over the world have one thing in common; we love our children more than we love ourselves. The smiles that melt your heart, the injuries that make you want to kiss away the pain—we would do any and everything to protect our precious little ones. What about insuring them for the unthinkable? No parent wants to think about their child becoming ill, or worse. As responsible parents, our duty is to prepare for all possible outcomes.

When a parent purchases a child life insurance policy early in life, they are ensuring their child’s insurability. Buying life insurance on a child will remove the following obstacles, each of which will increase their rates or even render them uninsurable if they were to apply once they were older.

  • Developing an adverse medical condition
  • Tobacco use
  • Avocation & Occupation factors
  • Family History – heart disease, cancer, etc.

Children who develop medical conditions will most likely not qualify for life insurance policies later in life, or, at the very least, their premium will increase. Juvenile diabetes is an excellent example. Many who are diagnosed before the age of 10 are now uninsurable. Your children may one day thank you for allowing them to have their own life insurance policy in the event they do become uninsurable. We have a client who shared a story about how her parents purchased a life policy for her when she was a child. Five years ago she had a kidney transplant which left her ineligible for life insurance. She had her first child last year and now, because of the life policy her parents purchased for her, she has protection for her income. Her parents never thought a simple decision made thirty years ago would have helped her in such a profound way.

Simplified Issue, whole life policies start at $7 a month for children below 5 years old. Protect your child’s future by calling us today.

NCCI Proposes 2.2% Rate Decrease in Workers’ Compensation

According to the Florida Office of Insurance Regulation, the National Council on Compensation Insurance (NCCI) has proposed an average Florida workers compensation rate decrease of 2.2 percent. This decrease includes a statewide average decrease of 1.9 percent, a reduction of the fixed cost expense applicable to every workers compensation policy from $200 to $160, and a change to the minimum premiums. The average overall decrease proposed is 2.2 percent and would take effect January 1, 2016. This is the second year in a row that rates have decreased.

Some key observations noted by NCCI include the following:

  • Loss experience shows overall improvement.
  • Indemnity and medical trends have declined, partially due to a decrease in frequency.
  • Loss adjustment expenses have decreased slightly but are still higher than the nationwide average.

The proposed rate level change for each industry is listed below.

Proposed 2016 Workers Compensation Rate Decrease By Industry

The Florida Office of Insurance Regulation “will review the filing to ensure the proposed changes are not excessive, inadequate, or unfairly discriminatory and evaluate its potential effects on the insurance marketplace and employers, who are required by law to carry this insurance on their employees,” the office said in its statement. The public hearing will take place in October. If approved by the State Insurance Office, the new rates would become effective January 1, 2016.

There are many factors that go into your individual workers’ compensation rates. Contact your WWW Representative if you have questions about how these proposed rates will affect your specific business.

Wind Mitigation Credits and Your Home Insurance

Are You Taking Advantage of Wind Mitigation Credits?

Wind Mitigation Credits and Your Home InsuranceThe State of Florida requires insurance companies to offer discounts for protecting your home against damage caused by windstorms.  These discounts are known as Wind Mitigation Credits and are offered after a certified inspection is done to your home. Unlike some home inspections, like a four-point inspection, this one is not mandated by your insurance company or your lender and is completely optional. However, most wind mitigation inspections result in savings that at least cover the cost of the inspection in the first year, so why not? It is important to note that you will never be penalized for not having these safety features. Your insurance premiums can only go down, not up.

What Does a Wind Mitigation Inspection Include?

An inspector will come to your home and look for specific factors that would make your home more resilient to a windstorm. Specifically, they will be looking at your roof and home openings such as doors and windows. Florida wind mitigation inspectors examine these key safety features:

  • Roof Shape
  • Roof Bracing of Gable End
  • Roof Deck Attachment
  • Roof Covering
  • Roof-to-Wall Connections
  • Secondary Water Resistance
  • Doors
  • Protection of Openings (windows and other openings)

These features will be evaluated to determine how wind resilient your home is with it’s current features. All Florida homes built after 2002 were constructed to certain safety codes that will likely result in a savings to you. If your roof has not been replaced after 2002 but was built after 1974, we still recommend having a wind mitigation inspection. Based on how it was constructed, there are some features of the roof that you may still qualify for discounts.

There are a few cost-effective measures you can take to safeguard your home and reduce your hurricane-wind premium. A few examples would be securing your roof with hurricane clips or wraps and hurricane protecting your windows, doors and other openings to your home. To qualify for the opening protection credit, all window and openings must be protected by wind impact resistant glass. This also includes a hurricane resistant garage door.

Cost vs. The Savings

A wind mitigation report will cost, on average, $75.00. However, with minimal wind mitigation features in place, the inspection will pay for itself in the first year. Credits can go up to the maximum savings of 88% off the hurricane/wind premium.

Good to Note

This credit is good for five years. After that time, a new inspection will be required to make sure that you still qualify for these credits based on the new forms submitted by the Office of Insurance Regulation.

Please contact your WWW Personal Insurance Advisor to discuss Wind Mitigation Credits & find out if you could benefit from the inspection.


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