Friday’s Post 11.25.11 –  Regulators in South Dakota have embarked on providing much-needed clarity in medical benefits that are covered by auto insurance firms in the health and motor industry. There is a general concern especially when it comes to vehicle accidents. The officials agree that this problem is now wide-spread and is being experienced in most states. Some of the issues policy holders have cited include: claims, billing and confusion on what coverage is to be applied in such circumstances. The stake holders were engaged in a fact-finding and brain storming hearing in the beginning of the year. They sought to show the depth of this issue and to possibly come up with changes that could offer a solution. After the delegation, they reported that no lasting remedy was arrived at.  The deputy director issued a statement in an interview and said that they were unable to come up with workable proposals. Normally, a health cover is expected to cover medical expenses such as surgeries and funeral costs. The uncertainty or confusion comes in where the benefits are duplicated. Regulators based in South Dakota report that there has been complaints where auto insurance companies have failed to honor claims which are outlined in the policy agreements.  In most states, regulatory agencies are responsible for educating and addressing the issues of auto insurance policy holders and the car insurance providers. Investigations into these auto insurance claims have been conducted and the findings show that there is no consistency in handling medical and health covers. This is largely attributed to the fact that there is a general lack of knowledge due to the fact that there are no clear-cut rules and guidelines. Randy the Deputy Director asserted that this issue was looked into in a delegation of National Association of Insurance Commissioners (NAIC). This was after regulators from different states had voiced their sentiments. They agreed to hold another meeting in March and further look into this problem. The way forward will be provided in the (NAIC) gathering. All the parties are waiting in anticipation for the proposed changes to be arrived at after the March discussion. It can only be hoped that a lasting solution and concrete answers will be reached at to put an end to the confusion.

-Mike

Michael E. Dortch
President &  Managing Agent
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