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General Insurance Law Questions
FLASH: THE GRAMM-LEACH-BLILEY ACT WAS PASSED BY CONGRESS ON NOVEMBER 4, 1999 AND SIGNED BY FORMER PRESIDENT CLINTON NOVEMBER 12, 1999. THE ACT IS THE MOST SIGNIFICANT
FINANCIAL SERVICES LEGISLATION IN 60 YEARS, AND IS THE CULMINATION OF DECADES OF EFFORT TO RESTRUCTURE THE FINANCIAL SYSTEM IN THE UNITED STATES. THE MOST SIGNIFICANT
CHANGE WROUGHT BY THE ACT IS TO ALLOW AFFILIATIONS AMONG BANKS, SECURITIES FIRMS AND INSURANCE COMPANIES. BUT THE ACT IS COMPLEX AND FAR-REACHING, AND DEALS WITH A
MULTITUDE OF ADDITIONAL BANKING, INSURANCE AND FINANCIAL SERVICES ISSUES AS WELL. WE WILL BE MODIFYING A SMALL PORTION THE FOLLOWING MATERIAL TO REFLECT THE IMPACT OF THE
NEW LAW SHORTLY. FOR A DETAILED ARTICLE ABOUT THE NEW LAW, PREPARED BY ONE OF AMERICA'S LEADING LAW FIRMS, CLICK HERE.
WHAT IS AN INSURANCE POLICY?
WHAT IS AN "INSURABLE INTEREST"?
HOW DOES AN INSURANCE POLICY "PROTECT" ME?
WHAT ARE "EXCLUSIONS" AND "LIMITATIONS" AND HOW DO THEY AFFECT MY COVERAGE?
ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW INSURANCE COMPANIES OPERATE?
WHY WOULD SOMEONE NEED OR BE REQUIRED TO HAVE INSURANCE?
IS A BUSINESS REQUIRED TO PROVIDE MEDICAL, LIFE AND SIMILAR INSURANCE COVERAGES FOR ITS EMPLOYEES?
ARE THERE LEGAL LIMITATIONS ON INSURANCE COMPANY BUSINESS PRACTICES?
CAN AN INSURANCE COMPANY REFUSE TO SELL ME INSURANCE FOR ANY REASON IT CHOOSES?
ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR INSURANCE?
CAN AN INSURANCE COMPANY CANCEL MY POLICY FOR ANY REASON IT CHOOSES?
CAN I CANCEL MY POLICY AT ANY TIME AND WILL THERE BE A PENALTY?
IF I MISS A PREMIUM PAYMENT AND GET A CANCELLATION NOTICE, IS THERE ANYTHING I CAN DO TO BE ABLE TO KEEP THE POLICY?
WHAT HAPPENS WHEN THERE IS A CLAIM?
WHAT AM I REQUIRED TO DO WHEN I HAVE A CLAIM?
IF I AM SUED, DOES MY INSURANCE COMPANY DEFEND ME IN COURT?
IF I AM SUED, CAN MY INSURANCE COMPANY SETTLE THE CASE WITHOUT MY CONSENT?
WHAT IS A "RESERVATION OF RIGHTS" LETTER?
WHAT CAN I DO WHEN AN INSURANCE COMPANY REFUSES TO PAY A CLAIM?
IF I THINK CERTAIN WORDS IN MY POLICY MEAN SOMETHING DIFFERENT FROM WHAT MY INSURANCE COMPANY SAYS THEY MEAN, HOW DO WE RESOLVE IT?
WHAT LEGAL REMEDIES DO I HAVE IF MY INSURANCE COMPANY WON'T PAY MY CLAIM OR WON'T PAY WHAT I THINK THE CLAIM IS WORTH? LAWSUIT FOR BREACH OF
CONTRACT
LAWSUIT FOR "BAD FAITH"
ARE THERE ANY OPTIONS FOR RESOLVING A DISPUTE WITH MY INSURANCE COMPANY OTHER THAN SUING THE COMPANY IN COURT?
ARBITRATION
COMPLAINT TO DEPARTMENT OF INSURANCE
WHY DOES IT MATTER THAT I GIVE AN ADJUSTER MY SOCIAL SECURITY NUMBER?
WE HAVE A POLICY LIMIT OF $100,000. DOES THIS MEAN THAT ANY MEDICAL BILLS, DAMAGES, LEGAL FEES, ETC. THAT EXCEED THAT LIMIT ARE MY
RESPONSIBILITY?
I HAVE A FRIEND WHO IS AN AVID MOTORCYCLE RIDER AND WHO PARTICULARLY ENJOYS DRIVING WHILE DRUNK. CAN I TAKE A OUT A LARGE INSURANCE POLICY ON HIM? MY ODDS OF COLLECTING
ARE HIGHER THAN THE LOTTERY!
Cancellations
CAN I CANCEL MY POLICY AT ANY TIME AND WILL THERE BE A PENALTY?
CAN AN INSURANCE COMPANY CANCEL MY POLICY FOR ANY REASON IT CHOOSES?
Employee benefits
IS A BUSINESS REQUIRED TO PROVIDE MEDICAL, LIFE AND SIMILAR INSURANCE COVERAGES FOR ITS EMPLOYEES?
Exclusions and limitations
WHAT ARE "EXCLUSIONS" AND "LIMITATIONS" AND HOW DO THEY AFFECT MY COVERAGE?
IF I THINK CERTAIN WORDS IN MY POLICY MEAN SOMETHING DIFFERENT FROM WHAT MY INSURANCE COMPANY SAYS THEY MEAN, HOW DO WE RESOLVE IT?
Government regulation
WHO REGULATES THEM?
ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW INSURANCE COMPANIES OPERATE?
ARE THERE LEGAL LIMITATIONS ON INSURANCE COMPANY BUSINESS PRACTICES?
ARE THERE ANY OPTIONS FOR RESOLVING A DISPUTE WITH MY INSURANCE COMPANY OTHER THAN SUING THE COMPANY IN COURT?
ARBITRATION
COMPLAINT TO DEPARTMENT OF INSURANCE
Insurance claims
WHAT HAPPENS WHEN THERE IS A CLAIM?
WHAT CAN I DO WHEN AN INSURANCE COMPANY REFUSES TO PAY A CLAIM?
WHAT LEGAL REMEDIES DO I HAVE IF MY INSURANCE COMPANY WON'T PAY MY CLAIM OR WON'T PAY WHAT I THINK THE CLAIM IS WORTH? LAWSUIT FOR BREACH OF
CONTRACT
LAWSUIT FOR "BAD FAITH"
ARE THERE ANY OPTIONS FOR RESOLVING A DISPUTE WITH MY INSURANCE COMPANY OTHER THAN SUING THE COMPANY IN COURT?
ARBITRATION
COMPLAINT TO DEPARTMENT OF INSURANCE
Insurance lawsuit
ARE THERE ANY OPTIONS FOR RESOLVING A DISPUTE WITH MY INSURANCE COMPANY OTHER THAN SUING THE COMPANY IN COURT?
ARBITRATION
COMPLAINT TO DEPARTMENT OF INSURANCE
WHAT LEGAL REMEDIES DO I HAVE IF MY INSURANCE COMPANY WON'T PAY MY CLAIM OR WON'T PAY WHAT I THINK THE CLAIM IS WORTH? LAWSUIT FOR BREACH OF
CONTRACT
LAWSUIT FOR "BAD FAITH"
IF I AM SUED, DOES MY INSURANCE COMPANY DEFEND ME IN COURT?
IF I AM SUED, CAN MY INSURANCE COMPANY SETTLE THE CASE WITHOUT MY CONSENT?
WHAT IS A "RESERVATION OF RIGHTS" LETTER?
WE HAVE A POLICY LIMIT OF $100,000. DOES THIS MEAN THAT ANY MEDICAL BILLS, DAMAGES, LEGAL FEES, ETC. THAT EXCEED THAT LIMIT ARE MY
RESPONSIBILITY?
Insurance marine
WHAT TYPE OF INSURANCE SHOULD I GET FOR MY BOAT?
WHAT CONCERNS SHOULD I HAVE ABOUT MY MARINE INSURANCE?
Insurance premiums
ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR INSURANCE?
I HAVE A LARGE TERM-LIFE POLICY IN WHICH MY SISTER AND BROTHER-IN-LAW ARE SOLE BENEFICIARIES. ON MY BEHALF, THEY ARE PAYING THE ANNUAL PREMIUM. ARE THERE ANY TAX
CONSEQUENCES IF THEY REMAIN (1) BENEFICIARIES OR (2) JOINT OWNERS OF THE POLICY? IS IT NECESSARY TO INFORM THE INSURANCE COMPANY THAT MY BENEFICIARIES ARE PAYING THE
PREMIUM?
Mortgage/title insurance
WHAT KINDS OF INSURANCE CAN I BUY?
WHAT ARE "TITLE INSURANCE" AND "MORTGAGE INSURANCE", AND ARE THEY NECESSARY?
WHAT IS TITLE INSURANCE AND WHY DO I NEED IT?
WHAT IS MORTGAGE INSURANCE?
Purpose
HOW DOES AN INSURANCE POLICY "PROTECT" ME?
WHAT IS AN "INSURABLE INTEREST"?
I HAVE A FRIEND WHO IS AN AVID MOTORCYCLE RIDER AND WHO PARTICULARLY ENJOYS DRIVING WHILE DRUNK. CAN I TAKE A OUT A LARGE INSURANCE POLICY ON HIM? MY ODDS OF COLLECTING
ARE HIGHER THAN THE LOTTERY!
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Health Insurance Law: Free Legal Information
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Health
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General Health Insurance Questions
WHAT IS HEALTH INSURANCE?
WHAT IS PRIVATE INDEMNITY INSURANCE?
WHAT ARE HEALTH CARE MAINTENANCE ORGANIZATIONS?
WHAT ABOUT EMPLOYER SPONSORED PLANS?
ARE THERE GOVERNMENT SPONSORED PROGRAMS?
WHAT IS A HEALTH INSURANCE POLICY?
WHAT IS A HEALTH INSURANCE PLAN?
HOW DOES A HEALTH INSURANCE POLICY OR HEALTH PLAN PROTECT ME?
HOW DOES AN INSURANCE POLICY "PROTECT" ME?
HOW DO I DETERMINE WHAT MY HEALTH CARE COVERAGE OR BENEFITS ARE?
SUPPOSE THE CONTRACT OR BOOKLET IS AMBIGUOUS OR UNCLEAR?
WHAT ARE "DEFINITIONS," "BENEFITS," "LIMITATIONS," AND "EXCLUSIONS?"
IF I THINK CERTAIN WORDS IN MY POLICY MEAN SOMETHING DIFFERENT FROM WHAT MY INSURANCE COMPANY SAYS THEY MEAN, HOW DO WE RESOLVE IT?
ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW HEALTH INSURANCE COMPANIES OR PLANS OPERATE?
WILL ONE OF THESE MANY AGENCIES BE ABLE TO HELP ME?
IS A BUSINESS REQUIRED TO PROVIDE HEALTH INSURANCE TO EMPLOYEES?
HOW DO I OBTAIN HEALTH INSURANCE?
ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR INSURANCE?
CAN A HEALTH INSURANCE COMPANY OR HEALTH SERVICE PLAN CANCEL MY POLICY FOR MEMBERSHIP FOR ANY REASON?
CAN THE INSURER OR PLAN CANCEL OR RESCIND AT ANY TIME?
CAN I CANCEL MY HEALTH INSURANCE, AND WILL THERE BE A PENALTY OR ADVERSE CONSEQUENCE?
IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?
ARE THERE DANGERS IN CANCELLING HEALTH INSURANCE?
WHAT ARE TYPICAL PROBLEMS THAT ARISE IN GETTING HEALTH CARE BENEFITS PROVIDED OR PAID?
WHAT IF THE INSURED LIED ABOUT A HEART ATTACK?
WHAT CAN, OR MUST, I DO WHEN A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM OR PROVIDE A BENEFIT OR SERVICE?
WHAT IS THE APPEALS AND GRIEVANCE PROCESS LIKE?
WHAT ARE MY LEGAL REMEDIES IF A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM FOR A BENEFIT OR SERVICE?
WOULD I NEED A LAWYER TO HANDLE MY CASE?
I CURRENTLY AM ON WORKER'S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I'M OFF?
WHAT WILL HAPPEN TO OUR HEALTH INSURANCE FOR MY DEPENDENT CHILDREN AND I AFTER THE DIVORCE FROM THEIR FATHER?
HOW LONG WILL MY MEDICAL INSURANCE ALLOW MY NEW BABY AND MYSELF REMAIN IN THE HOSPITAL FOLLOWING CHILDBIRTH?
MY FATHER WHO HAS CONJESTIVE HEART FAILURE AND TYPE 2 DIABETES RECENTLY UNDERWENT A QUINTUPLE HEART BYPASS. HIS MEDICAL BILLS ARE STAGGERING AND HE HAS NO HEALTH
INSURANCE. SHORT OF FILING BANKRUPTCY, WHAT ARE HIS OPTIONS IN GETTING THESE AMOUNTS REDUCED?
I HAVE INCURRED SUBSTANTIAL MEDICAL BILLS FOR MY CHILDREN. MY HEALTH INSURANCE IS PAID THROUGH EMPLOYEE DEDUCTIONS. NOW I FIND MY COMPANY HAS NOT PAID ITS INSURANCE
PREMIUMS AND HAS FILED BANKRUPTCY. IS THERE ANY WAY TO FORCE MY COMPANY TO PAY THE COVERAGE?
Cancellation
CAN A HEALTH INSURANCE COMPANY OR HEALTH SERVICE PLAN CANCEL MY POLICY FOR MEMBERSHIP FOR ANY REASON?
CAN I CANCEL MY HEALTH INSURANCE, AND WILL THERE BE A PENALTY OR ADVERSE CONSEQUENCE?
IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?
ARE THERE DANGERS IN CANCELLING HEALTH INSURANCE?
I CURRENTLY AM ON WORKER'S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I'M OFF?
Coverage
IF I THINK CERTAIN WORDS IN MY POLICY MEAN SOMETHING DIFFERENT FROM WHAT MY INSURANCE COMPANY SAYS THEY MEAN, HOW DO WE RESOLVE IT?
DO I AUTOMATICALLY LOSE MY HEALTH INSURANCE WHEN I LOSE MY JOB?
CAN I LOSE MY HEALTH INSURANCE AFTER I'M FIRED OR QUIT?
WHAT ARE TYPICAL PROBLEMS THAT ARISE IN GETTING HEALTH CARE BENEFITS PROVIDED OR PAID?
I CURRENTLY AM ON WORKER'S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I'M OFF?
WHAT IS PRIVATE INDEMNITY INSURANCE?
HOW LONG WILL MY MEDICAL INSURANCE ALLOW MY NEW BABY AND MYSELF REMAIN IN THE HOSPITAL FOLLOWING CHILDBIRTH?
MY FATHER WHO HAS CONJESTIVE HEART FAILURE AND TYPE 2 DIABETES RECENTLY UNDERWENT A QUINTUPLE HEART BYPASS. HIS MEDICAL BILLS ARE STAGGERING AND HE HAS NO HEALTH
INSURANCE. SHORT OF FILING BANKRUPTCY, WHAT ARE HIS OPTIONS IN GETTING THESE AMOUNTS REDUCED?
WHAT WILL HAPPEN TO OUR HEALTH INSURANCE FOR MY DEPENDENT CHILDREN AND I AFTER THE DIVORCE FROM THEIR FATHER?
Denial
WHAT CAN, OR MUST, I DO WHEN A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM OR PROVIDE A BENEFIT OR SERVICE?
WHAT IS THE APPEALS AND GRIEVANCE PROCESS LIKE?
WHAT IF THE INSURED LIED ABOUT A HEART ATTACK?
Divorce
WHAT WILL HAPPEN TO OUR HEALTH INSURANCE FOR MY DEPENDENT CHILDREN AND I AFTER THE DIVORCE FROM THEIR FATHER?
CAN MEDICAL INSURANCE BE INCLUDED IN ALIMONY?
Employer bankruptcy
I HAVE INCURRED SUBSTANTIAL MEDICAL BILLS FOR MY CHILDREN. MY HEALTH INSURANCE IS PAID THROUGH EMPLOYEE DEDUCTIONS. NOW I FIND MY COMPANY HAS NOT PAID ITS INSURANCE
PREMIUMS AND HAS FILED BANKRUPTCY. IS THERE ANY WAY TO FORCE MY COMPANY TO PAY THE COVERAGE?
Employer sponsored plans and benefits
DOES AN EMPLOYER HAVE TO OFFER EMPLOYEES BENEFITS, SUCH AS VACATIONS, HEALTH PLANS, PENSION, ETC.?
DO I AUTOMATICALLY LOSE MY HEALTH INSURANCE WHEN I LOSE MY JOB?
CAN I LOSE MY HEALTH INSURANCE AFTER I'M FIRED OR QUIT?
WHAT IS PRIVATE INDEMNITY INSURANCE?
I CURRENTLY AM ON WORKER'S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I'M OFF?
Government regulation
WHO REGULATES THEM?
ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW HEALTH INSURANCE COMPANIES OR PLANS OPERATE?
ARE THERE LEGAL LIMITATIONS ON INSURANCE COMPANY BUSINESS PRACTICES?
Government sponsored plans
ARE THERE GOVERNMENT SPONSORED PROGRAMS?
HMOs
WHAT ARE HEALTH CARE MAINTENANCE ORGANIZATIONS?
Premiums
ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR COVERAGE?
IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?
Private indemnity policies
WHAT IS PRIVATE INDEMNITY INSURANCE?
HOW DO I OBTAIN HEALTH INSURANCE?
Purpose
WHAT IS HEALTH INSURANCE?
HOW DOES AN INSURANCE POLICY "PROTECT" ME?
Rates
ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR INSURANCE?
Self-employed
HOW DO I OBTAIN HEALTH INSURANCE?
Social Security recipients
HOW DO I OBTAIN HEALTH INSURANCE?
Spousal support payments
CAN MEDICAL INSURANCE BE INCLUDED IN ALIMONY?
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Results from search: http://www.edgarsnyder.com/auto_insurance/medical.html
The Consumer Guide to Pennsylvania's Auto Insurance Law brought to you by Edgar Snyder & Associates, a Personal Injury and Worker's Compensation law firm with offices in western Pennsylvania, Pittsburgh, Altoona, Ebensburg, Erie, and Johnstown
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Medical Expense Benefit
Required Minimum Under Law:
$5,000
Our Recommended Minimum:
$10,000
The Medical Expense Benefit on your insurance policy covers medical bills that
result from any injuries you suffer in an auto accident.
Although the required coverage remains at $5,000, our experience shows that
it is an insufficient limit. It doesn't take much to reach $5,000 when you're
dealing with medical bills, especially when you consider the potential costs of
hospital treatment, surgery, extensive physical therapy, rehabilitation, and
other medical services. We recommend a minimum coverage of $10,000 or possibly
even more, especially if you do not have other medical insurance.
It is important to remember that Pennsylvania is a " first-party
benefits " state. This means your auto insurance covers any
injuries you receive when you are in any type of motor vehicle accident. Only
after the coverage on your auto insurance runs out does your healthcare
insurance take over.
If you have other medical insurance:
If you use up the limit of Medical Expense Benefit on your automobile insurance
policy, you may be able to pass the excess charges on to your own medical or
health insurance plan (such as Blue Cross/Blue Shield). However, you should be aware
that some medical plans may not cover certain treatments or may only pay a
portion of your bills.
You should also know that your health insurance plan, or any other assistance
program, may demand
that you reimburse them if you recover other money for your injuries. Remember : If the only coverage you have
is the auto Medical Expense Benefit, you may be personally
responsible for any bills over the limit of that coverage. This is why it
is so important that you carry the right auto insurance coverages along with the
right levels of coverage that will protect you and cover any medical bills you
may have.
Example:
You are injured in an auto accident that you caused. The cost
of your medical treatment for injuries is $10,000. If you have the minimum
Medical Expense Benefit of $5,000, and no other source of medical insurance (such as
Blue Cross/Blue Shield or anHMO), you will be personally
responsible for any bills that remain unpaid once your auto Medical Expense
Benefit is exhausted.
If you were not at fault for your accident, once the required coverage
of $5,000 is reached, your medical bills may not be paid unless and until you
claim against the person who was at fault is settled. If you carry additional coverage on
your automobile insurance policy,
your medical bills will continue to be paid until you reach the limit of that
coverage.
This guide is NOT a complete summary of the Pennsylvania Auto Insurance Law. It is designed to highlight certain important features of this law and should not be considered legal advice. Everyone has different insurance needs. If you have any questions concerning your coverage, please contact your insurance agent.
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National Health Insurance
Israel has a well-developed infrastructure of medical and paramedical
services, as research and bioengineering capacities.
The health-care system provides extensive medical coverage through a
network compromising hospitals, clinics and mother-and-child care centers.
The high quality of medical care is reflected in the life expectancy of
79.1 for women and 75.3 for men, and an infant mortality rate of 7.5 per
1000 live births.
The National Health Insurance Law, in effect since January 1995, sets
forth the state's responsibility to provide health services for all
residents of the country (not including tourists). Until the introduction
of this law, the majority of residents had been insured by one of four
comprehensive health-care organizations; the law stipulates that a
standardized basket of medical services (including hospitalization), will
continue to be supplied by those health-care organizations.
Provisions of the law
Every resident must register as a member with one of the health-care
organizations.
The health-care organizations may not bar applicants on any ground,
including age or state of health.
Residents who had been insured with one of these organizations before
the law came into effect, will continue to be members of that
organization.
Residents who had been insured with one of these organizations before
the law came into effect, will continue to be members of that
organization.
Residents who had not been insured prior to the law taking effect, are
assigned to a health-care organization by the Ministry of Health. After a
period of six months they may transfer to another organization of their
choice.
Spouses may each register in a different organization. Children under
18 belong to the organization of the parent who is receiving child
benefits from the National Insurance Institute.
Israeli citizens who have been living abroad for more than five years
and have not spent more than 90 days in Israel must renew registration
with a health-care organization upon their return to Israel.
New immigrants must register with a health-care organization upon
arrival in the country. They will be exempt from payment during their
first year in Israel.
Any person registered for at least one year with one of the
health-care organizations, may transfer to another organization.
The law accords equal status to all four health-care organizations.
Health Care Services
The health care organizations are required to supply all the services
enumerated in the standardized basket, within reasonable time and distance
from the insured persons homes; they include:
Medical diagnosis and treatment both at clinics and at the home of the
patient.
Preventive medicine and health education (i.e. early diagnosis of
embryo abnormalities, vaccinations, counseling for pregnant women, mothers
and the elderly).
Hospitalization (general, maternity, psychiatric and chronic).
Surgery and transplant. If medical treatment is not available in
Israel, treatment abroad will be covered.
Preventive dental care for children.
First Aid and transportation to a clinic or hospital.
Medical services at the workplace.
Medical treatment for drug abuse and alcoholism.
Medical equipment and appliances.
Obstetrics and fertility treatment.
Treatment of injuries caused by violence.
Medication, in accordance with a list issued by the Ministry of
Health.
Treatment of chronic diseases.
Paramedical services (i.e. physical therapy, occupational therapy,
etc.).
Funding
The sources for funding include:
Health insurance premiums paid be each resident.
Parallel-tax payments by employers and self-employed persons.
National Insurance Institute funds.
Funds from the Ministry of Health budget.
Consumer participation payments.
Collection
Payment of health insurance premiums is compulsory. The National Insurance
Institute collects health insurance premiums in the same way it collects
national insurance premiums.
Employees will have the premium deducted by their employer. Self-employed
persons will remit them directly to the National Insurance Institute.
The collection of health insurance premiums is progressive: low-income
earners pay less and high-income earners pay more. When both spouses are
employed, they pay separate insurance premiums.
The maximum income for purposes of health insurance premiums is four times
the average wage, that of minimum income is one quarter of the average
wage.
Employers and self-employed persons pay 3.1% of the portion of the salary
which is equal to half of the average wage, and 4.8% of the rest of the
salary (up to a maximum of four times the average wage).
Workers who receive retirement pensions or benefits from the National
Insurance Institute, or from the Ministries of Defense or Finance, pay
health insurance premiums only on their income from work (the pensions and
benefits are exempt from payment).
Persons who receive old-age pensions, pay a premium of 2% of the average
wage. Those receiving pensions prior to retirement age, pay a premium of
4.8% of half the amount of their pension.
Additional services
The government may augment, but not diminish medical services under the
National Health Insurance Law, unless authorized to do so by the Knesset
Committee on Labor and Social Affairs.
The health-care organization may offer supplementary insurance to cover
medical services that are not included in the basic-services basket. The
premium must be equal for all members of a given organization, except for
nursing services, for which payment according to the age of the insured,
may be charged.
Supervision
The Ministry of Health will supervise the equality and availability of the
medical services supplied by the health-care organizations, who are also
required to submit quarterly financial statements which are open to public
scrutiny. A public complaints office will also function in the Ministry of
Health.
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Results from search: http://www.gruberkantor.com/health_insurance.html
Medical Insurance/Health Insurance Law - Gruber and Kantor
Back to Practice Information
Gruber & Kantor Health Insurance Rights. Californians now have the right to sue HMO's and other Health Insurers. The California legislature has recently passed, and the Governor has signed, bills
giving residents of California the right to sue their health insurers, including HMO's, in the event the insurance company, or HMO, denies treatment. This is a major victory for the people of the State of
California.
If the legislation works as intended, it will provide greater access to medical insurance to the vast majority of Californians. In summary, the law requires HMO's to give you the opportunity to get a second opinion. Furthermore, and perhaps more importantly, if you are forced to go out of your network or plan, to get needed treatment, you will have the right to sue the HMO to obtain payment for the treatment you had previously been denied. Previously this type of action was preempted by ERISA. It is not surprising that it took so long for this reform to occur because, the people who work for the government have had this right all along. It never effected the legislators. Therefore, they had no incentive to fix the problem.
Free Initial Consultation ! E-mail: dgruber@gruberkantor.com
Health Insurance
The U.S House of Representative will soon adopt similar measures to allow law suits against HMO's and other Health Insurers. The House of Representatives has passed similar legislation to that
adopted in California, which, if it becomes law, will give a national scope to the changes adopted by California. If you think this reform is necessary, you should contact your senator and urge him or her to
adopt the bill passed by the House of Representatives. The new law in California will help us help you. For the past ten years we have been fighting for the rights of insureds against insurance companies.
We have a great deal of experience in resolving health insurance disputes. We have obtained settlements and judgments against insurers and HMO's for failing to provide proper testing, failing to provide referral to a specialist, failing to do a necessary procedure requiring the patient to go out of network for treatment, and many other disputes.
Please contact us regarding your problem with your health insurance company, or HMO.
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Results from search: http://www.lectlaw.com/tmed.html
Medicine and Law - Malpractice Topic Area
The 'Lectric Law Library Lawcopedia's
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Medical Malpractice
Topic Area
Practical Info & 'News' about Medical Malpractice, Litigation, Standards of Care, Using Expert Medical Consultants & Witnesses, other Med/Law issues...
Lawyers are just like physicians: what one says, the other contradicts. - Sholem Aleichem
Practical Litigation Info
What is a Strong Malpractice Case?
Special Medical Malpractice Statutes
Evaluating the Medical Malpractice Client
Chosing Proper Medical Malpractice Defendants
Initial Malpractice Case Review by Medical Experts
Errors to Avoid when Handling Medical Malpractice Cases
Some Tips to ease using Medical Experts
Direct Exam of Medical Experts - Checklist
Compensating the Medical Malpractice Expert
Choosing & Using Pathologists as Expert Witnesses
Preparing the Plaintiff's Medical Expert Witness for Trial
Determining Injured Plaintiff's Economic & Financial Losses
Determining Potential Defendant Liability in Large Class-Actions
Using Physician Assistants as Expert Consultants & Witnesses
Establishing Medical Standard of Care & Breach Without Experts
Medical Experts & Establishing Standards of Care in Malpractice Cases
Start Preparing for the coming "Wellness" Industry Litigation Tidal-Wave
Lawyers Beware! - Your Client's Personality Disorder can Destroy your Case
Discovering your Opponent's Expert Consultant's Work under FedRCivP 26(b)(4)(B)
FIRST, KILL ALL THE EXPERTS , Proposed Solution to Serious Problems re Medical Experts
From MediScene: Medical CLE Courses & many more Medical Resources for Legal Pros
Be sure to Check Out the Articles, Cases & other Resources
For and About Legal Experts in our
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Q: Before signing the death certificate had you taken the man's pulse? -- A: No.
Q: Did you listen for a heart beat? -- A: No.
Q: Did you check for breathing? -- A: No.
Q: So when you signed the death certificate you hadn't taken any steps to make sure the man was dead, had you?
A: Well, let me put it this way. The man's brain was sitting in a jar on my desk, but for all I know he could be out
there practicing law somewhere. - Cross of Coroner by Defense Atty
Related Medical Issues
Advance Health Care Directives, 9k
Organ Donations - All You Need to Know, 13k
Medical Records - Confidentiality & Access, 6k
Multiple Chemical Sensitivities - Fact, Fiction, Disability & the Law, 17k
Proving Links Between Toxic Exposures & Injury - Epidemiology
Proving Links between Toxic Exposures & Injury - Toxicology
Food-borne Illness' -- Solutions to this Growing Concern?
Medical-Legal Issues in Quality Assurance
Hepatitis C - A Silent Epidemic
Dialyzer Reactions
Only Pink Eye?
Plastic Surgery
Rheumatoid Arthritis & Medication
The Practice of Emergency Medicine
Emergency Medicine's 11 Commandments
Snoring & Sleep Apnea - Missing the Warning Signs
Common Negligence Issues In Cardiology
Pulmonary & Critical Care Medicine
Cardiovascular & Vascular Surgery
Acute Cardiac Ischemia Diagnosis
Radiation Oncology
The Gynecologic Oncologist
Medical Malpractice, Cancer & the Oncologist
Mammography & the Diagnosis of Breast Cancer
Cancer Growth - Medical & Malpractice Implications
Managed Care, Cancer & Mohs Micrographic Surgery
Failed Back Surgery Syndrome (FBSS)
Facts about Steffe Plate Spinal Litigation
Trauma & Temporomandibular Injury (TMJ)
Temporomandibular Joint Syndrome - A Primer
Common Obstetrical Complications
Respiratory Distress in the Newborn
Pediatric Orthopedic Surgery Problems
Placental Pathologist's Role Re Birth Problems
Bile Duct Injury & Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy Information
Q: Do you recall approximately the time that you examined that body of Mr. Edington at the Rose Chapel?
A: It was in the evening. The autopsy started about 8:30 p.m.
Q: And Mr. Edington was dead at the time, is that correct?
A: No, you idiot, he was sitting on the table wondering why I was doing an autopsy! - True Court Quote
'Lectric Law & Medicine News
APPLETON, WI. (UPI '97) - Nadean Cool, 44, has sued her psychiatrist for malpractice in a suit alleging that Dr. Kenneth Olson convinced her that she had 120 personalities, then billed her insurance company for group therapy . Her insurance carrier, after adding up bills it paid for her psychiatric care -- about $300,000 -- has joined the suit. Ms Cool claims that Olson said her 120 personalities included a duck and angels. Thankfully, it appears no one is alleging Cool is mentally healthy.
MIAMI, Fl. (Press-Telegram '95) - A diabetic patient woke up after an operation to find that the surgeon had mistakenly cut off a foot and one toe. The Fl. State Board of Medicine reduced a state hearing officer's recommended stiff sentence, and fined Dr. Rolando Sanchez $10,000 and suspended his practice for six months instead. I'm not saying what he did wasn't wrong, board member Dr. Edward Dauer said, but doctors are not God, and hospitals are not heaven.
NEW YORK, NY. (AP '96) - Rajeswari Ayyappan, 59, checked-in the Memorial Sloan-Kettering Cancer Center for brain surgery. Medical personnel performed the operation flawlessly... but on the wrong side of his brain. Chief of Neurosurgery, Dr. Ehud Arbit, has been relieved of his duties.
LONDON, England. (Daily Telegraph '96) - Cancer patient Cyril Smith, 59, gave up his job in 1993 when doctors said he had three months to live. Now Smith, who since giving up his well-paying job has only averaged 48 pounds ($72) a week, is suing the doctors for loss of earnings because he outlived their predictions. I'm not suing the hospital for thousands of pounds. I just want compensation for their mistake, for the last three years when I could have earned a living to support my family. I want the hospital to apologize, Smith said.
It's astonishing. People sue for anything these days, absolutely anything, said a British Med. Assn. spokesman.
ALBANY, NY. (AP '97) New York Attorney General Dennis Vacco said that the state was being sued for $10 million by Francis Hugh Smith, a convicted burglar, claiming that poor medical care was the cause for his amnesia that made him leave his work release job and forget to return to prison.
NORFOLK, Va. (AP '96) - Thomas Passmore, 32, was working at a construction site when he thought he saw '666', a demonic sign, on his hand. So, recalling the Bible's instruction, If thy right hand offend thee, cut it off, he did... with a circular saw. Doctors at Sentara Norfolk General Hosp. wanted to re-attach the hand, but Passmore refused, believing that he would go to hell if he agreed. The doctors contacted a judge, who advised them to follow Passmore's wish and not re-attach his hand.
Now Passmore is suing both the hospital and the doctors, claiming the hospital should have contacted his parents or sister to overrule the judge's decision and that the hospital didn't tell the judge that he was incompetent.
HARARE, Zimbabwe. (Reuters '96) - A Zimbabwe man was arrested for having sex with a cow. He claimed he was afraid of contacting AIDS from a human partner, so he developed a special, monogamous relationship with the animal. During his court appearance, he expressed his deep affection and love for the cow, recited marriage vows and promised to be faithful while serving his nine month jail sentence.
PITTSBURGH, Pa. (Tribune-Review '97) - An Indiana County man shot himself in the mouth after he mistook a .22 caliber gun for a medicine inhaler. Daniel Sutherland, 49, kept both the inhaler and gun in the same drawer and accidentally shot himself just before 2 a.m. He was airlifted to Presbyterian Univ. Hospital in Pittsburgh where he was listed in fair condition. The .22 caliber bullet did not exit his head.
ANKARA, Turkey. (AFP '97) - A 52-year-old Turkish man was shot in the leg over his attempts to have a penis transplant from a donkey . On two previous occasions Mehmet Esirgen, 52, purchased donkeys, amputated their sexual organs and appealed in vain to doctors to perform a transplant in order to cure his sexual impotence. His family, opposed to the plan, became hysterical when he purchased a third donkey on his way home from Ankara and one of his sons shot him. For a long time now I have had sexual problems and I have spent all my pension funds to overcome them, said Esirgen. He plans to buy a fourth donkey as soon as he recovers from his wound.
SANTA BARBARA, Ca. (AP '96) - A woman, claiming emotional distress, sued her veterinarian for $1 million in damages for breaking the back of her pet iguana.
GOA, India. (Reuters '96) - More than 600 scientists from 17 nations, many of whom drink their own urine and use it for body massage, gathered in western India for the First World Conference on Auto-Urine Therapy to present research showing human urine's healing powers and its effectiveness against cancer, hepatitis B, influenza and diabetes. Several doctors had data showing that urine therapy can ease the painful symptoms of AIDS.
Many patients on auto-urine therapy recover from serious illness, said Dr. Shigeyuri Arai of Japan. His study of 1,752 people who practiced urine therapy found that 60 percent - and 73 percent of cancer patients - reported that their symptoms disappeared. Yes, urine can cure cancer, agreed Dr. Ming Liau, while Dr. Ryoichi Nakao said that about 200,000 Japanese, and perhaps 5 million Germans, gargle their own urine. The Conference attendees, though puzzled as to the reason, generally agreed that some doctors are skeptical and don't even offer their patients urine therapy, despite all the evidence.
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Results from search: http://www.insurance-chart.net/medical_insurance_law.html
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Results from search: http://www.law.suffolk.edu/academic/sweden/2002/medical.htm
Suffolk University Law School : Sweden 2002
Main Page
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Important ABA Info
Why Choose Sweden?
Study in Sweden, Summer 2002 Medical Care and Insurance Requirement
As a condition of enrollment, each student is required to
have current health insurance. Please fill out and return
the Health and Accident Insurance
Certification form. If you do not have insurance, or if your
health insurance does not provide adequate coverage, a
supplement policy may be available at a nominal cost
through your law school insurance program.
Another insurance option is to purchase the International
Student Identity Card, which costs approximately $20 and is
available from the Council Travel Agency .
Call toll free at 1-800-2-COUNCIL for
the office near you. For Suffolk law students, or others in the Boston area, there is a
Council Travel Agency office located at 273 Newbury Street,
Boston, MA (617) 266-1926. Other offices are located at MIT
and Harvard Square, Cambridge. This travel card provides
health insurance coverage as well as other services such as
airline, train, car rental and hotel discounts.
Last updated: 2-Nov-01
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