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Monroe Native

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Re: Michigan Catastrophic Claims Association
« Reply #15 on: July 10, 2017, 05:44:08 PM »

And you have to wonder how many people in Detroit that don't even pay for car insurance are collecting big rewards.

I know out of state people injured in the State are covered by it - even though their insurance policies didn't include it - and they didn't pay into the fund.

It's a kind of freebie for them.  Please come to Michigan and play our lifetime benefits if you get in a wreck lotto.

Why wouldn't people in Detroit who don't have insurance also be covered?
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I have learned that only two things are necessary to keep one's wife happy. First, let her think she's having her own way. And second, let her have it.
Lyndon B. Johnson

You do not examine legislation in the light of the benefits it will convey if properly administered, but in the light of the wrongs it would do and the harms it would cause if improperly administered.
Lyndon B. Johnson

blue2

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Re: Michigan Catastrophic Claims Association
« Reply #16 on: July 10, 2017, 07:31:00 PM »

That's a fact.  A friend of mine who lives in Michigan but his son doesn't was injured a number of years ago.  He is A Okay now and working.  But besides the medical he was given he was awarded enough to buy a small farm outside of Toledo.  So i guess it pays more than medical.
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Monroe Native

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Re: Michigan Catastrophic Claims Association
« Reply #17 on: July 10, 2017, 08:51:16 PM »

That's a fact.  A friend of mine who lives in Michigan but his son doesn't was injured a number of years ago.  He is A Okay now and working.  But besides the medical he was given he was awarded enough to buy a small farm outside of Toledo.  So i guess it pays more than medical.

Yep.  He won the Michigan Get in a Car Wreck Lotto - without even buying a ticket.

SWEEEEEET!
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I have learned that only two things are necessary to keep one's wife happy. First, let her think she's having her own way. And second, let her have it.
Lyndon B. Johnson

You do not examine legislation in the light of the benefits it will convey if properly administered, but in the light of the wrongs it would do and the harms it would cause if improperly administered.
Lyndon B. Johnson

Professor H

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Re: Michigan Catastrophic Claims Association
« Reply #18 on: July 12, 2017, 07:24:20 PM »

Yep.  He won the Michigan Get in a Car Wreck Lotto - without even buying a ticket.

SWEEEEEET!
I'll pass on that "win"...   

I just want the payments to be based on what other insurance policy holders get.   
Just think if they cut the payouts down %50 by negotiations...   that $20Billion slush fund would go much further!
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Marion Berry

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Monroe Native

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Re: Michigan Catastrophic Claims Association
« Reply #19 on: July 12, 2017, 07:33:40 PM »

I'll pass on that "win"...   

I just want the payments to be based on what other insurance policy holders get.   
Just think if they cut the payouts down %50 by negotiations...   that $20Billion slush fund would go much further!

I would just like to be able to go purchase the type of policy I want, with the coverage's I want, and not have to deal with a poorly run monopoly to get it.

Oh wait - the Michigan Legislature said I couldn't do that.
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I have learned that only two things are necessary to keep one's wife happy. First, let her think she's having her own way. And second, let her have it.
Lyndon B. Johnson

You do not examine legislation in the light of the benefits it will convey if properly administered, but in the light of the wrongs it would do and the harms it would cause if improperly administered.
Lyndon B. Johnson

Professor H

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Re: Michigan Catastrophic Claims Association
« Reply #20 on: July 14, 2017, 01:51:21 PM »

Patrick M. McPharlin, Director
Department of Insurance and Financial Services
530 W. Allegan Street – 7 th Floor P.O. Box 30220
Lansing, Michigan 48909-7720

Cc:  Sen Zorn, Rep Bellino, Rep Sheppard, Gov Snyder

As an auto policy holder – I’m questioning the fiduciary practice of the MCCA organization under 500.008 4 a  duty to policy holders   as well as   500.3104  8 e    contract for for goods and services – including independent claims management to assure the efficient operation of the association. 
1.    Is the current established pay rates from the MCCA based on any coexisting rates from the individual members?     To clarify the question  I’m asking if they pay 100% of the billable amounts.   If so why isn’t it prudent to use the negotiated rates from individual board member companies like BCBS and save the taxpayers in premium costs for such claims?                                                                                                                   
2.   What role does the Director have to ensure that policy holders are given a fair cost basis for insurances they are forced to subsidize or buy.
3.   Did the legislation intend to force taxpayers to pay higher (non-negotiated) rates for services provided under the MCCA than what is typically paid under most other plans?  Or did fiduciary responsibility to the individual auto policy holders (and taxpayers)  get lost in the formation of a private organization of insurers?




Professor H
Monroe MI 48161   
     
Attachment – excerpts from legislation

References from the legislation attached – I’m not a lawyer just a retired citizen with a question that seems unanswered from any reading I’ve been able to find on the subject.
500.3104 Catastrophic claims association

7. 
(g) Establish procedures for reviewing claims procedures and practices of members of the association. If the claims procedures or practices of a member are considered inadequate to properly service the liabilities of the association, the association may undertake or may contract with another person, including another member, to adjust or assist in the adjustment of claims for the member on claims that create a potential liability to the association and may charge the cost of the adjustment to the member

8. 
(d) Pursuant to the plan of operation, adopt reasonable rules for the administration of the association, enforce those rules, and delegate authority, as the board considers necessary to assure the proper administration and operation of the association consistent with the plan of operation.
(e) Contract for goods and services, including independent claims management, actuarial, investment, and legal services, from others within or without this state to assure the efficient operation of the association.
(f) Hear and determine complaints of a company or other interested party concerning the operation of the association.
(g) Perform other acts not specifically enumerated in this section that are necessary or proper to accomplish the purposes of the association and that are not inconsistent with this section or the plan of operation.
(9) A board of directors is created, hereinafter referred to as the board, which shall be responsible for the operation of the association consistent with the plan of operation and this section.

From the section 50 the legislature put this organization under:
Section 500.5008
(4) The articles of incorporation may contain a provision providing that a director is not personally liable to the corporation or its shareholders or policyholders for monetary damages for a breach of the director's fiduciary duty. However, the provision does not eliminate or limit the liability of a director for any of the following:
(a) A breach of the director's duty of loyalty to the corporation or its shareholders or policyholders.
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First, it was not a strip bar, it was an erotic club. And second, what can I say? I'm a night owl.
Marion Berry

But we have to pass the bill so you can find out what is in it, away from the fog of the controversy.
Nancy Pelosi

Professor H

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Re: Michigan Catastrophic Claims Association
« Reply #21 on: July 14, 2017, 01:52:00 PM »

Think I'll get a response?   :)
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First, it was not a strip bar, it was an erotic club. And second, what can I say? I'm a night owl.
Marion Berry

But we have to pass the bill so you can find out what is in it, away from the fog of the controversy.
Nancy Pelosi

Maverick

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Re: Michigan Catastrophic Claims Association
« Reply #22 on: July 14, 2017, 02:24:12 PM »

I guarantee that you will get some response. Probably a form letter that restates some position that someone too at one point and thanks you for reaching out.

Personal response ??  Probably not
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The Fuzz

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Re: Michigan Catastrophic Claims Association
« Reply #23 on: July 15, 2017, 07:46:29 AM »

I agree, Mav.

Nicely put together Prof, I hope you get a rationale response to share.

You should have complained about the cost to insure the White Lincoln though.
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BigRedDog

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Re: Michigan Catastrophic Claims Association
« Reply #24 on: July 15, 2017, 12:19:33 PM »

Good job Professor H...

I send a 'lot' of communications to state and federal legislators although usually at the point that it is in discussion for passing as new or a modification to an existing bill.

The 'typical' reply I get is something about thanking me for passing my thoughts along and that they will certainly keep my thoughts in mind when the legislation is on the floor for debate!!!

I'm not aware of anything on the floor about this right now although there is lots and lots of talk about getting it to the floor for discussion...

I'll be anxiously awaiting your reply (replies) ;) ;) ;)
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Professor H

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Re: Michigan Catastrophic Claims Association
« Reply #25 on: July 27, 2017, 08:27:31 AM »

Well it wasn't a form letter - here's the Insurance division response:

No "internal costs controls" is the eye opener  - and they hang their hat on the fact that reasonable isn't defined in the code. 

Sounds like a new direction for the legislature requests in the future - since they won't get rid of this beast maybe they can tame it. 
=========================================================================
Thank you for contacting the Department of Insurance and Financial Services (DIFS).  Your inquiry regarding the MCCA has been forwarded to me for response.
 
Under Michigan’s no-fault law, Personal Injury Protection (PIP) benefits cover all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.  The automobile insurer only owes what is determined to be a reasonable and customary amount for the medical services provided; reasonable and necessary are not defined in the Insurance Code.  Unlike health insurance benefits, PIP benefits contain no internal cost controls.
 
The MCCA files financial statements with the DIFS Director and has independent audits done annually.  In addition, they are subject to audit by the DIFS Director.  According to information provided in the 2016 Annual Report to the Director, the MCCA’s Total Assets as of 6/30/16 were over $18.5 billion, and Total Liabilities were over $20.2 billion, resulting in a Total Deficit exceeding $1.7 billion.  MCCA’s Annual Statements, Audit Reports, and Plan of Operation are available on the MCCA’s website at www.michigancatastrophic.com.
 
We hope this information is helpful.  Please feel free to contact our office if you have any further questions.
 
 
Audrey Feldpausch, Analyst
Department of Insurance and Financial Services
Office of Consumer Services
530 W. Allegan Str., 7th Floor, Lansing, MI  48933-1521
Toll free:  877-999-6442
Fax Number:  517-284-8837
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First, it was not a strip bar, it was an erotic club. And second, what can I say? I'm a night owl.
Marion Berry

But we have to pass the bill so you can find out what is in it, away from the fog of the controversy.
Nancy Pelosi

blue2

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Re: Michigan Catastrophic Claims Association
« Reply #26 on: July 27, 2017, 10:08:57 AM »

"benefits cover all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation"

apparently accommodations is a very key word in that statement.
Because the friend i know of has a son that was able to collect $300,000 over and above all medical expenses.
So apparently the fund determines how much of a payout a victim may walk away with.
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Monroe Native

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Re: Michigan Catastrophic Claims Association
« Reply #27 on: July 27, 2017, 06:32:40 PM »

I've had people come over to look at the rental house that were living in hotels because of an "accident."

They claimed they needed a one floor arrangement.

I told them this wasn't a one floor house, and you had to go up steps to get into it.

They insisted on looking at it.

They got there, and said nope - this isn't going to work.  They didn't even go in - noting it had stairs to get into the house - which I had told them on the phone.

They then asked - Will you please sign this form that we tried to find some place else cheaper to stay?

I said nope, and thanks for wasting my time a hole.
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I have learned that only two things are necessary to keep one's wife happy. First, let her think she's having her own way. And second, let her have it.
Lyndon B. Johnson

You do not examine legislation in the light of the benefits it will convey if properly administered, but in the light of the wrongs it would do and the harms it would cause if improperly administered.
Lyndon B. Johnson

Professor H

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Re: Michigan Catastrophic Claims Association
« Reply #28 on: July 28, 2017, 08:54:16 AM »

If we could get that 18 Billion to stretch out a little more by cutting the payouts by even 30 percent just think of what you'd save!      5.4 Billion!       But it appears the lobbyist have ensured the politicians won't be fiscally responsible with our premium tax! 
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First, it was not a strip bar, it was an erotic club. And second, what can I say? I'm a night owl.
Marion Berry

But we have to pass the bill so you can find out what is in it, away from the fog of the controversy.
Nancy Pelosi

nails

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Re: Michigan Catastrophic Claims Association
« Reply #29 on: July 28, 2017, 01:13:56 PM »

If we could get that 18 Billion to stretch out a little more by cutting the payouts by even 30 percent just think of what you'd save!      $5.4 Billion!     
But it appears the lobbyist have ensured the politicians won't be fiscally responsible with our premium tax!

Quoting Gomer Pyle.   " Surprise . . . Surprise . . . Surprise "

And just when have you seen an example of politicians being fiscally responsible with OUR  tax dollars if it didn't benefit them directly.

Here's another recommendation for the swamp clearing project.
Outlaw the current system of lobbyist.



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