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ANSWERING LAY QUERIES AN ALL-CONSUMING TASK

Posted On: Sep. 27, 1998 12:00 AM CST

There's an old saying that a journalist is a jack of all trades and the master of none. That's true even for a journalist who has spent a career covering one subject, as I was reminded in the last week. In various social settings, I was asked insurance-related questions by people who don't work in insurance, and I had no practical answers. This was a bit embarrassing as the subject of insurance didn't just come up. It was raised because my position as publisher and editorial director of Business Insurance was known.

Here are the problems that were posed to me:

Why would an insurer non-renew homeowners coverage on a Nantucket cottage after 20 years of collecting premiums and paying no claims, leaving the broker to put the coverage into the Massachusetts Property Insurance Underwriting Assn.?

How can an American, living abroad most of the year managing a small charity she founded, buy health insurance in the United States? The father of the altruistic woman is very concerned, not about paying for treatment for minor ailments or injuries but about the prospect of his daughter becoming seriously ill without insurance. The father tells me he has talked to insurers and agents, and no one seems interested in helping.

Why are employers buying health insurance programs that require so much pre-authorization but are not forcing the health insurers to promptly answer doctors' telephone calls concerning proposed care? The questioner is an orthopedic surgeon, who also complained that when on call at his hospital he has to patch up the uninsured. He is concerned not only that he is not paid for his services but also that he is as at risk for malpractice while giving uncompensated care. Is that fair?

Personal lines insurance is not my area of expertise, but I gave the cottage owner my best shot at an answer. I started to explain that insurers are analyzing their accumulations of values, especially in hurricane-exposed areas. I talked about insurers reducing their exposures to limit their losses under larger retentions and to make their programs more attractive to reinsurers. The more I tried to explain it, the more skeptical he looked, concluding, "Sounds like a racket to me."

I had to admit that non-renewing a 20-year customer did not sound like the best approach to re-underwriting, and I suggested that he write the chief executive officer of the insurance company. Curious, I contacted my personal broker, who referred me to an agent on Nantucket. He says property insurance capacity is loosening up a bit, though insurers of high-value homes on Nantucket are requiring a 1% to 2% windstorm deductible. On a $1 million home, that's $10,000 to $20,000.

I also remembered that the Insurance Information Institute sponsors a toll-free hot line to answer consumer questions about insurance (800-942-4242). I'm sorry to report, though, that the hot line can't handle health insurance questions anymore, because the Health Insurance Assn. of America pulled out of the project. So much for finding a quick answer to the second question regarding health insurance for a person doing good deeds abroad. So, to help a concerned father, I've put out some calls for contacts whom I think may be able to help.

The third question, though more up my alley than the first two, also was somewhat difficult for me to answer. I suggested that employers will pressure their health plans to respond more quickly to doctors, or will reduce pre-authorization requirements in their plans, only if they are convinced that health plan costs will go down, not up. On the issue of the uninsured and malpractice exposure, I could only sympathize.

It occurs to me that if I find it difficult to answer these questions based on my experience, the insurance industry has a lot of work to do to improve public access to insurance information. How these issues are resolved for these people and those in similar situations also will influence public perception of insurance and, in the long run, public policy toward insurers on everything from non-renewal regulations to the Patients' Bill of Rights legislation under consideration in Congress.

But these are the observations of a jack of all trades. And knowing I am master of none of this, I've entered the III hot line number into my electronic organizer for future reference -- and I vow not to wear my Business Insurance windbreaker while off duty.

Publisher and Editorial Director Kathryn J. McIntyre and Editor Paul D. Winston publish columns on alternate weeks.