Maria-Joseph Council 4022
• 3150B South Dixie Dr.		•Moraine, OH  45439		• (937) 299-4728

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4022 Field Agent

From Agent Steve: 

Condensed from an article in the Wall Street Journal, January 7-8, 2012, When Insurance Fails; Cheaper Policies Bought in the Workplace can have Drawbacks, by Leslie Scism

1. When you buy insurance on your own, it is governed by the laws of the state in which you purchased it. Any dispute can be tried before a jury. A judge often rules in favor of the consumer, concerning ambiguities in the policy language. This is good for you.
2. Policies sold through employers are governed by ERISA (the 1974 Employee Retirement Income Security Act) The insurer often has discretion to interpret policy language. Disputes are decided by the ruling of a federal judge. The only consequence is that the insurer might have to pay the denied benefit. This gives the insurer more incentive to deny a claim. This is bad for you.
3. The author wrote of a real case, bringing home the point in 2 above: A man bought an Accidental Death Policy through work. 6 years later, he became drunk, crashed his BMW, and was killed. The insurer, a unit of CIGNA, ruled it was not an 'accident', because it was neither external, nor unforeseeable. They denied the claim.
4. What can you do? As a consumer, you should obtain a copy of the employer's Plan Document. You should hunt for any language giving the plan the discretion to make eligibility decisions.
5. What else can you do? Supplement your work insurance with real insurance from the Knights of Columbus. Let's talk!

Fraternally,
Steve Timmer, FICF, PGK
(937)293-1542, phone and fax
(937)470-3616, cell
stephen.timmer@kofc.org
I really want to be your agent!

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