When you need medical attention, sometimes it’s obvious where to turn: Lingering cough and sore throat? Make an appointment with your doctor. Think you might be having a heart attack? Get to the emergency room, stat.
Other times, though, the answer isn’t so clear. Maybe your doctor is booked for days, or you’re traveling far from home. Or maybe you get sick over the weekend when the office is closed. What should you do then? Knowing where to go is key to getting the best care—and might just save you time and money.
Right Care, Right Place
“If you’ve got a problem that strikes you as severe or maybe even life-threatening, like you’re vomiting blood or you wake up with the worst headache of your life—get to the hospital or call 911,” says Ellen Miller, MD, CareConnect medical director and professor of medicine at Hofstra Northwell School of Medicine. “But if you’ve got a problem that would normally make you go to your doctor, only your doctor isn’t available, an urgent care clinic is probably a better choice.”
Urgent care facilities specialize in the treatment of medical problems that are urgent (like the name says) but not severe enough to warrant a trip to the ER. These facilities don’t require appointments and are often open on weekends and in the evening. Their physicians can diagnose and treat patients for illness and minor injuries like cuts and sprains.
After-hours availability is just one of the benefits an urgent care facility has to offer, Miller says. “If you can avoid the emergency room, you’ll probably save yourself a lot of time,” she says. “The ER is going to prioritize the real emergencies. If your case is not that serious, you will spend a huge amount of time waiting and waiting.”
Saving the ER for real emergencies may save you money, too. The co-pay for an emergency room visit is usually higher than for a trip to urgent care or your own doctor, although the specifics vary between plans and tiers.
There’s one more thing worth remembering, Miller says, and that’s to make your primary care provider your go-to whenever possible. Schedule your check-ups, and when a routine problem crops up, see if you can get a same-day appointment. “The preferable scenario is almost always to go to your primary care physician,” Miller says. “That’s the person who knows you and your history, has your full medical record, and will be able to follow up with you after your treatment is over.”
Jan. 19 (UPI) -- The largest money service business in the world agreed on Thursday to a half-billion dollar settlement over charges they failed to protect customers from fraud and permitted their agents to illegally launder money for customers.
Western Union will pay a $586 million fine after pleading guilty to charges of willfully failing to run an effective anti-money laundering program and aiding and abetting wire fraud with the U.S. Department of Justice, Federal Trade Commission and the U.S. Attorneys' Offices of the Middle and Eastern districts of Pennsylvania, Central District of California and Southern District of Florida.
"Western Union owes a responsibility to American consumers to guard against fraud, but instead the company looked the other way, and its system facilitated scammers and rip-offs," FTC Chairwoman Edith Ramirez said in a press release. "The agreements we are announcing today will ensure Western Union changes the way it conducts its business and provides more than a half billion dollars for refunds to consumers who were harmed by the company's unlawful behavior."
Based on a complaint filed Thursday in the U.S. District Court for the Middle District of Pennsylvania, Western Union violated U.S. laws when they processed thousands of transactions for Western Union agents and others as part of multiple national and international fraud schemes.
Among the allegations are criminals who contacted victims in the United States posing as family members, potential employers or people awarding some kind of prize asking for money to be wired to them. The company's agents were often complicit in the schemes, the FTC said, and sometimes took a cut of the money.
Previous cases have also established that Western Union failed to halt the transfer of hundreds of millions of dollars to human traffickers in China and drug traffickers in other parts of the world, as well as not adhering to laws requiring verification and investigation of daily transfer limits.
The settlement requires Western Union to block money transfers to any person who is the subject of a fraud report, provide clear warnings to consumers about fraud on their paper and electronic forms, refund fraudulently induced money transfers if the company did not follow proper anti-fraud protocol and to increase the availability for how consumers can file fraud complaints.
Western Union will also be monitored by an independent auditor for its adherence to the telemarketing sales rule, which bars companies from processing transfers known to be fraud, or those the company "should know is payment for a telemarketing transaction."
Western Union said in a press release it has increased compliance consistently during the last five years and has dedicated about 20 percent of its employees to compliance functions, noting the issues it settled Thursday occurred mostly between 2004 and 2012.
"We share the government's goal of protecting consumers and the integrity of our global money transfer network, and we worked hard to resolve these matters with the government," Western Union said in the release. "We are committed to enhancing our compliance programs to prevent illicit activity on our network and protect customers who transfer money to friends, family and businesses."
With the government’s move to demonetize high-value currency notes in early November also came a push towards digital transactions. According to data released by the Reserve Bank of India (RBI), the volume of smaller value transactions, largely represented by modes like Point of Sale (PoS), Unified Payments Interface (UPI), Immediate Payment Servic (IMPS) and mobile e-wallets saw a strong growth. Even though all electronic transactions’ combined value saw a growth of over 10%, the volume growth was in excess of 42%, indicating that various small value transactions were made through digital channels.
While the shift towards less-cash is encouraging, there remains an aspect of vulnerability when it comes to digital transactions. “The convenience that digital payments have brought to an individual is massive. On the other hand, there is a cost in the form of risks. So the consumers need to be informed and educated about being intelligent in their usage,” said Saket Modi, co-founder and chief executive officer at Lucideus Tech, an IT risk assessment and digital security services provider. At this juncture, it is important for consumers to know the dos and don’ts when it comes to safety of information while transacting digitally. It is imperative to understand that large-scale adoption of digital transactions also attracts cyber criminals who wait for opportune moments to exploit a system’s vulnerabilities.
Types of frauds to be aware of
Cyber security experts are of the opinion that with the use of online payment platforms, the fraudulent use of payment networks and data theft has also gone up. “While people are getting comfortable with mobile wallets and banking through apps and smartphones, Wi-Fi networks continue to have major security flaws that can make it very dangerous to conduct transactions using mobile devices,” said Amit Nath, head of Asia-Pacific (corporate business) F-Secure, a cyber security company.
Following are the major types of risks that you should be aware of:
Malware: These are specifically designed applications and programs that compromise the security of mobile phones and computers. It gives cyber criminals access to devices, and hence also to sensitive consumer data. Therefore, download and install applications only from authentic sources and that too from developers having a good reputation.
Phishing: In this case, the user is trapped using fake emails or websites and is made to enter account-related sensitive information. Those who are new to the world of electronic transactions are more prone to such traps. Do not click on attractive or suspicious links that you get through SMSs or emails.
Public networks: Using a public network can expose your mobile device and information to cyber criminals. Avoid doing digital transactions on public computers and networks like a cyber cafe or a public Wi-Fi hotspot.
Ransomware: In this security issue, the hacker gains remote access to the device as well as the data of the victims, and can block access to the device until a sum of money is received.
There are also other forms of cyber attacks where cyber criminals look for vulnerabilities within a technology and turn it to their advantage. “Some of these security breaches are much harder to detect and can only be identified using advanced security systems,” said Rajat Mohanty, chief executive officer, Paladion Networks, a cyber security firm.
What should you do?
“There is nothing called 100% secure. Anyone who says that their system is 100% watertight neither understands technology nor risk management. You can only manage and minimize the risk,” Modi said. At the institutional level, mechanisms have been put in place for constant monitoring of the systems. Certainly, more needs to be done. “When a customer makes a purchase (online), the business loses control of a large portion of the transaction interaction as customers use a variety of devices, operating systems and browsers to access e-commerce sites,” said Rana Gupta, vice-president, Asia-Pacific, identity and data protection, Gemalto, a digital security firm.
Closer look deters arsonists, discovers scams, benefits all policyholders
Kenny Allen was a likable fellow. He went to church, coached youth basketball in the Muncie, Ind. area, and was making his way through life with limitless potential ahead.
He also lived in a secret world: He was an insurance thief. Kenny was a driving force behind the largest home arson ring in Indiana history. And one of the largest ever in the U.S. His gang helped torch at least 73 buildings while he sang hymns of righteousness in pews.
Insurers were easy to defraud, Allen says. Their adjusters were so intent on making customers happy — he contends — that they rarely asked tough questions. Insurers could’ve quickly exposed the claims for burned homes as money grabs with a little more effort.
Kenny went straight after nearly five years in federal prison. He admits he screwed up, and today gives workshops for investigators to help make amends. He partners with Mike Vergon, the former ATF agent who arrested him. They’re friends and supporters in life — a touching story of Kenny’s redemption.
Yet his saga speaks to a bigger dilemma for insurers. If they investigate too many claims too closely, they risk policyholders thinking they’re cold and money-grubbing.
If insurers let too many suspect claims slide through too easily, they risk being prey for hunters like Kenny was. This slippery slope can grow fraud losses, help raise premiums and — yes — reinforce a belief among many consumers that insurers are cold and money-grubbing.
Life isn’t always fair when you’re an insurance company, no matter how many good deeds you perform. Corporations are targets of consumer upset simply because they’re big and make money.
Checking closely into suspicious claims can trigger a lot of emotions. Fair or not, people’s feelings of aggrievement or entitlement can quickly damage an insurer’s reputation. Especially when viral social posts can reach millions of sympathetic consumers in just hours.
Over the longterm, it’s a risk worth taking, and a story worth telling.
Insurers should do a far better job of telling people why they fight fraud — and why all policyholders benefit.
Being justifiably known for protecting policyholders from thieves seems like a pretty good way to build a business brand. And doing right by consumers.
If Kenny Allen’s right, taking the easy way out could’ve cost insurers more than millions in false arson claims. He’s the first to admit, it’s a miracle nobody died in his fires.
Award bestowed by New York Alliance Against Insurance Fraud
March 16, 2016, New York, NY — Cited for an aggressive campaign to counter workers-compensation scams throughout the state, New York Inspector General Catherine Leahy Scott was honored with the “Fraud Fighter of the Year” award by the New York Alliance Against Insurance Fraud.
The award was presented during NYAAIF’s recent annual meeting held here.
NYAAIF Chair Jim Berrigan credited the IG’s leadership in compiling an impressive record of prosecuting wide-ranging workers-compensation cases. They included fraud by claimants, medical providers and businesses.
“The IG’s efforts put teeth behind our anti-fraud marketing campaigns in providing valuable deterrence though public awareness and vigorous prosecution,” Berrigan said in presenting the award. He also commended Scott for reaching out and working with insurers to identify fraud trends and develop strategies to counter them.
NYAAIF also previewed its 2016 consumer campaign. It will include TV & radio ads, billboards and a roaming “Fraud Squad” van plastered with anti-fraud messages. The campaign theme is “Insurance Fraud Hurts . . . Everyone.” It launches in May.
Frank Orlando, head of the fraud unit of the state Department of Financial Services, briefed fraud fighters on no-fault fraud trends in the state. The Massachusetts Insurance Fraud Bureau profiled a huge automobile rate- evasion ring that operated in New York and Massachusetts.
NYAAIF also elected four members to three-year board terms: Jim Potts (New York Central Mutual), Frank Sztuk (Hanover Insurance), Ken Jones (Travelers) and James Egner (Farmers Insurance).
NYAAIF is an alliance of 104 insurance companies in New York. NYAAIF was created in 1999 to educate consumers about the cost of insurance fraud and help consumers avoid becoming victims.
The Internet of Things is the latest in a long line of technological developments to be embraced by the insurance industry, but is perhaps the most important. At its heart, the Internet of Things is the connection of everyday items to the internet. Almost anything you can think of can now be a “smart” device: coffee machines, washing machines, home thermostats, gym equipment, watches, the list goes on.
By connecting to the internet, these devices become smarter. For instance, when your coffee machine runs out of coffee it can send you a text to tell you so; when your washing machine is due a service it can email you the details, when you want to turn the heating on during an unexpectedly cold day, you can do so from your mobile phone before you get home. By wearing an internet-enabled health tracker device, so-called “wearable”, your doctor can track your health remotely. It is estimated that by 2020, 34 billion devices will be connected to the internet.
But there is another major use of the internet of things, and that is in the data that they produce. The coffee machine manufacturer now knows all about your coffee consumption, what type and flavour you like the best, and can tailor its offering to you. Your doctor can see when your blood pressure is getting dangerously high, and can intervene.
How is this relevant to insurance? The insurance industry has always been about data. Specifically, collecting data in order to calculate an accurate risk premium. The internet of things allows insurance companies to collect vast amounts of data, making the most of increasingly sophisticated computer power to help them in their calculations, and its transforming the way they do business.
The devices transforming the industry
Traditionally, calculating a car insurance premium relied upon up-to-date information about the type of car the customer travels in, his or her lifestyle, including their geographical location, and the nature of their business. That information can now be calculated quickly thanks to sophisticated algorithms, and customers get a near instant quote once they have handed these details over.
Now there is a new level of data available. Insurers are offering black box-style monitoring systems, that, when fitted to the car, gather a history of speed, distance, turning and braking patterns, time of day and much more. These so-called “telematics” allow the insurance company to offer “usage-based” insurance, in other words, cheaper policies for those that drive more carefully, and vice versa.
Similarly, in the health insurance market, wearable technology such as Fitbit can send data on the lifestyles of their wearers back to the insurance company. Consequently, a customer’s health risks can be determined more accurately, giving policyholders the power to adjust their premiums by adopting healthier habits.
It’s the same case in the home. Insurers offer discounts to policyholders who opt to use smart home technology, such as carbon monoxide and smoke detectors. These devices can provide predictive alerts on potentially dangerous conditions in the near future, thus helping to minimise the event of a claim.
Increasingly, these devices don’t just provide a more personalised insurance product but a claims model built around prevention rather than reaction.
As more and more information gets shared over wireless connections, so the issue of cybersecurity becomes more prevalent. Protecting consumer’s data is of the utmost importance. But this also represents another opportunity for the insurance industry, because the demand for cyber insurance has grown considerably in recent years. Last year, the insurance industry took in $2.5 billion (around £1.9 billion) in premiums on policies to protect companies from losses resulting from hacks. That was up from around $2 billion (around £1.5 billion) a year before, and less than $1 billion (around £750 million) two years before that.
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