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April 2024

TDI Seeks Input on Draft Updates to Rules for the Texas APCD

April 18, 2024 The Texas Department of Insurance (TDI) is seeking input on updates to the rules for the Texas All-Payor Claims Database (APCD). TDI is seeking input on the informal draft rules updates for the Texas APCD.

 

The APCD was created by House Bill 2090, passed during the regular session of the 87th Texas Legislature to provide for the establishment of a statewide all payor claims database and health care cost disclosures by health benefit plan issuers and third-party administrators. HB 2090 also established disclosure requirements around health care costs to enrollees, including via an internet-based self-service tool and a physical copy of requested information.

If adopted, the informal working draft would update the Texas APCD Common Data Layout (CDL), make technical clarifications, require more timely data submissions from carriers after their claim adjudication is complete, and implement changes to the advisory committee consistent with House Bill 3414, 88th Legislature, 2023. 

The comment period for the informal working draft rule updates will close at 5 p.m. Central time, on May 16, 2024. Comments must be submitted to Rachel Bowden in TDI's Life and Health Division at LHLComments@tdi.texas.gov

 

The informal draft amended rules can be viewed here

The informal working draft Common Data Layout Version 3.01 can be viewed here

Triple-I: Insurance Economic Drivers Outperform Overall US GDP

April 17, 2024 The Claims Journal reported that the economic drivers of the U.S. property/casualty insurance industry are growing faster than the nation’s Gross Domestic Product and are expected to gain further momentum in the event of Federal Reserve monetary rate cuts, according to the Insurance Information Institute’s latest Insurance Economics Outlook.

“We’ve been forecasting that P/C underwriting growth would catch up on overall GDP and it has,” said Michel Léonard, chief economist and data scientist, Triple-I. “Triple-I forecasts P&C underlying growth to increase to 3.4% in 2024, 1.2% above the Fed’s GDP forecast of 2.2%. It will likely take at least another year for this economic rising tide to lift the P/C industry’s overall growth and performance,” added Léonard.

P&C underlying growth is expected to continue outperforming overall GDP growth into 2025 and 2026, he said in the report.

 

Fitch: U.S. Cyber Insurers Saw Strong Profits, Slowdown in Premium Growth in 2023

April 17, 2024 The Insurance Journal reported that according to a Fitch Ratings analysis, the U.S. cyber insurance line generated strong direct underwriting profits for the second straight year in 2023, but written premium volume has stalled amid renewed pricing pressure.

For standalone cyber coverage, the direct incurred loss and defense and cost containment (DCC) expenses ratio held relatively steady at 44% in 2023 versus 43% in 2022, Fitch found in a first look at data compiled from cyber insurance supplemental filings in statutory financial statements.

 

The ratings firm said insurer are “requiring that customers maintain proper cyber hygiene and risk management practices before agreeing to insure them.”

 

Additionally, insurers are tightening policy language to more strictly define terms, with more frequent insertion of sub-limits and exclusions., the report noted.

Read the rest of the news story here

 

U.S. Cyber Insurance Market to Harden in 2024: Survey

April 16, 2024 Risk & Insurance reported that the U.S. cyber insurance market is likely to experience hardening conditions in 2024, with higher underwriting standards and increasing rates due to the escalating threat of cyberattacks, according to a survey by cyber risk management provider KYND Ltd.

 

The survey, conducted in collaboration with Intelligent Insurer, involved over 100 brokers and insurers who shared their insights on U.S. cyber insurance trends.

The full survey results can be accessed on the KYND website.

DWC Adopts Accident Prevention Services Rules Changes

April 16, 2024 The Commissioner of Workers' Compensation has adopted amendments to Rules 166.1, 166.2, 166.3, and 166.5, concerning certain submission requirements for insurance companies about their accident prevention services, that were proposed by Texas Department of Insurance Division of Workers' Compensation staff. The amended rules are effective July 1, 2024. 

 

The rule amendments eliminate overly burdensome reporting requirements that companies must adhere to in order to demonstrate the sufficiency of their accident prevention services to DWC. The rule amendments also bring the administrative rule requirements more in line with the statutory requirements while updating citations, removes obsolete references, and applies plain language and agency style editorial changes.

 

The rules adoption order and amended rules can be found here.  

Texas Among States Facing New Fire Risks: Weather Watch

April 15, 2024 Insurance Journal reported that more than 2.5 million people in the US face critical fire weather conditions on Monday as dry winds sweep parts of New Mexico, Colorado, Kansas, Oklahoma and Texas, which had the largest fire in the state’s history earlier this year.

The Texas Tribune reported that the largest wildfire Texas’ history burned more than 1,500 square miles of rangeland in the Panhandle northeast of Amarillo in February and March 2024. Wildfires have become more frequent and severe in the Western United States because of warmer and drier conditions, factors that worsen because of climate change.

The Texas Tribune also reported that Texas’ top emergency manager told a panel of lawmakers Tuesday that the state should establish its own firefighting aircraft division after a series of wildfires, including the largest in state history, scorched the Panhandle region earlier this year.

 

The late firefighting air support was one of the first topics discussed Tuesday. For days, ranchers and residents could only look up to the sky and wonder where firefighting aircraft were as they watched the historic Smokehouse Creek fire rip across their land. Dozens of families, many in nearby Hemphill County, were displaced after their homes and ranches were destroyed and their livestock killed.

Without its own fleet of aircraft to fight fires, Texas relies on a series of contractors. Many of the planes were being serviced at the time the fires started in late February.

Employers Focusing on Cost Reduction Amid Rising Health Care Costs

April 15, 2024 Risk Insurance reported that the 2024 Lockton National Benefits Survey reveals a shift in employer benefits strategies, with cost reduction now rivaling talent attraction and retention amid rising health care costs.

 

Reducing employee benefit costs is an increasing priority for employers facing rising health care costs, in addition to continued reliance on benefits to attract and retain employees, according to the 2024 Lockton National Benefits Survey.

 

The survey, which gathered responses from 1,611 employers across the U.S., showed a closing gap between those who cite attracting and retaining talent as the most important factor in benefit decisions (33%) and those who said reducing costs 29%). While talent attraction and retention topped the list in 2022 and 2023, by 2024, reducing costs was almost equally important, Lockton found.

 

With health care costs projected to rise by an average of 6 to 8 percent next year under current market conditions, employers are adopting more conservative strategies to manage costs.

Digital and virtual solutions are gaining traction, especially among larger groups, with telemedicine being offered by 96% of all respondents, per the survey. In addition, 40% are offering telemedicine for mental/behavioral health care.

To gain further insights into the 2024 survey findings, you can access the executive summary here.

La Niña is on Track to Amplify Hurricane Season

April 14, 2024 Axios has reported that the tropical Pacific Ocean continues to trend toward a La Niña phase, coming out of one of the strongest El Niño events on record since 1950.

 

Why it matters: This has potentially huge implications, since depending on the timing, a switch could bring ideal conditions for Atlantic hurricanes.

The latest federal outlook for the larger climate cycle known as the El Niño-Southern Oscillation, or ENSO, calls for the currently fading El Niño to give way to neutral (sometimes called, "La Nada") conditions this summer.

 

This is likely to be followed by a 60% chance of the onset of a La Niña during the June through August timeframe, and the odds increase from there going into the fall and early winter.

The bottom line: There's a lot to watch, and coastal residents have many reasons to prepare for this upcoming hurricane season.

Read the rest of the story here

USAA to Lay Off 220 Employees

April 12, 2024 Insurance Journal reported that USAA is laying off 220 employees in an effort to reprioritize positions amid changing business needs, the San Antonio-based insurer announced this week.

This is the latest round of layoffs at USAA, which let go of nearly 1,000 employees in 2023 after reporting its first annual financial loss in nearly a century.

 

USAA did not specify which departments were impacted by the layoffs. The insurer did not share whether the layoffs were at the local or national level.

Read the rest of the story here

DWC Accepting Comments on Routine Rule Review

April 8, 2024 DWC is in the process of reviewing all sections in the following rule chapters in Title 28, Texas Administrative Code: Chapter 120 (Compensation Procedure--Employers); Chapter 122 (Compensation Procedure--Claimants); and Chapter 124 (Insurance Carriers: Notices, Payments. 

DWC is accepting public comments on whether the reasons for initially adopting these rules continue to exist, and whether these rules should be repealed, readopted, or readopted with amendments in accordance with Texas Government Code §2001.039. 

Additional information about the rule review and how to comment on the continuing need for or to propose edits to the rules can be found here

 

Earliest Look at Hurricane Season is Calling for More Storms than Ever Predicted

April 4, 2024 According to CNN the 2024 Atlantic hurricane season isn’t here yet, but is already shaping up to be one for the books, with more hurricanes and named storms predicted in a pre-season forecast from Colorado State University than ever before.

 

This June through November could see 23 named storms in all, including 11 hurricanes and five Category 3 or higher “major” hurricanes, according to the university’s Atlantic hurricane season forecast, released Thursday.

 

The overarching impacts of climate change are also, as ever, at play. 

 

Planet-warming pollution is driving global and ocean temperature rise, and the world’s oceans have now experienced an entire year of unprecedented heat thanks to this human-caused warming and El Niño.

 

And as the planet warms, the impacts of hurricanes are becoming more dangerous.

 

Global sea levels are also on the rise, driven mainly by the rapid melting of ice sheets and glaciers. A rise of only a couple of inches can make a dramatic difference in how far inland a hurricane’s storm surge can travel.

Read the rest of the story here

TDI Adopts Amendments to Consumer Rights Notices for Homeowners and Personal Auto Insurance

April 4, 2024 In response to a petition by the Office of Public Insurance Counsel (OPIC), the Texas Department of Insurance (TDI) adopts an updated personal automobile insurance consumer bill of rights and homeowners insurance consumer bill of rights.

The amendments reflect statutory changes to consumer rights related to personal automobile insurance made by Senate Bill 1602 (2021), House Bill 2065 (2023), and House Bill 1900 (2023), and statutory changes to consumer rights related to homeowners' insurance made by House Bill 1706 (2023) and House Bill 1900 (2023).

View the adoption order (PDF).

For other dates and documents related to this action, visit TDI's Proposed and Adopted Rules for 2023 webpage.

TDI Doesn’t Set Your insurance Premiums

April 1, 2024 Consumers often tell the Texas Department of Insurance (TDI) that their insurance company or agent told them that their premium went up because the state made them raise rates. TDI doesn’t set the homeowners or auto insurance rates that your insurance company charges.

Insurance companies can change their rates and premium formulas by sending them to TDI. This is called a “rate filing.” Companies can use the new rates as soon as they send them to TDI.

Companies are required to provide an analysis that supports the rate changes they file. TDI staff review the analysis and ask for more information, if needed, to evaluate whether the rate changes are supported and follow state law.

By law, rates must be adequate; not be excessive; be based on sound actuarial principles; be reasonably related to all costs; and not be based on the insured’s race, creed, color, ethnicity, or national origin.

If your auto or home insurance bill is rising, ask your company to explain the increase and if you’re getting all available discounts.

You might want to shop for a better deal.

You can start your search at HelpInsure.com to get sample estimates. Then call companies to get price quotes.

You might want to call an independent insurance agent. They can help make sure you’re comparing the same type and amount of coverage.

Have a question about insurance? Call the Texas Department of Insurance at 800-252-3439 or visit  www.tdi.texas.gov.

March 2024

Former Army Maj. Gen. John B. Richardson IV Joins USAA To Lead Military Affairs

Two-star general and decorated combat veteran to bring forward-looking vision in continued service to military members and their families.

March 28, 2024 USAA has welcomed retired Army Maj. Gen. John B. Richardson IV as senior vice president and head of the company’s Military Affairs team. Johnny retired from the Army after a distinguished 33-year military career and brings a wealth of experience, a fervent passion for caring for military families and a forward-thinking approach to leadership. His family has had continuous membership in USAA for five generations and he has been a member himself for 36 years.

“Johnny has dedicated his life in service to the military community and we are honored to leverage his experiences as USAA continues to evolve our support and advocacy of our military community and their families,” said Ameesh Vakharia, executive vice president and chief strategy and brand officer. “We are incredibly pleased to have him join our team and bring his forward-thinking, adaptive leadership to our organization.”

Johnny culminated his career as the Commanding General of the First Cavalry Division stationed in Fort Cavazos, Texas. After graduating from the U.S. Military Academy at West Point, he commanded at every level as an armored cavalryman from tank platoon to armored division. Johnny served four combat tours in Iraq and one in Afghanistan.

A highly decorated officer, his awards include the Distinguished Service Medal, Defense Superior Service Medal with Combat device, the Legion of Merit with Combat device, the Bronze Star Medal for Valor and the Purple Heart. He was also awarded the French National Order of Merit and French National Defense Medal-Gold.

In his role at USAA, Johnny will oversee the Military Affairs team’s strategic direction and contribute to and influence the company’s growth and operations. Additionally, his team of passionate and dedicated veterans stationed across the U.S. that have nearly 1,400 years of combined military service, will lead purposeful outreach and relationship building throughout the military community to help enable USAA deliver exceptional services to current and future USAA members. 

“There’s no better leader to help us understand and continue to be at the forefront of serving our ever-evolving military community and members,” added Vakharia.

DWC Requests Comments on Dispute Resolution Rule Changes

March 28, 2024 The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is accepting public comments on a proposed rule amending 28 Texas Administrative Code (TAC) Chapter 147 concerning dispute resolution through agreements and settlements. 

The rulemaking will amend 28 TAC Sections 147.4, 147.5, 147.7, 147.10, and 147.11; repeal 28 TAC Sections 147.1, 147.2, 147.3, 147.6, 147.8, and 147.9; and add new Section 147.1.  Chapter 147 implements Texas Labor Code Sections 401.011, 408.005, 410.029, 410.030, and 410.258.

 

The amendments will:  

• Condense some sections into others, so the rule is more organized and easier to navigate.

• Remove some sections and subsections that are outdated and unnecessary.

• Remove references to penalties specific to certain violations of agreements and settlements because       

   Labor Code Chapter 415 and 28 TAC Chapter 180 address these penalties.

• Update citations, remove obsolete references, and make plain language updates and agency style

   editorial changes.  

 

These amendments will streamline the agreements and settlements process and remove unnecessary work for DWC staff.  

The proposed rule will be published in the April 5, 2024, issue of the Texas Register and is available at pr147dispute0424.pdf (texas.gov)

AI’s Dark Side: The Growing Menace of Cyberattacks

 

March 14, 2024 Risk & Insurance published an article by Richard DePiero, Executive Vice President and Head of Sompo Pro, U.S., which provides solutions for Cyber, Technology, MPL, A&E, MPL and Lawyers Indemnity, which reported on the growing menace of cyberattacks.

DePiero reported that Artificial Intelligence (AI) and its capabilities have captured the attention of cybercriminals as well. "As 2024 gets underway, we expect to see AI further weaponized by bad actors as a force multiplier to broaden attack vectors, resulting in increased social engineering attacks across the board."

DePiero also reported that with the advent of GenAI, bad actors are now able to leverage AI to launch and support hundreds of attacks simultaneously, resulting in a higher “close rate” for their efforts. This weaponization of AI has the potential to greatly broaden these cybercriminals’ attack vector.

"As a result of the latest AI-inspired risk trends, underwriters and brokers now need to ask more specific questions about training and validation to ensure that insureds are in the best possible position to protect themselves against threat actors’ latest tactics for leveraging AI," said DePiero. "Reputable cyber insurers will have multiple experienced cyber breach response partners on retainer which can be deployed to mitigate an attack and get an organization back up and running. Whether it’s a law firm, a forensic investigation firm, a public relations firm or a technology restoration firm, cyber insurers have experience managing these events and will help navigate an organization through one of their worst-case scenarios as efficiently as possible."

Read the rest of the news story here

DWC Proposes Rule on Medical Billing Complaints

March 12, 2024  The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is accepting public comments on a proposed rule amending 28 Texas Administrative Code §180.2 to ensure that no health care provider or agent can use DWC’s complaint process to bypass the medical fee dispute resolution filing deadline in 28 TAC §133.307(c). The restriction does not apply to a health care provider submitting a complaint under Insurance Code Chapter 1305.  

 

Under the MFDR process, health care providers have one year after the date of service to bring a fee dispute, unless an exception applies. However, some health care providers and their agents have tried to use DWC’s complaint process to collect disputed fees when they fail to file a fee dispute before the MFDR deadline. To address this problem, the proposed amendments clarify that a health care provider cannot submit a complaint about a medical billing issue if the date of service for the medical billing issue was more than 12 months before the date of the complaint, unless an MFDR deadline exception applies. The restriction does not apply to a health care provider submitting a complaint under Insurance Code Chapter 1305.  

The deadline to submit comments is 5 p.m., Central time, on April 22, 2024. 

DWC has scheduled a public hearing for 11 a.m., Central time, on 4/16/24 to receive testimony on the proposed rule amendment. 

The proposed rule amendment can be viewed here

Workers’ Compensation Claims in a Post-Pandemic Era

March 11, 2024 Risk & Insurance published an article by Liz Wiles, an attorney in the workers’ compensation practice at Turner Padget in Charleston, South Carolina. In her article, Wiles noted that twenty-eight states and Puerto Rico have taken steps to ensure workers’ compensation coverage includes COVID-19 as a compensable illness. She reported that eleven states have created a presumption of coverage for varying types of employees and fields of work while some states limit coverage to first responders, health care workers and essential employees. 

Wiles also discussed Long COVID and said it is an official diagnosis recognized by the Centers for Disease Control and Prevention. 

The article is worth taking some time to read. The article is available here

TDI Provides Insurance Claims Tips for Texas Wildfires

 

March 4, 2024 The Texas Department of Insurance (TDI) has provided tips for policy holders who file insurance claims related to Texas wildfires. The tips are part of TDI's ongoing effort to educate Texas insurance policy holders.  

 

Texas recently dealt with the Smokehouse Creek fire which was a record-breaking wildfire affecting the northeastern Texas panhandle and western Oklahoma that started on February 26, 2024. The fire affected numerous communities in Hemphill and Roberts counties, including the town of Canadian. As of March 16, 2024, the fire had burned approximately 1,058,482 acres (1,654 sq mi; 428,352 ha) before it was successfully contained, making it the largest wildfire on record in Texas's history (going back to 1988) as well as the largest wildfire in the United States during 2024.

 

Texas faces threats from wildfires each year. Home and property owners and business owners who live or whose business is located in areas where wildfires are common need to check with their insurance agent to make sure that they have insurance coverage that will cover losses from a wildfire. 

 

TDI recommended that residents whose property was damaged by the Texas wildfires should contact their insurance company to file a claim as soon as possible after sustaining fire damage.

TDI also provided tips on how to avoid fraud committed by contractors. The National Insurance Crime Bureau (NICB) has reported that contractor fraud is a problem after natural disasters. “After many natural disasters and catastrophic weather events, contractor fraud surges as dishonest contractors target and exploit homeowners, as well as insurance providers, which result in higher insurance costs for everyone,” said NICB President and CEO David J. Glawe. “Recovering and rebuilding from a natural disaster can be an overwhelming task and it is important to make sure homeowners and business owners are not victimized twice.”

View NICB's tips on how to avoid contractor fraud after a major loss on their website

TDI's tips are available here

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