Can a PPO plan be combined with an HSA or FSA?

Some PPO plans are compatible with Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), which allow members to set aside pre-tax money for medical expenses. However, PPOs with low deductibles may not qualify for an HSA. Reviewing plan eligibility requirements is essential before setting up an account.

How does the loss ratio affect the insurer’s profitability?

The loss ratio directly affects an insurer’s profitability because high claims payments relative to premiums result in a loss. If the loss ratio exceeds 100%, the insurer is losing money on the policies written, leading to financial instability if not corrected.

What is an example of adverse selection in health insurance?

A person with chronic health issues is more likely to buy health insurance, while healthier individuals may opt out, leading to a risk imbalance in the insured pool.

Can TPAs handle non-health insurance claims?

Yes, TPAs can manage claims for various types of insurance, including travel, motor, and liability insurance. However, they are most commonly associated with health insurance. In non-health sectors, TPAs assist in claim processing, fraud detection, and compliance for different insurance products.

What does the term “General Average” mean in Freight Marine Insurance?

General Average refers to a situation where a ship or its cargo is intentionally sacrificed (e.g., jettisoned) to save the vessel or the remaining cargo in an emergency. Freight Marine Insurance may cover the owner's portion of loss or damage under this principle, spreading the loss among all parties.

What happens if I only have liability insurance and my car gets damaged?

Liability insurance does not cover your car’s repairs; you would need collision or comprehensive coverage for your own vehicle.

How do I file a claim under replacement cost coverage?

After a loss, policyholders should document damage, file a claim with their insurer, and provide receipts or estimates for replacements. Some policies initially reimburse based on actual cash value, with the remaining balance paid after proof of replacement is provided. Check policy terms for details.

Does comprehensive coverage protect against theft and vandalism?

Yes, comprehensive policies cover theft, attempted theft, and vandalism-related damages, including stolen parts, broken windows, and keying damage, subject to policy terms and conditions.