what is an assignment of benefits of a health policy

Construction Accidents

Practice Areas

Assignment of benefits: what you need to know.

August 17, 2022
Steven Schwartzapfel

Insurance can be useful, but dealing with the back-and-forth between insurance companies and contractors, medical specialists, and others can be a time-consuming and ultimately unpleasant experience. You want your medical bills to be paid without having to act as a middleman between your healthcare provider and your insurer.

However, there’s a way you can streamline this process. With an assignment of benefits, you can designate your healthcare provider or any other insurance payout recipient as the go-to party for insurance claims. While this can be convenient, there are certain risks to keep in mind as well.

Below, we’ll explore what an assignment of insurance benefits is (as well as other forms of remediation), how it works, and when you should employ it. For more information, or to learn whether you may have a claim against an insurer, contact Schwartzapfel Lawyers now at 1-516-342-2200 .

What Is an Assignment of Benefits?

An assignment of benefits (AOB) is a legal process through which an insured individual or party signs paperwork that designates another party like a contractor, company, or healthcare provider as their insurance claimant .

Suppose you’re injured in a car accident and need to file a claim with your health insurance company for medical bills and related costs. However, you also need plenty of time to recover. The thought of constantly negotiating between your insurance company, your healthcare provider, and anyone else seems draining and unwelcome.

With an assignment of benefits, you can designate your healthcare provider as your insurance claimant. Then, your healthcare provider can request insurance payouts from your healthcare insurance provider directly.

Through this system, the health insurance provider directly pays your physician or hospital rather than paying you. This means you don’t have to pay your healthcare provider. It’s a streamlined, straightforward way to make sure insurance money gets where it needs to go. It also saves you time and prevents you from having to think about insurance payments unless absolutely necessary.

What Does an Assignment of Benefits Mean?

An AOB means that you designate another party as your insurance claimant. In the above example, that’s your healthcare provider, which could be a physician, hospital, or other organization.

With the assignment of insurance coverage, that healthcare provider can then make a claim for insurance payments directly to your insurance company. The insurance company then pays your healthcare provider directly, and you’re removed as the middleman.

As a bonus, this system sometimes cuts down on your overall costs by eliminating certain service fees. Since there’s only one transaction — the transaction between your healthcare provider and your health insurer — there’s only one set of service fees to contend with. You don’t have to deal with two sets of service fees from first receiving money from your insurance provider, then sending that money to your healthcare provider.

Ultimately, the point of an assignment of benefits is to make things easier for you, your insurer, and anyone else involved in the process.

What Types of Insurance Qualify for an Assignment of Benefits?

Most types of commonly held insurance can work with an assignment of benefits. These insurance types include car insurance, healthcare insurance, homeowners insurance, property insurance, and more.

Note that not all insurance companies allow you to use an assignment of benefits. For an assignment of benefits to work, the potential insurance claimant and the insurance company in question must each sign the paperwork and agree to the arrangement. This prevents fraud (to some extent) and ensures that every party goes into the arrangement with clear expectations.

If your insurance company does not accept assignments of benefits, you’ll have to take care of insurance payments the traditional way. There are many reasons why an insurance company may not accept an assignment of benefits.

To speak with a Schwartzapfel Lawyers expert about this directly, call 1-516-342-2200 for a free consultation today. It will be our privilege to assist you with all your legal questions, needs, and recovery efforts.

Who Uses Assignments of Benefits?

Many providers, services, and contractors use assignments of benefits. It’s often in their interests to accept an assignment of benefits since they can get paid for their work more quickly and make critical decisions without having to consult the insurance policyholder first.

Imagine a circumstance in which a homeowner wants a contractor to add a new room to their property. The contractor knows that the scale of the project could increase or shrink depending on the specifics of the job, the weather, and other factors.

If the homeowner uses an assignment of benefits to give the contractor rights to make insurance claims for the project, that contractor can then:

Bill the insurer directly for their work. This is beneficial since it ensures that the contractor’s employees get paid promptly and they can purchase the supplies they need.
Make important decisions to ensure that the project completes on time. For example, a contract can authorize another insurance claim for extra supplies without consulting with the homeowner beforehand, saving time and potentially money in the process.

Practically any company or organization that receives payments from insurance companies may choose to take advantage of an assignment of benefits with you. Example companies and providers include:

Ambulance services
Drug and biological companies
Lab diagnostic services
Hospitals and medical centers like clinics
Certified medical professionals such as nurse anesthetists, nurse midwives, clinical psychologists, and others
Ambulatory surgical center services
Permanent repair and improvement contractors like carpenters, plumbers, roofers, restoration companies, and others
Auto repair shops and mechanic organizations

Advantages of Using an Assignment of Benefits

An assignment of benefits can be an advantageous contract to employ, especially if you believe that you’ll need to pay a contractor, healthcare provider, and/or other organization via insurance payouts regularly for the near future.

These benefits include but are not limited to:

Save time for yourself. Again, imagine a circumstance in which you are hospitalized and have to pay your healthcare provider through your health insurance payouts. If you use an assignment of benefits, you don’t have to make the payments personally or oversee the insurance payouts. Instead, you can focus on resting and recovering.
Possibly save yourself money in the long run. As noted above, an assignment of benefits can help you circumvent some service fees by limiting the number of transactions or money transfers required to ensure everyone is paid on time.
Increased peace of mind. Many people don’t like having to constantly think about insurance payouts, contacting their insurance company, or negotiating between insurers and contractors/providers. With an assignment of benefits, you can let your insurance company and a contractor or provider work things out between them, though this can lead to applications later down the road.

Because of these benefits, many recovering individuals, car accident victims, homeowners, and others utilize AOB agreements from time to time.

Risks of Using an Assignment of Benefits

Worth mentioning, too, is that an assignment of benefits does carry certain risks you should be aware of before presenting this contract to your insurance company or a contractor or provider. Remember, an assignment of benefits is a legally binding contract unless it is otherwise dissolved (which is technically possible).

The risks of using an assignment of benefits include:

You give billing control to your healthcare provider, contractor, or another party. This allows them to bill your insurance company for charges that you might not find necessary. For example, a home improvement contractor might bill a homeowner’s insurance company for an unnecessary material or improvement. The homeowner only finds out after the fact and after all the money has been paid, resulting in a higher premium for their insurance policy or more fees than they expected.
You allow a contractor or service provider to sue your insurance company if the insurer does not want to pay for a certain service or bill. This can happen if the insurance company and contractor or service provider disagree on one or another billable item. Then, you may be dragged into litigation or arbitration you did not agree to in the first place.
You may lose track of what your insurance company pays for various services . As such, you could be surprised if your health insurance or other insurance premiums and deductibles increase suddenly.

Given these disadvantages, it’s still wise to keep track of insurance payments even if you choose to use an assignment of benefits. For example, you might request that your insurance company keep you up to date on all billable items a contractor or service provider charges for the duration of your treatment or project.

For more on this and related topic, call Schwartzapfel Lawyers now at 1-516-342-2200 .

How To Make Sure an Assignment of Benefits Is Safe

Even though AOBs do carry potential disadvantages, there are ways to make sure that your chosen contract is safe and legally airtight. First, it’s generally a wise idea to contact knowledgeable legal representatives so they can look over your paperwork and ensure that any given assignment of benefits doesn’t contain any loopholes that could be exploited by a service provider or contractor.

The right lawyer can also make sure that an assignment of benefits is legally binding for your insurance provider. To make sure an assignment of benefits is safe, you should perform the following steps:

Always check for reviews and references before hiring a contractor or service provider, especially if you plan to use an AOB ahead of time. For example, you should stay away if a contractor has a reputation for abusing insurance claims.
Always get several estimates for work, repairs, or bills. Then, you can compare the estimated bills and see whether one contractor or service provider is likely to be honest about their charges.
Get all estimates, payment schedules, and project schedules in writing so you can refer back to them later on.
Don’t let a service provider or contractor pressure you into hiring them for any reason . If they seem overly excited about getting started, they could be trying to rush things along or get you to sign an AOB so that they can start issuing charges to your insurance company.
Read your assignment of benefits contract fully. Make sure that there aren’t any legal loopholes that a contractor or service provider can take advantage of. An experienced lawyer can help you draft and sign a beneficial AOB contract.

Can You Sue a Party for Abusing an Assignment of Benefits?

Sometimes. If you believe your assignment of benefits is being abused by a contractor or service provider, you may be able to sue them for breaching your contract or even AOB fraud. However, successfully suing for insurance fraud of any kind is often difficult.

Also, you should remember that a contractor or service provider can sue your insurance company if the insurance carrier decides not to pay them. For example, if your insurer decides that a service provider is engaging in billing scams and no longer wishes to make payouts, this could put you in legal hot water.

If you’re not sure whether you have grounds for a lawsuit, contact Schwartzapfel Lawyers today at 1-516-342-2200 . At no charge, we’ll examine the details of your case and provide you with a consultation. Don’t wait. Call now!

Assignment of Benefits FAQs

Which states allow assignments of benefits.

Every state allows you to offer an assignment of benefits to a contractor and/or insurance company. That means, whether you live in New York, Florida, Arizona, California, or some other state, you can rest assured that AOBs are viable tools to streamline the insurance payout process.

Can You Revoke an Assignment of Benefits?

Yes. There may come a time when you need to revoke an assignment of benefits. This may be because you no longer want the provider or contractor to have control over your insurance claims, or because you want to switch providers/contractors.

To revoke an assignment of benefits agreement, you must notify the assignee (i.e., the new insurance claimant). A legally solid assignment of benefits contract should also include terms and rules for this decision. Once more, it’s usually a wise idea to have an experienced lawyer look over an assignment of benefits contract to make sure you don’t miss these by accident.

Contact Schwartzapfel Lawyers Today

An assignment of benefits is an invaluable tool when you need to streamline the insurance claims process. For example, you can designate your healthcare provider as your primary claimant with an assignment of benefits, allowing them to charge your insurance company directly for healthcare costs.

However, there are also risks associated with an assignment of benefits. If you believe a contractor or healthcare provider is charging your insurance company unfairly, you may need legal representatives. Schwartzapfel Lawyers can help.

As knowledgeable New York attorneys who are well-versed in New York insurance law, we’re ready to assist with any and all litigation needs. For a free case evaluation and consultation, contact Schwartzapfel Lawyers today at 1-516-342-2200 !

Schwartzapfel Lawyers, P.C. | Fighting For You™™

What Is an Insurance Claim? | Experian

What is assignment of benefits, and how does it impact insurers? | Insurance Business Mag

Florida Insurance Ruling Sets Precedent for Assignment of Benefits | Law.com

What is attorney-client privilege.

Attorney-client privilege is a cornerstone of the American legal system. This essential protection guarantees that you can speak openly and

What Is A Letter Of Protection In A Personal Injury Case?

Injured in an accident and worried about medical bills? A Letter of Protection (LOP) could be the solution you’re looking

Do I Need Uninsured Motorist Coverage?

A car crash can be a painful, distressing, and extremely costly experience. However, auto insurance can make it easier for

We'll Fight For You

Schwartzapfel® lawyers has a 99% client satisfaction rate, quick links.

News & Events
Verdicts & Settlements
Video Gallery
Wrongful Death
Vehicle Accidents
Slip & Fall
Medical Malpractice
Workers' Compensation
Personal Injuries
Product Liability
Garden City

What is an assignment of benefits?

Jim Probasco is an expert in the areas of personal income, saving and investing, banking, home buying, insurance, and more. A Dayton, Ohio-based writer, Jim has written for radio and television, and authored books for parents in arts education opportunities for their children.

The last time you sought medical care, you likely made an appointment with your provider, got the treatment you needed, paid your copay or deductible, and that was it. No paperwork, no waiting to be reimbursed; your doctor received payment from your insurance company and you both went on with your lives.

This is how most people receive health care in the U.S. This system, known as assignment of benefits or AOB, is now being used with other types of insurance, including auto and homeowners coverage .

What is an assignment of benefits?

An AOB is a legal agreement that allows your insurance company to directly pay a third party for services performed on your behalf. In the case of health care, it could be your doctor or another medical professional providing care. With a homeowners, renters, or auto insurance claim, the third party could be a contractor, auto repair shop, or other facility.

Assignment of benefits is legal, thanks to a concept known as freedom of contract, which says two parties may make a private agreement, including the forfeiture of certain rights, and the government may not interfere. There are exceptions, making freedom of contract something less than an absolute right. For example, the contract may not violate the law or contain unfair terms.

Not all doctors or contractors utilize AOBs. Therefore, it’s a good idea to make sure the doctor or service provider and you are on the same page when it comes to AOBs before treatment or work begins.

How an AOB works

The function of an AOB agreement varies depending on the type of insurance policy involved, the healthcare provider, contractor, or service provider, and increasingly, state law. Although an AOB is normal in health insurance, other applications of assignment of benefits have now included the auto and homeowners insurance industry.

Because AOBs are common in health care, you probably don’t think twice about signing a piece of paper that says “assignment of benefits” across the top. But once you sign it, you’re likely turning over your right to deal with your insurance company regarding service from that provider. Why would you do this?

According to Dr. David Berg of Redirect Health , the reason is simple: “Without an AOB in place, the patient themselves would be responsible for paying the cost of their service and would then file a claim with their insurance company for reimbursement.”

With homeowners or auto insurance, the same rules apply. Once you sign the AOB, you are effectively out of the picture. The contractor who reroofs your house or the mechanic who rebuilds your engine works with your insurance company by filing a claim on your behalf and receiving their money without your help or involvement.

“Each state has its own rules, regulations, and permissions regarding AOBs,” says Gregg Barrett, founder and CEO of WaterStreet , a cloud-based P&C insurance administration platform. “Some states require a strict written breakdown of work to be done, while others allow assignment of only parts of claims.”

Within the guidelines of the specific insurance rules for AOBs in your state, the general steps include:

You and your contractor draw up an AOB clause as part of the contract.
The contract stipulates the exact work that will be completed and all necessary details.
The contractor sends the completed AOB to the insurance company where an adjuster reviews, asks questions, and resolves any discrepancies.
The contractor’s name (or that of an agreed-upon party) is listed to go on the settlement check.

After work is complete and signed off, the insurer will issue the check and the claim will be considered settled.

The 10 best insurance companies for small businesses What is bond insurance, and how can it protect your business?

Example of an assignment of benefits

If you’re dealing with insurance, how would an AOB factor in? Let’s take an example. “Say you have a water leak in the house,” says Angel Conlin, chief insurance officer at Kin Insurance . “You call a home restoration company to stop the water flow, clean up the mess, and restore your home to its former glory. The restoration company may ask for an assignment of benefits so it can deal directly with the insurance company without your input.”

In this case, by eliminating the homeowner, whose interests are already represented by an experienced insurance adjustor, the AOB reduces redundancy, saves time and money, and allows the restoration process to proceed with much greater efficiency.

When would you need to use an assignment of benefits?

An AOB can simplify complicated and costly insurance transactions and allow you to turn these transactions over to trusted experts, thereby avoiding time-consuming negotiations.

An AOB also frees you from paying the entire bill upfront and seeking reimbursement from your insurance company after work has been completed or services rendered. Since you are not required to sign an assignment of benefits, failure to sign will result in you paying the entire medical bill and filing for reimbursement. The three most common uses of AOBs are with health insurance, car insurance, and homeowners insurance.

Assignment of benefits for health insurance

As discussed, AOBs in health insurance are commonplace. If you have health insurance, you’ve probably signed AOBs for years. Each provider (doctor) or practice requires a separate AOB. From your point of view, the big advantages of an AOB are that you receive medical care, your doctor and insurance company work out the details and, in the event of a disagreement, those two entities deal with each other.

Assignment of benefits for car owners

If your car is damaged in an accident and needs extensive repair, the benefits of an AOB can quickly add up. Not only will you have your automobile repaired with minimal upfront costs to you, inconvenience will be almost nonexistent. You drop your car off (or have it towed), wait to be called, told the repair is finished, and pick it up. Similar to a health care AOB, disagreements are worked out between the provider and insurer. You are usually not involved.

Assignment of benefits for homeowners

When your home or belongings are damaged or destroyed, your primary concern is to “return to normal.” You want to do this with the least amount of hassle. An AOB allows you to transfer your rights to a third party, usually a contractor, freeing you to deal with the crisis at hand.

When you sign an AOB, your contractor can begin immediately working on damage repair, shoring up against additional deterioration, and coordinating with various subcontractors without waiting for clearance or communication with you.

The fraud factor

No legal agreement, including an AOB, is free from the possibility of abuse or fraud. Built-in safeguards are essential to ensure the benefits you assign to a third party are as protected as possible.

In terms of what can and does go wrong, the answer is: plenty. According to the National Association of Mutual Insurance Companies (NAMICs), examples of AOB fraud include inflated invoices or charges for work that hasn’t been done. Another common tactic is to sue the insurance company, without the policyholder’s knowledge or consent, something that can ultimately result in the policyholder being stuck with the bill and higher insurance premiums due to losses experienced by the insurer.

State legislatures have tried to protect consumers from AOB fraud and some progress has been made. Florida, for example, passed legislation in 2019 that gives consumers the right to rescind a fraudulent contract and requires that AOB contracts include an itemized description of the work to be done. Other states, including North Dakota, Kansas, and Iowa have all signed NAMIC-backed legislation into law to protect consumers from AOB fraud.

The National Association of Insurance Commissioners (NAIC), offers advice for consumers to help avoid AOB fraud and abuse:

File a claim with your insurer before you hire a contractor. This ensures you know what repairs need to be made.
Don’t pay in full upfront. Legitimate contractors do not require it.
Get three estimates before selecting a contractor.
Get a full written contract and read it carefully before signing.
Don’t be pressured into signing an AOB. You are not required to sign an AOB.

Pros and cons of an assignment of benefits

The advantages and disadvantages of an AOB agreement depend largely on the amount and type of protection your state’s insurance laws provide.

An AOB frees you from paying for services and waiting for reimbursement from your insurer
Some people appreciate not needing to negotiate with their insurer
You are not required to sign an AOB.
Signing an AOB could make you the victim of a scam without knowing it until your insurer refuses to pay
An AOB doesn’t free you from the ultimate responsibility to pay for services rendered, which could drag you into expensive litigation if things go south
Any AOB you do sign is legally binding

The takeaway

An AOB, as the health insurance example shows, can simplify complicated and costly insurance transactions and help consumers avoid time-consuming negotiations. And it can save upfront costs while letting experts work out the details.

It can also introduce a nightmare scenario laced with fraud requiring years of costly litigation. Universal state-level legislation with safeguards is required to avoid the latter. Until that is in place, your best bet is to work closely with your insurer when signing an AOB. Look for suspicious or inflated charges when negotiating with contractors, providers, and other servicers.

Our ranking of the best jewelry insurance can help you insure your personal treasures.
Entrepreneurs need to check out this list of the best small business insurance companies .
Check out the best personal loans to help fund your next big purchase.
Small business owners should check out this ranking of the best business checking accounts .

Follow Fortune Recommends on Facebook and Twitter .

About the contributors

EDITORIAL DISCLOSURE : The advice, opinions, or rankings contained in this article are solely those of the Fortune Recommends ™ editorial team. This content has not been reviewed or endorsed by any of our affiliate partners or other third parties.

Caring ‣ Urgent ‣ Aggressive

Call For A Free Legal Consultation: (201) 261-1700
Physician Reimbursement
PIP / No-Fault Arbitration
Workers’ Compensation Recovery
Hospital Reimbursement
ERISA Litigation Claim Attorneys
Healthcare Arbitration
Bicycle Accident
Brain Injury
Bus Accident
Car Accident
Construction Accident
Hit and Run
Motorcycle Accident
Negligent Supervision
Nursing Home Negligence
Pedestrian Accident
Slip and Fall
Truck Accident
Train Accident
Wrongful Death
Workers Compensation
Business Disputes
Business Justice Attorneys
Employment Counseling and Litigation
Shareholder/Partner Issues
Shareholder Derivative Actions
Business Dissolutions
Business Transactions
Buying/Selling a Business
Corporate Entity Formation
Director and Officers Duties
Executive Compensation
Negotiating Vendor Agreements
Regulatory and Statutory Compliance
Age Discrimination
Disability Discrimination
Gender Identity Discrimination
Race Discrimination
Religious Discrimination
Sex Discrimination
Appellate Law
Child Custody
Child Custody College Expenses
Child Support
Divorce for Business Owners
Divorce Mediation
Domestic Violence
Prenuptial Agreements
Property Distribution
Understanding The Divorce Process
Auto Insurance/Property Damage
All-risks Property Insurance
Commercial General Liability (CGL) Insurance
Disability Insurance
Health Insurance
Insurance Agent/Broker Negligence
Life Insurance
Long-term Care Insurance
Marine/Boat Insurance
Wind & Flood Property Insurance
Commercial Purchase
Commercial Sales
Commercial Lease Agreement
First-Time Home Buyer
Lease Agreements
Real Estate Closing
Refinancing
Residential Purchases
Residential Sales
Title Review
Estate Planning
Estate Planning for Business Owners
Healthcare Directives
Powers of Attorney
Trust Drafting
Will Contest
Will Drafting
Sean Callagy Esq
The Callagy Law Team
Testimonials
Join Our Team
Message of Empathy
Business Law
Commercial Litigation
News & Events
Medical Revenue Recovery
Personal Injury
Free Legal Guides
Paramus, NJ Office
New York, NY Office
Phoenix, AZ Office
East Hanover, NJ Office

Call For A Free Legal Consultation

(201) 261 - 1700

Insurance claims , medical revenue recovery, what should an assignment of benefits form include.

An assignment of benefits form (AOB) is a crucial document in the healthcare world. It is an agreement by which a patient transfers the rights or benefits under their insurance policy to a third-party – in this case, the medical professional who provides services. This way, the medical provider can file a claim and collect insurance payments. In the context of personal injury protection coverage, an AOB is a critical step in the reimbursement process.

Personal injury protection coverage , or PIP, is designed to cover medical expenses and lost wages incurred after an auto accident, regardless of who is at fault. In New Jersey, drivers are required to carry PIP. Now, let’s say there’s an accident: the driver sees a medical provider for treatment, and the provider bills the patient’s carrier. There is nothing that requires that the insurance carrier to pay the provider.

This is why an assignment of benefits form is so important. It essentially removes the patient from the equation and puts the medical provider in their place as far as the insurance policy is concerned. This enables the provider to be paid directly. If you see PIP patients and want to be paid directly by the insurer (and avoid claim denials or complex legal situations later) you must get an AOB.

The AOB authorization creates a legal relationship between the provider and the insurance carrier. What should it include?

Correct Business Entity

Fill out your business name correctly: it seems simple, but this can be a stumbling block to reimbursement. If your business name is Dr. Smith’s Chiropractic Care Center, you cannot substitute Dr. Smith’s, Smith’s Chiropractic, etc. It must be Dr. Smith’s Chiropractic Care Center. If you have a FEIN number, use the name that is listed on your Health Care Financing Administration (HCFA) form.

“Irrevocable”

It is important that you include this term to indicate that the patient cannot later revoke the assignment of benefits. This tells the court that the AOB is the only document determining standing , or the ability to bring a lawsuit on related matters.

Another key term: the court sees benefits as payments. It does not necessarily give you the right to bring a lawsuit. Include language such as, “assigns the rights and benefits, including the right to bring suit…”

Benefit of Not Being Billed At This Time for Services

Essentially, this means that a provider gives up the right to collect payments at the time of service in exchange for the right to bring suit against the insurance company if they are not paid in full. Likewise, the patient gives up the right to bring suit, but they do not have to pay now. The wording will look like this: “In exchange for patient assigning the rights and benefits under their PIP insurance, Dr. Smith’s Chiropractic Care Center will allow patients to receive services without collecting payments at this time.”

Patient Signature

Yes, it’s basic, but make sure the assignment of benefits form is signed and dated by the patient! This renders the AOB , for all intents and purposes, null and void. It is not an executed contract. You would have to start the entire process again, which means waiting longer to be reimbursed for the claim.

Power of Attorney Clause

Including a power of attorney clause, which supports not only “the right of collecting payment” but also the provider’s ability to take legal action on behalf of the patients, is vital. At Callagy Law, we always argue this is inherent within the no-fault statute; however, there are carriers to argue against the right to arbitration when the language is not in the AOB.

As medical providers, it is critical that you receive proper – and timely – reimbursement for services rendered. The assignment of benefits form is one of the most important pieces in this puzzle. It is essential for an attorney to prepare, or at least review, your AOB and other admission paperwork to ensure that you are able to collect pursuant to your patients’ insurance benefits in whatever ways needed.

Callagy Law can not only review these documents, but also ensure you are pursuing all recoverable bills to which you are eligible. If you have any questions, would like us to review your AOB form, or have issues collecting payment from insurance companies, please contact the Callagy Law team today .

Your email address will not be published. Required fields are marked *

Wind & Flood Property Insurance
FREE LEGAL GUIDES

We’ve paused selling policies in Texas to focus on our members’ safety. You can still get a quote by calling 855-216-7674. Please click here to report a claim.

855-717-0022
Log In / Create an Account

Assignment of benefits

Assignment of benefits is an agreement that gives your claims benefits to someone else.

What is an assignment of benefits?

An assignment of benefits (or AOB for short) is an agreement that gives your claims benefits, and in some instances complete control of your claim, to someone else. It’s usually used so that a contractor can "stand in your shoes" and file a claim, make decisions about repairs, and collect insurance payments from your insurance company directly for covered repairs. In some states, the contractor will even file a lawsuit against your insurer as your assignee.

Why do homeowners agree to an assignment of benefits?

Homeowners may sign an assignment of benefits form because they think it’s more convenient and efficient than dealing with the claims process firsthand.

Once a contractor has been assigned your benefits, they tell the insurance company what work they believe is required and negotiate the claim. For example, say you have a water leak in the house. You call a home restoration company to stop the water flow, clean up the mess, and restore your home to its former glory. The restoration company may ask for an assignment of benefits so it can deal directly with the insurance company without your input. That may sound like a relief at first glance – someone else can deal with all that!

But signing away your rights in the claims process may not be worth the risk.

Assignment of benefits in Florida: a case of rampant fraud

Because the assignment of benefits takes control out of the homeowner’s hands, insurance fraud is a major concern. Some contractors may take advantage of the situation and inflate repair needs and costs or bill for work that was never completed. They may also hire attorneys to sue the insurance company if it does not pay the full amount of their estimate or denies claims.

These lawsuits became a huge problem in Florida – by 2018, there were 135,000 AOB lawsuits , a 70 percent increase in 15 years. On the whole, the FBI estimates fraudulent claims account for nearly $6 billion of the $80 billion appropriated for post-hurricane reconstruction.

Florida eventually passed a bill in 2019 to curb the abuse of the assignment of benefits.

Ultimately, AOB fraud hurts homeowners the most. It increases homeowners insurance rates across the board, and you may be stuck with incomplete work and no recourse.

What responsibilities does the AOB contractor have?

Once you sign an AOB, a contractor has full power to make all decisions about the claim without consulting you. The assignment of benefits gives contractors the ability to:

File the insurance claim .
Work directly with insurance claims adjusters.
Make repair decisions.
Complete repairs.
Directly bill the insurance carrier for all work completed.
Sue your insurance company regarding your claim.

Sometimes the assignment of benefits limits the scope of the work the contractor was hired for. For example, say your home has a leaky pipe. You may hire a plumber to fix the leak, a remediation company to dry the walls and carpet, and a general contractor to replace the bathroom cabinets. Each of the three contractors may have a respective assignment of benefits for their part of the job.

How assignment of benefits impact homeowners

Under some circumstances, an assignment of benefits agreement could work out for homeowners who don’t want to handle their insurance claim. If the contractor is reputable, performs the work, and knows what information the insurance company needs, it can be a big help.

For example:

The claims adjuster will work directly with the contractor.
The contractor would handle remediation and repairs.
The contractor would bill the insurance company, not the homeowner.

AOB arrangements only work for covered damage in need of repair. If you must replace belongings or appliances, you’d still need to work directly with your insurer and payments would go to you.

Protecting yourself in an assignment of benefits agreement

Don’t sign an assignment of benefits agreement right off the bat. Before you hire any contractor:

Get multiple quotes.
Check references, licenses, and their insurance.
Get written estimates for potential work.
Get a guarantee to back the workmanship.
Make sure you get to approve the completed work.
Request copies of all paperwork sent to your insurance company.
Require that the contractor show you the documents you are actually signing.

You might be tempted to hire the first contractor you find, but you save yourself headaches if you do some due diligence before signing an assignment of benefits. Great contractors use this to expedite repairs and spare you some work. Take a beat to find that great contractor.

What is an Assignment of Benefits?

Small and Medium Business Solutions

This is how most people receive health care in the U.S. This system, known as assignment of benefits or AOB, is now being used with other types of insurance, including auto and homeowners coverage .

What is an assignment of benefits?

How an AOB works

According to Dr. David Berg of Redirect Health, the reason is simple: “Without an AOB in place, the patient themselves would be responsible for paying the cost of their service and would then file a claim with their insurance company for reimbursement.”

Within the guidelines of the specific insurance rules for AOBs in your state, the general steps include:

You and your contractor draw up an AOB clause as part of the contract.
The contract stipulates the exact work that will be completed and all necessary details.
The contractor sends the completed AOB to the insurance company where an adjuster reviews, asks questions, and resolves any discrepancies.
The contractor’s name (or that of an agreed-upon party) is listed to go on the settlement check.

After work is complete and signed off, the insurer will issue the check and the claim will be considered settled.

Example of an assignment of benefits

When would you need to use an assignment of benefits?

An AOB can simplify complicated and costly insurance transactions and allow you to turn these transactions over to trusted experts, thereby avoiding time-consuming negotiations.

Assignment of benefits for health insurance

Assignment of benefits for car owners

Assignment of benefits for homeowners

The fraud factor

The National Association of Insurance Commissioners (NAIC), offers advice for consumers to help avoid AOB fraud and abuse:

File a claim with your insurer before you hire a contractor. This ensures you know what repairs need to be made.
Don’t pay in full upfront. Legitimate contractors do not require it.
Get three estimates before selecting a contractor.
Get a full written contract and read it carefully before signing.
Don’t be pressured into signing an AOB. You are not required to sign an AOB.

Pros and cons of an assignment of benefits

The advantages and disadvantages of an AOB agreement depend largely on the amount and type of protection your state’s insurance laws provide.

Pros of assignment of benefits

With proper safeguards in place to reduce opportunities for fraud, AOBs have the ability to streamline and simplify the insurance claims process.

An AOB frees you from paying for services and waiting for reimbursement from your insurer.
Some people appreciate not needing to negotiate with their insurer.
You are not required to sign an AOB.

Cons of assignment of benefits

As with most contracts, AOBs are a double-edged sword. Be aware of potential traps and ask questions if you are unsure.

Signing an AOB could make you the victim of a scam without knowing it until your insurer refuses to pay.
An AOB doesn’t free you from the ultimate responsibility to pay for services rendered, which could drag you into expensive litigation if things go south.
Any AOB you do sign is legally binding.

The takeaway

By: Jim Probasco

From: Fortune Recommends

Assignment Of Benefits

What does assignment of benefits mean.

Assignment of benefits (AOB) is the official way an insured person asks their insurance company to pay a professional or facility for services rendered.

Insuranceopedia Explains Assignment Of Benefits

Assignment of benefits is a document that directs payment to a third party at the insured’s request. It becomes legitimate once both the insured party and their insurer have signed the AOB form. AOB is used in a number of insurance contexts, such as paying physicians or clinics through health insurance or paying contractors for repairs through a homeowner’s insurance policy.

Usually, AOBs are issued when the third party pursues it in the hopes that payment from the insurance company will be more certain and delivered more quickly than it would be from the insured.

Related Definitions

Rental value insurance, change of occupation provision, force-placed insurance, guaranteed asset protection insurance, insurance to value, loss report, no benefit to bailee provision, guaranteed renewable contract, related terms, certificate of coverage, third party, medical payments insurance, related articles, how to lower your health insurance rates, 10 tips for choosing the right health insurance policy, 10 things you need to know about health insurance in the united states, the ultimate guide to auto insurance, insurance self-service portal: the future of customer experience, blockchain’s impact on transforming the insurance landscape, trending articles.

Today's news
Reviews and deals
Climate change
2024 election
Fall allergies
Health news
Mental health
Sexual health
Family health
So mini ways
Unapologetically
Buying guides

Entertainment

How to Watch
My Portfolio
Latest News
Stock Market
Biden Economy
Stocks: Most Actives
Stocks: Gainers
Stocks: Losers
Trending Tickers
World Indices
US Treasury Bonds
Top Mutual Funds
Highest Open Interest
Highest Implied Volatility
Stock Comparison
Advanced Charts
Currency Converter
Basic Materials
Communication Services
Consumer Cyclical
Consumer Defensive
Financial Services
Industrials
Real Estate
Mutual Funds
Credit Cards
Balance Transfer Cards
Cash-back Cards
Rewards Cards
Travel Cards
Credit Card Offers
Best Free Checking
Student Loans
Personal Loans
Car Insurance
Mortgage Refinancing
Mortgage Calculator
Morning Brief
Market Domination
Market Domination Overtime
Asking for a Trend
Opening Bid
Stocks in Translation
Lead This Way
Good Buy or Goodbye?
Financial Freestyle
Fantasy football
Pro Pick 'Em
College Pick 'Em
Fantasy baseball
Fantasy hockey
Fantasy basketball
Download the app
Daily fantasy
Scores and schedules
GameChannel
World Baseball Classic
Premier League
CONCACAF League
Champions League
Motorsports
Horse racing
Newsletters

New on Yahoo

Privacy Dashboard

Yahoo Finance

What is an assignment of benefits.

This is how most people receive health care in the U.S. This system, known as assignment of benefits or AOB, is now being used with other types of insurance, including auto and homeowners coverage .

How an AOB works

Because AOBs are common in health care, you probably don’t think twice about signing a piece of paper that says "assignment of benefits" across the top. But once you sign it, you’re likely turning over your right to deal with your insurance company regarding service from that provider. Why would you do this?

According to Dr. David Berg of Redirect Health, the reason is simple: “Without an AOB in place, the patient themselves would be responsible for paying the cost of their service and would then file a claim with their insurance company for reimbursement.”

Within the guidelines of the specific insurance rules for AOBs in your state, the general steps include:

You and your contractor draw up an AOB clause as part of the contract.

The contract stipulates the exact work that will be completed and all necessary details.

The contractor sends the completed AOB to the insurance company where an adjuster reviews, asks questions, and resolves any discrepancies.

The contractor’s name (or that of an agreed-upon party) is listed to go on the settlement check.

After work is complete and signed off, the insurer will issue the check and the claim will be considered settled.

Example of an assignment of benefits

When would you need to use an assignment of benefits?

An AOB can simplify complicated and costly insurance transactions and allow you to turn these transactions over to trusted experts, thereby avoiding time-consuming negotiations.

Assignment of benefits for health insurance

Assignment of benefits for car owners

Assignment of benefits for homeowners

The fraud factor

The National Association of Insurance Commissioners (NAIC), offers advice for consumers to help avoid AOB fraud and abuse:

File a claim with your insurer before you hire a contractor. This ensures you know what repairs need to be made.

Don’t pay in full upfront. Legitimate contractors do not require it.

Get three estimates before selecting a contractor.

Get a full written contract and read it carefully before signing.

Don’t be pressured into signing an AOB. You are not required to sign an AOB.

Pros and cons of an assignment of benefits

The advantages and disadvantages of an AOB agreement depend largely on the amount and type of protection your state’s insurance laws provide.

Pros of assignment of benefits

With proper safeguards in place to reduce opportunities for fraud, AOBs have the ability to streamline and simplify the insurance claims process.

An AOB frees you from paying for services and waiting for reimbursement from your insurer.

Some people appreciate not needing to negotiate with their insurer.

You are not required to sign an AOB.

Cons of assignment of benefits

As with most contracts, AOBs are a double-edged sword. Be aware of potential traps and ask questions if you are unsure.

Signing an AOB could make you the victim of a scam without knowing it until your insurer refuses to pay.

An AOB doesn’t free you from the ultimate responsibility to pay for services rendered, which could drag you into expensive litigation if things go south.

Any AOB you do sign is legally binding.

The takeaway

This story was originally featured on Fortune.com

Can You Assign Your Insurance Benefits to Someone Else?

Monashee Frantz / Getty Images

Most business insurance policies contain a so-called anti-assignment clause. This clause prohibits policyholders from transferring any of their rights under the policy to someone else. This means that the insured business cannot cede its right to collect claim payments to another party. However, laws in most states permit policyholders to transfer their rights to another party under certain circumstances.

Anti-Assignment Clause

In the standard ISO policies , the anti-assignment clause is located in a separate form called the Common Policy Conditions. These conditions apply to all coverages that are included in the policy. For instance, if a policy includes business auto , general liability , and commercial property coverages, the anti-assignment clause applies to all three coverages.

The clause is entitled Transfer of Your Rights and Duties Under This Policy. It includes the following provision:

Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured.

The anti-assignment clause prohibits the named insured from transferring any of its rights or obligations under the policy to someone else without the insurer's permission. The only exception is if the named insured is an individual (sole proprietor) and he or she dies. An assignment is permitted in this case because a sole proprietorship and the individual owner are one and the same. If the individual dies, the business cannot survive unless it is sold to someone else.

An anti-assignment clause is intended to prevent the insurer from unwittingly assuming risks it never intended to take on. Commercial insurers review business insurance applicants carefully. Before they issue policies, underwriters consider the knowledge and experience of a company's owners and managerial staff. If a business is sold to someone else, the new owners may not be as skilled or attentive as the previous ones. From the insurer's perspective, the new owners are an unknown risk.

Post-Loss Assignments Permitted

The anti-assignment clause doesn't distinguish between assignments made before a loss and those made afterward. Even so, courts in most states have allowed policyholders to assign their rights to another party after a loss has occurred. Pre-loss assignments are still prohibited. Here is an example of a post-loss assignment of insurance benefits.

Victor operates a restaurant called Vital Vittles out of a building he owns. Late one January night two water pipes in the building freeze. The pipes subsequently burst, causing considerable water damage to Victor's building. Victor is forced to close his restaurant until the repairs are completed.

Victor hires a water damage contractor called Rapid Restoration to repair the damage to his building. He tells the contractor that he needs the repairs done quickly as he is anxious to reopen his restaurant. The contractor says that the repairs can be expedited if Victor signs over his rights under the policy to Rapid Restoration. The contractor will then proceed with the repairs and negotiate a claim settlement with Vital Vittles' commercial property insurer. Victor agrees to the assignment and the contractor begins the repair work.

While Vital Vittles' commercial property policy contains an anti-assignment clause, Victor has assigned his rights to Rapid Restoration after a loss has occurred. Thus, in most states, Victor's insurer cannot reject the assignment (assuming post-loss assignments are permitted in Victor's state).

Problems With Assignments of Benefits

In recent years, assignment of benefits (AOB) agreements have been problematic in some states, particularly Florida. Unscrupulous contractors have preyed on unsuspecting homeowners and business owners who have suffered water damage . Some contractors work alone while others operate in cahoots with crooked lawyers. In either event, the contractor convinces the policyholder to assign his or her rights under the policy over to the contractor. The contractor then exaggerates the cost of the repairs and collects the inflated amount from the insurer. The policyholder is left with a large claim on his or her loss history. When the policy expires, the insurer may refuse to renew it.

In the previous example, Victor has assigned his rights under the policy to Rapid Restoration. Suppose that Rapid Restoration completes only half of the repair work on Victor's building. The actual cost is $15,000 but the contractor submits a bill to the insurer for $30,000. Alternatively, the contractor never submits a bill but sues the insurer for $30,000. In either case, the insurer may refuse to pay on the basis that the contractor has committed insurance fraud. Victor cannot intervene because he has signed his rights over to the contractor. If the contractor is unsuccessful in its lawsuit against the insurer, it may demand payment from Victor's company.

Avoiding Problems With AOBs

As a business owner, you can avoid problems associated with AOBs and unscrupulous contractors by taking the following steps:

Report any loss or accident directly to your insurer (or your agent or broker ). Notify your insurer immediately. Don't allow a contractor to do the notification on your behalf.
Take photos of the damage.
Don't allow any contractor to begin work until an insurance adjuster has documented the damage
Vet contractors thoroughly before hiring them. Make sure they are properly licensed. If your area has suffered a natural disaster, watch out for construction scams.
Don't sign an AOB unless you have reviewed it carefully. If you don't understand it, ask your agent, insurer, or attorney for assistance.
If your contractor won't do any work until you've signed an AOB, find another contractor.

AOBs in Health Insurance

Assignment of benefit agreements are common in health insurance. Patients are often asked to agree to such clauses before they receive treatment from a physician, hospital, or another healthcare provider. The assignment of benefits clause transfers a patient's right to collect benefits under his or her health policy to the provider. By signing the document, the patent agrees that payments will be made directly to the provider for the services rendered. The clause states that the patient is ultimately responsible for the charges if the insurer fails to pay.

Once the treatment has been performed, the provider submits the AOB along with a claim to the patient's health insurer. The insurer pays the provider for services rendered to the patient.

Search NAIC

Recommended.

Back to Newsroom

Consumer Insight

what is an assignment of benefits of a health policy

Sept. 13, 2023

Assignment of Benefits: Consumer Beware

You've just survived a severe storm, or a tornado and you've experienced some extensive damage to your home that requires repairs, including the roof. Your contractor is now asking for your permission to speak with your insurance company using an Assignment of Benefits. Before you sign, read the fine print. Otherwise, you may inadvertently sign over your benefits and any extra money you’re owed as part of your claim settlement.

The National Association of Insurance Commissioners (NAIC) offers information to help you better understand insurance, your risk and what to do in the event you need repairs after significant storm damage.

Be cautious about signing an Assignment of Benefits. An Assignment of Benefits, or an AOB, is an agreement signed by a policyholder that allows a third party—such as a water extraction company, a roofer or a plumber—to act on behalf of the insured and seek direct payment from the insurance company. An AOB can be a useful tool for getting repairs done, as it allows the repair company to deal directly with your insurance company when negotiating repairs and issuing payment directly to the repair company. However, an AOB is a legal contract, so you need to understand what rights you are signing away and you need to be sure the repair company is trustworthy.

With an Assignment of Benefits, the third party, like a roofing company or plumber, files your claim, makes the repair decision and collects insurance payments without your involvement.
Once you have signed an AOB, the insurer only communicates with the third party and the other party can sue your insurer and you can lose your right to mediation.
It's possible the third party may demand a higher claim payment than the insurer offers and then sue the insurer when it denies your claim.
You are not required to sign an AOB to have repairs completed. You can file a claim directly with your insurance company, which allows you to maintain control of the rights and benefits provided by your policy in resolving the claim.

Be on alert for fraud. Home repair fraud is common after a natural disaster. Contractors often come into disaster-struck regions looking to make quick money by taking advantage of victims.

It is a good idea to do business with local or trusted companies. Ask friends and family for references.
Your insurer may also have recommendations or a list of preferred contractors.
Always get more than one bid on work projects. Your adjuster may want to review estimates before you make repairs.

Immediately after the disaster, have an accurate account of the damage for your insurance company when you file a claim.

Before removing any debris or belongings, document all losses.
Take photos or video and make a list of the damages and lost items.
Save damaged items if possible so your insurer can inspect them, some insurance companies may have this as a requirement in their policy.

Most insurance companies have a time requirement for reporting a claim, so contact your agent or company as soon as possible. Your state insurance department can help you find contact information for your insurance company, if you cannot find it.

Insurance company officials can help you determine what damages are covered, start your claim and even issue a check to start the recovery process.
When reporting losses, you will need insurance information, current contact information and a home inventory or list of damaged and lost property . If you do not have a list, the adjuster will give you some time to make one. Ask the adjuster how much time you have to submit this inventory list. The NAIC Post Disaster Claims Guide has details on what you can do if you do not have a home inventory list.

After you report damage to your insurance company, they will send a claims adjuster to assess the damage at no cost to you . An adjuster from your insurance company will walk through and around your home to inspect damaged items and temporary repairs you may have made.

A public adjuster is different from an adjuster from your insurance company and has no ties to the insurance company.
They estimate the damage to your home and property, review your insurance coverage, and negotiate a settlement of the insurance claim for you.
Many states require public adjusters to be licensed. Some states prohibit public adjusters from negotiating insurance claims for you. In those states, only a licensed attorney can represent you.
You have to pay a public adjuster.
The NAIC Post Disaster Claims Guide has information on the different types of adjusters.

Once the adjuster has completed an assessment, they will provide documentation of the loss to your insurer to determine your claims settlement. When it comes to getting paid, you may receive more than one check. If the damage is severe or you are displaced from your home, the first check may be an emergency advance. Other payments may be for the contents of your home, other personal property, and structural damages. Please note that if there is a mortgage on your home, the payment for structural damage may be payable to you and your mortgage lender. Lenders may put that money into an escrow account and pay for repairs as the work is completed.

More information. States have rules governing how insurance companies handle claims. If you think that your insurer is not responding in a timely manner or completing a reasonable investigation of your claim, contact your state insurance department .

About the National Association of Insurance Commissioners

As part of our state-based system of insurance regulation in the United States, the National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The U.S. standard-setting organization is governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

Assignment of benefits

Assignment of benefits is a legal agreement where a patient authorizes their healthcare provider to receive direct payment from the insurance company for services rendered.

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

What is Assignment of Benefits?

Assignment of benefits (AOB) is a crucial concept in the healthcare revenue cycle management (RCM) process. It refers to the legal transfer of the patient's rights to receive insurance benefits directly to the healthcare provider. In simpler terms, it allows healthcare providers to receive payment directly from the insurance company, rather than the patient being responsible for paying the provider and then seeking reimbursement from their insurance company.

Understanding Assignment of Benefits

When a patient seeks medical services, they typically have health insurance coverage that helps them pay for the cost of their healthcare. In most cases, the patient is responsible for paying a portion of the bill, known as the copayment or deductible, while the insurance company covers the remaining amount. However, in situations where the patient has assigned their benefits to the healthcare provider, the provider can directly bill the insurance company for the services rendered.

The assignment of benefits is a legal agreement between the patient and the healthcare provider. By signing this agreement, the patient authorizes the healthcare provider to receive payment directly from the insurance company on their behalf. This ensures that the provider receives timely payment for the services provided, reducing the financial burden on the patient.

Difference between Assignment of Benefits and Power of Attorney

While the assignment of benefits may seem similar to a power of attorney (POA) in some respects, they are distinct legal concepts. A power of attorney grants someone the authority to make decisions and act on behalf of another person, including financial matters. On the other hand, an assignment of benefits only transfers the right to receive insurance benefits directly to the healthcare provider.

In healthcare, a power of attorney is typically used in situations where a patient is unable to make decisions about their medical care. It allows a designated individual, known as the healthcare proxy, to make decisions on behalf of the patient. In contrast, an assignment of benefits is used to streamline the payment process between the healthcare provider and the insurance company.

Examples of Assignment of Benefits

To better understand how assignment of benefits works, let's consider a few examples:

Sarah visits her primary care physician for a routine check-up. She has health insurance coverage through her employer. Before the appointment, Sarah signs an assignment of benefits form, authorizing her physician to receive payment directly from her insurance company. After the visit, the physician submits the claim to the insurance company, and they reimburse the physician directly for the covered services.

John undergoes a surgical procedure at a hospital. He has health insurance coverage through a private insurer. Prior to the surgery, John signs an assignment of benefits form, allowing the hospital to receive payment directly from his insurance company. The hospital submits the claim to the insurance company, and they reimburse the hospital for the covered services. John is responsible for paying any copayments or deductibles directly to the hospital.

Mary visits a specialist for a specific medical condition. She has health insurance coverage through a government program. Mary signs an assignment of benefits form, granting the specialist the right to receive payment directly from the government program. The specialist submits the claim to the program, and they reimburse the specialist for the covered services. Mary is responsible for any applicable copayments or deductibles.

In each of these examples, the assignment of benefits allows the healthcare provider to receive payment directly from the insurance company, simplifying the billing and reimbursement process for both the provider and the patient.

Assignment of benefits is a fundamental concept in healthcare revenue cycle management. It enables healthcare providers to receive payment directly from the insurance company, reducing the financial burden on patients and streamlining the billing process. By understanding the assignment of benefits, patients can make informed decisions about their healthcare and ensure that their providers receive timely payment for the services rendered.

Get paid in full by bringing clarity to your revenue cycle

Related terms.

Transfer is the process of moving a patient from one healthcare facility to another, ensuring seamless continuity of care and appropriate billing for services rendered.

Gatekeeper is a term used in healthcare revenue cycle management (RCM) to refer to the individual or system responsible for controlling access to patient information and managing the flow of revenue within the healthcare organization.

Subscribe to the

Healthcare Clarified newsletter

Get the latest insights on RCM and healthcare policy in your inbox

Assignment of benefits: A growing concern

By Kevin Poll

Evaluating claims properly and determining the appropriate amount of a loss are crucial for insurance companies, especially when trying to offer competitive premiums to customers and maintain profitable financial results.

Factors that affect profitability

In the business of insurance, many factors—some that can’t be controlled—affect financial profitability. Predictive analytics and more refined modeling are helping insurers reduce uncertainty, but even the best of models have their limitations.

Further, many variables can’t be predicted but could have significant financial impact on the bottom line. One of those variables—the potential for the benefits of an insurance policy being assigned post-loss to predatory adjusters—has been a hot topic, particularly in those states where laws and regulations currently prevent insurance companies from being able to mitigate the problem.

What is assignment of benefits?

Typically, an insurance policy has a loss payment provision that advises the policyholder that any payment for a first-party loss will be paid directly to the insured unless another party is legally entitled to collect payment. However, a common practice by consumers after a loss is to have the contractor that will be making the repairs to the damaged property work directly with the insurance company for payment.

Some insurance providers have simplified this process by developing a network of trusted contractors that are allowed to inspect claims on their behalf. This creates a consumer-friendly environment where the insured, for the most part, is removed from the claims settlement process. However, consumers generally are free to make other choices, so if they decide on a contractor not in that network, the insurer most likely will work with the entity selected by the insured.

When a contractor, who is not in an insurance provider’s network, is chosen, the insured has two options: either receive payment from the insurance company and then work directly with the contractor or allow the contractor to work directly with the insurance company regarding repairs and payment. Insurance companies would likely prefer the first option because they can then more closely monitor the claims process. While the second option may be less desirable to the insurance company, certain states, like Florida, have laws in place that actually prevent the carrier from disallowing it.

What are the concerns with assignment of benefits?

Transferring the benefits of a policy to a third party, such as a contractor, does create a better customer experience; however, insurers generally lose a bit of control managing the claims process when working directly with the third party.

Several states (especially Florida as discussed below) have seen an influx in predatory public adjusters and contractors that seek out consumers who may potentially have a loss covered by their homeowners policy. These adjusters (that may also serve as the contractor making the repairs to the home) will have the consumer sign a transfer of benefits to them almost immediately after suffering the loss, and then they will work directly with the insurance company to complete the claims process.

One issue that arises (and often the consumer is unaware of this) is that the adjuster/contractor could be inflating the actual cost of the claim by reporting damage that may not actually have occurred. Additionally, the claim may not be reported to the insurance company until the repairs have already been completed so the insurance company has not had an opportunity to inspect the damage. Such tactics can result in additional profits for the adjuster/contractor, which translates to inflated severity and rising premiums for the consumer.

This issue may be particularly problematic in Florida, where insurance carriers may not be aware of potential losses until they’re served with a lawsuit for expenses incurred by the contractor that completed the repairs. In fact, the Florida Office of Insurance Regulation (FLOIR) released results from a study it conducted showing that the number of lawsuits attributed to assignment of benefits (AOB) increased from 408 in 2000 to more than 28,000 in 2016. Further, the average severity for claims where there is an AOB is about 85 percent more than those claims without an AOB.

How has this issue escalated?

Several factors have contributed to the growing problem of assignment of benefits in Florida; however, a combination of case law and legislation, which has made it difficult for insurance companies to mitigate claim costs and potential fraud, may be the most impactful.

In the 1917 landmark case of West Florida Grocery Co. v. Teutonia Fire Ins. Co., 77 So. 209, 210-, the state Supreme Court rendered a decision holding that the insured was able to assign the benefits of the policy following a loss directly to a third party without the written consent of the insurance provider. The precedent established by this 100-year-old case continues to make it very difficult for an insurance company to prohibit the assignment of benefits in Florida.

In addition to this case, Florida Statute §627.428 governing payment of attorneys’ fees related to insurance practices requires that insurance companies pay legal fees to third parties successfully suing to obtain payment for their services even if the ruling from the court places the amount of the claim only $1 above the insurance company’s offer in settlement. As a result, this statute incentivizes contractors to sue insurance companies for reimbursement, because the likelihood that they’ll have to pay their own legal fees for the case is very slim.

As reported by The Sun Sentinel earlier this year, consumers in southern Florida could expect to see rate increases averaging 5-15% as a result of claims abuse. Additionally, if it can be assumed that a significant number of the lawsuits complied in the FLOIR study referenced above were initiated by public adjusters and contractors seeking to be unjustly compensated, it could be suggested that this predatory behavior is factoring into these rate increases.

Despite this potential correlation, the legislature has yet to make changes to existing laws. While some members of Florida’s legislature favor the existing legislation, others are advocating for consumers and supporting legislation that would eliminate the abuse. Although remedial legislation did fail in 2017, some members have said they’re hopeful to get legislation passed in 2018.

How is ISO responding?

ISO has been reviewing policy language to determine the best course of action for responding to the growing crisis, especially in Florida. While prohibiting assignment of benefits post-loss altogether is not allowed by state law, several policy provisions can be modified to introduce parameters on how the benefits of the policy can be assigned to a third party. ISO is finalizing these changes and hopes to file in the first quarter of 2018 so that member companies can address this concern with or without any future changes to Florida law.

Personal Property
Risk Assessment
Homeowners Underwriting

Assignment of Benefits: What It Is, and How It Can Affect your Property Insurance Claim

Table of Contents

What is an Assignment of Benefits?

In the context of insured property claims, an assignment of benefits (AOB) is an agreement between you and a contractor in which you give the contractor your right to insurance payments for a specific scope of work . In exchange, the contractor agrees that it will not seek payment from you for that scope of work, except for the amount of any applicable deductible. In other words, you give part of your insurance claim to your contractor, and your contractor agrees not to collect from you for part of its work.

The most important thing to know about an assignment of benefits is that it puts your contractor in control your claim , at least for their scope of work. Losing that control can significantly affect the direction and outcome of your claim, so you should fully understand the implications of an AOB (sometimes called an assignment of claims or AOC) before signing one.

How Does an Assignment of Benefits Work in Practice?

Let’s say you’re an insured homeowner, and Hurricane Ian significantly damaged your roof. Let’s also assume your homeowner’s policy covers that damage. A roofer, after inspecting your roof and reviewing your insurance policy, might conclude that your insurer is probably going to pay for a roof replacement under your insurance policy. The only problem is that it’s early in the recovery process, and your insurer hasn’t yet stated whether it will pay for the roof replacement proposed by your contractor. So if you want your roof replaced now, you would ordinarily agree to pay your roofer for the replacement, and wait in hopes that your insurer reimburses you for the work. This means that if your insurance company refuses to pay or drags out payment, you’re on the hook to your roofer for the cost of the replacement.

As an alternative to agreeing to pay your roofer for the full cost of the work, you could sign an assignment of benefits for the roof replacement. In this scenario, your roofer owns the part of your insurance claim that pertains to the roof replacement. You might have to pay your roofer for the amount of your deductible, but you probably don’t have to pay them for the rest of the cost of the work. And if your insurance company refuses to pay or drags out payment for the roof replacement, it’s your roofer, and not you, who would be on the hook for that shortfall.

So should you sign an AOB? Not necessarily. Read below to understand the pros and cons of an assignment of benefits.

Are There any Downsides to Signing an Assignment of Benefits?

Yes.

You lose control of your claim . This is the most important factor to understand when considering whether to sign an AOB. An AOB is a formal assignment of your legal rights to payment under your insurance contract. Unless you’re able to cancel the AOB, your contractor will have full control over your claim as it relates to their work.

To explain why that control could matter, let’s go back to the roof replacement example. When you signed the AOB, the scope of work you agreed on was to replace the roof. But you’re not a roofing expert, so you don’t know whether the costs charged or the materials used by the roofer in its statement of work are industry appropriate or not. In most cases, they probably are appropriate, and there’s no problem. But if they’re not – if, for instance, the roofer’s prices are unreasonably high – then the insurer may not approve coverage for the replacement. At that point, the roofer could lower its prices so the insurer approves the work, but it doesn’t have to, because it controls the claim . Instead it could hold up work and threaten to sue your insurer unless it approves the work at the originally proposed price. Now the entire project is insnared in litigation, leaving you in a tough spot with your insurer for your other claims and, most importantly, with an old leaky roof.

Misunderstanding the Scope of Work. Another issue that can arise is that you don’t understand the scope of the assignment of benefits. Contractor estimates and scopes of work are often highly technical documents that can be long on detail but short on clarity. Contractors are experts at reading and writing them. You are not. That difference matters because the extent of your assignment of benefits is based on that technical, difficult-to-understand scope of work. This can lead to situations where your understanding of what you’re authorizing the contractor to do is very different from what you’ve actually authorized in the AOB agreement.

In many cases, it’s not necessary . Many contractors will work with you and your insurer to provide a detailed estimate of their work, and will not begin that work until your insurer has approved coverage for it. This arrangement significantly reduces the risk of you being on the hook for uninsured repairs, without creating any of the potential problems that can occur when you give away your rights to your claim.

Do I have to sign an Assignment of Benefits?

No. You are absolutely not required to sign an AOB if you do not want to.

Are There any Benefits to Signing an Assignment of Benefits?

Potentially, but only if you’ve fully vetted your contractor and your claim involves complicated and technical construction issues that you don’t want to deal with.

First, you must do your homework to fully vet your contractor! Do not just take their word for it or be duped by slick ads. Read reviews, understand their certificate of insurance, know where they’re located, and, if possible, ask for and talk to references. If you’ve determined that the contractor is highly competent at the work they do, is fully insured, and has a good reputation with customers, then that reduces the risk that they’ll abuse their rights to your claim.

Second, if your claim involves complicated reconstruction issues, a reputable contractor may be well equipped to handle the claim and move it forward. If you don’t want to deal with the hassle of handling a complicated claim like this, and you know you have a good contractor, one way to get rid of that hassle is an AOB.

Another way to get rid of the hassle is to try Claimly, the all-in-one claims handling tool that get you results but keeps you in control of your claim.

Can my insurance policy restrict the use of AOBs?

Yes, it’s possible that your Florida insurance policy restricts the use of AOBs, but only if all of the following criteria are met:

When you selected your coverage, your insurer offered you a different policy with the same coverage, only it did not restrict the right to sign an AOB.
Your insurer made the restricted policy available at a lower cost than the unrestricted policy.
If the policy completely prohibits AOBs, then it was made available at a lower cost than any policy partially prohibiting AOBs.
The policy includes on its face the following notice in 18-point uppercase and boldfaced type:

THIS POLICY DOES NOT ALLOW THE UNRESTRICTED ASSIGNMENT OF POST-LOSS INSURANCE BENEFITS. BY SELECTING THIS POLICY, YOU WAIVE YOUR RIGHT TO FREELY ASSIGN OR TRANSFER THE POST-LOSS PROPERTY INSURANCE BENEFITS AVAILABLE UNDER THIS POLICY TO A THIRD PARTY OR TO OTHERWISE FREELY ENTER INTO AN ASSIGNMENT AGREEMENT AS THE TERM IS DEFINED IN SECTION 627.7153 OF THE FLORIDA STATUTES.

627.7153.

Pro Tip : If you have an electronic copy of your complete insurance policy (not just the declaration page), then search for “policy does not allow the unrestricted assignment” or another phrase from the required language above to see if your policy restricts an AOB. If your policy doesn’t contain this required language, it probably doesn’t restrict AOBs.

Do I have any rights or protections concerning Assignments of Benefits?

Yes, you do. Florida recently enacted laws that protect consumers when dealing with an AOB.

Protections in the AOB Contract

To be enforceable, a Assignments of Benefits must meet all of the following requirements:

Be in writing and executed by and between you and the contractor.
Contain a provision that allows you to cancel the assignment agreement without a penalty or fee by submitting a written notice of cancellation signed by the you to the assignee:
at least 30 days after the date work on the property is scheduled to commence if the assignee has not substantially performed, or
at least 30 days after the execution of the agreement if the agreement does not contain a commencement date and the assignee has not begun substantial work on the property.
Contain a provision requiring the assignee to provide a copy of the executed assignment agreement to the insurer within 3 business days after the date on which the assignment agreement is executed or the date on which work begins, whichever is earlier.
Contain a written, itemized, per-unit cost estimate of the services to be performed by the assignee .
Relate only to work to be performed by the assignee for services to protect, repair, restore, or replace a dwelling or structure or to mitigate against further damage to such property.
Contain the following notice in 18-point uppercase and boldfaced type:

YOU ARE AGREEING TO GIVE UP CERTAIN RIGHTS YOU HAVE UNDER YOUR INSURANCE POLICY TO A THIRD PARTY, WHICH MAY RESULT IN LITIGATION AGAINST YOUR INSURER. PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING IT. YOU HAVE THE RIGHT TO CANCEL THIS AGREEMENT WITHOUT PENALTY WITHIN 14 DAYS AFTER THE DATE THIS AGREEMENT IS EXECUTED, AT LEAST 30 DAYS AFTER THE DATE WORK ON THE PROPERTY IS SCHEDULED TO COMMENCE IF THE ASSIGNEE HAS NOT SUBSTANTIALLY PERFORMED, OR AT LEAST 30 DAYS AFTER THE EXECUTION OF THE AGREEMENT IF THE AGREEMENT DOES NOT CONTAIN A COMMENCEMENT DATE AND THE ASSIGNEE HAS NOT BEGUN SUBSTANTIAL WORK ON THE PROPERTY. HOWEVER, YOU ARE OBLIGATED FOR PAYMENT OF ANY CONTRACTED WORK PERFORMED BEFORE THE AGREEMENT IS RESCINDED. THIS AGREEMENT DOES NOT CHANGE YOUR OBLIGATION TO PERFORM THE DUTIES REQUIRED UNDER YOUR PROPERTY INSURANCE POLICY.

Contain a provision requiring the assignee to indemnify and hold harmless the assignor from all liabilities, damages, losses, and costs, including, but not limited to, attorney fees.

Contractor Duties

Under Florida law, a contractor (or anyone else) receiving rights to a claim under an AOB:

Must provide you with accurate and up-to-date revised estimates of the scope of work to be performed as supplemental or additional repairs are required.
Must perform the work in accordance with accepted industry standards.
May not seek payment from you exceeding the applicable deductible under the policy unless asked the contractor to perform additional work at the your own expense.
Must, as a condition precedent to filing suit under the policy, and, if required by the insurer, submit to examinations under oath and recorded statements conducted by the insurer or the insurer’s representative that are reasonably necessary, based on the scope of the work and the complexity of the claim, which examinations and recorded statements must be limited to matters related to the services provided, the cost of the services, and the assignment agreement.
Must, as a condition precedent to filing suit under the policy, and, if required by the insurer, participate in appraisal or other alternative dispute resolution methods in accordance with the terms of the policy.
If the contractor is making emergency repairs, the assignment of benefits cannot exceed the greater of $3,000 or 1% of your Coverage A limit.

Top 9 Techniques of Writing An Assignment of Benefits of a Health Policy

Writing An Assignment

Here are the 9 key points to craft an assignment of benefits of a health policy:

Understand the basic requirements of the paper.
Do detailed research before writing the paper,
Write a strong thesis statement for the assignment.
Start writing the first draft of your work.
Provide context of research in the introduction.
The main body should be structured.
Summarise the key points in the conclusion.
Reference the sources you have used in the work.
Edit and proofread the papers for any probable mistakes.

The article below explores these points in further detail. Read on to learn more about it.

With the continuous advancement in the field of medicine, the demand for healthcare professionals has been increasing day in and day out. Writing an assignment of benefits of a health policy is an essential step to express your ideas in the field you have chosen for yourself. Submitting quality assignments is a key to gaining good grades in medical and nursing school.

When you feel like it is becoming too challenging for you, it will be better to hire a reliable assignment writing service to fix all the problems you are facing. Just make sure to choose one that is trusted by a large number of students, has a global audience, and has a high customer satisfaction rate.

Coming back to the topic, this article explores in detail the top 9 tips that you should follow when writing an assignment of benefits of a health policy. Let’s explore them in further detail.

What Is the Assignment of Benefits of a Health Policy?

In an assignment of benefits of a health policy, a student has to discuss in detail the significance of different medical policies that promote health in public and prevent diseases. Such assignments are great for public awareness purposes because all should have the opportunity to live a healthy lifestyle. Also, everyone should have timely access to comprehensive healthcare services in the vicinity of their livelihood.

How to Write an Assignment of Benefits of a Health Policy? Top 9 Techniques

Here are the top 9 techniques to follow for writing a successful health policy analysis assignment:

1. Understand the Assignment Requirements

It is important to understand the requirements of your assignment completely before you start working. You should carefully read the task and guidelines about your papers and review the questions to understand them in detail. Doing so shall help you narrow down your research and craft an assignment of benefits of health policy that provides some value to the readers. If you do not understand the basic requirements, you will fail to accomplish the task properly.

2. Do In-Depth Research

Before you start writing your health policy assignment, you have to do in-depth research to find the relevant facts, information and statistics that support your arguments. You not only have to add all the necessary information about your topic but also discuss the background of your work. You can add multiple resources to give a thorough analysis of your topic, such as course material, open libraries, textbooks, past research papers, medical journals, etc.

3. A Strong Thesis Statement

A thesis statement is a one-liner statement that effectively summarises the conclusion of your research and the main points of your key arguments in front of your readers. Needless to say, the thesis statement of an assignment of benefits of a health policy should be interesting enough to let the reader develop his interest in it. Focus on writing a clear, specific and concise statement that can serve as the foundation of your paper.

4. Crafting the First Draft

When working on an assignment of benefits of a health policy, you should know that the first draft is not going to be the final draft of your work. It goes without saying that you should have a clear plan in your mind for you to proceed with the assignment. Write about the mutual connection between the accidents and the healthcare of the patients and follow an organised structure. You will have plenty of time to edit the draft later.

5. Introduction of Assignment

Just like any other academic paper, the first part of an assignment of benefits of a health policy is the introduction. Ideally, you should craft this part of your work at the end of the work because then, you will easily be able to write an overview of your assignment. It will be best to provide the readers with the context of your work and write about the problems that you have addressed in your papers. The introduction of your assignment should end with a thesis statement.

6. Main Body of the Papers

In the main body of an assignment of benefits of a health policy, you have to add all the research points, evidence, arguments, and data in your work. You should make sure that you have used enough headings, illustrations, subheadings, charts, and tables to improve the quality of your papers. The best thing to do is to cite all the sources you have utilised in your assignment and use shorter paragraphs whenever you can. You can also get assignment writing help online whenever you need it.

7. Conclusion of Your Work

The conclusion of an assignment of benefits of a health policy should focus on the summarisation of the main points of your work. Keep in mind that you should avoid adding any new information in the conclusion of your papers. However, you can add recommendations that you have come across in your research, and it should act as a bridge between the practical solution and the theory you are working on.

8. Referencing

The proper referencing of an assignment of benefits of a health policy matters a lot so you should ensure to use only scholarly articles and authorised websites for your research. Also, needless to say you will have to follow a specific formatting and referencing style such as APA, Chicago, MLA and more. If confused, ask your professor or university instructor to tell you about what referencing style to follow for your work.

9. Editing and Proofreading

So, once you are done writing an assignment of benefits of a health policy, take a small break and come back to it with a fresh mind. After that, you should sit down to edit and proofread the content you have written. If you want to achieve better results, try reading your assignment aloud and remove anything that sounds out of context or informal to you. Also, keep in mind that you essentially have to get rid of all the spelling mistakes and grammatical issues in your work.

Assignment of Benefits of a Health Policy Examples

Here is an example of an assignment of benefits of a health policy by the University of St. Augustine for Health Sciences that you can read and review for better comprehension:

So, the bottom line is that you should research your content well enough when it comes to writing an assignment of benefits of a health policy. It will be better if you know more about the impact of health policies on the well-being of citizens and the ways that can improve the health of people at the local, territorial, federal, and state levels. Know that establishing informed policies is a key to the improvement of health around the globe.

If you need personalised assistance with your assignment, do not hesitate to seek support from a professional assignment writer online . Such writers have a knack for crafting top-scoring academic papers, so they will help you achieve your desired grades in the work you do.

The Benefits Of Occupational Therapy For Autism: An Essential...

man wearing blue scrub suit and mask sitting on bench

Effective De-escalation Techniques Every Psychiatric Nurse Needs...

The Pregnancy Journey: Managing Health Hurdles Along the Way

Pathways to Empowerment: Tools and Tips for Navigating Care Plans

Decoding Ear Discomfort: Causes and Solutions

Beyond Brushing: Comprehensive Care for Your Smile

Home » Coverage Exclusions » Assignment of Benefits

Assignment of Benefits for Homeowners

How They Work
Using Your AOB
Pros & Cons
Safe & Secure
Watch Out for Abuse
Frequently Asked Questions

An assignment of benefits (AOB) is a contractual agreement that enables a third party to access insurance benefits on behalf of the policyholder.[1] When the policyholder signs an AOB agreement, it grants the third party the authority to initiate an insurance claim and receive reimbursement directly from the insurance company.

Assignment of benefits for homeowners means that any contractors , plumbers, or other professionals who perform work to repair your home or property after a claim will work with your insurance provider directly to get compensated. You step aside as the middleman, and they work together.

While AOB can work with most types of insurance, not every insurance company will allow it. The party performing the work (the insurance claimant) and your insurance company must both agree to the process.

As the policyholder, you must willingly sign an AOB agreement, giving explicit consent for a third party to access their insurance benefits.
AOBs make things easier for both you as the policyholder and for the service provider.
The service provider takes care of filing the claim, deciding on repairs, and getting paid by the insurance company, relieving you (the policyholder) of having to manage these details.

How Do Assignment of Benefits Work?

AOB is a straightforward process that simplifies insurance billing for both service providers and policyholders. Here is how an AOB works:

Coverage Approved

Before hiring a service provider, the policyholder must make sure that the service is covered by their policy by checking in with the insurance provider. In most medical situations, the billing staff will handle this on behalf of the patient, but in the cases of homeowners insurance, it may be necessary for the policyholder to manage this step.

Service Rendered

The policyholder, whether a patient or property owner, receives necessary services covered by their insurance policy, such as medical treatment or repairs.

Mutual Agreement

The policyholder and the service provider agree to utilize an AOB form.[2] This agreement authorizes the service provider to handle direct billing to the insurance company for the services provided.

Billing Submission

With the AOB form in place, the service provider submits all relevant documentation, including invoices and service records, to the insurance company for payment.

Claim Evaluation

The insurance company thoroughly reviews the submitted documents to verify that the provided services are indeed covered under the policy terms and that the contractor provided those same services.

Direct Payment

If the services are eligible and covered by the insurance policy, the insurance company promptly issues payment directly to the service provider. This payment aligns with the agreed-upon costs as outlined in the insurance policy.

Policyholder’s Responsibility

Generally, the policyholder is only responsible for any deductibles, copays, or out-of-pocket expenses specified in their insurance policy.[3] They are relieved of the responsibility of managing the billing process or handling reimbursement paperwork.

Example of an Assignment of Benefits

A hurricane hit Rachel’s town, severely damaging the shed where she keeps her tools and lawn equipment. The shed is covered under her home insurance policy, and she files a claim with the insurance provider quickly with photographs and documents that show the damage and provide proof of the value and potential cost to rebuild. The insurance provider approves the replacement of the shed.

To streamline the process of paying the contractor, Rachel signs an AOB allowing the contractor to bill the insurance provider rather than billing her. This means that if there are any disputes about the costs of materials, timeliness of payment, or any other issues, those will happen between the insurance company and the contractor, and Rachel will not be required to step in.

Additionally, rather than having to pay the contractor out of pocket and wait for a reimbursement check from the provider, the contractor will be paid directly by the insurance company, so Rachel doesn’t have to pay the cost of the shed replacement.

When Would You Use Your Assignment of Benefits?

AOBs can be useful in various situations:

Assign benefits to contractors for property damage repairs, simplifying the insurance claim process. It can often expedite the process and help claimants to get paid faster.
AOBs can help in emergencies, ensuring timely payment without paperwork hassles. This can be particularly helpful during already high-stress times.
Consider AOBs for complex claims with multiple providers or extensive paperwork. You’ll have less to manage if the parties work together directly.
You can use an AOB for a range of professionals that relate to a homeowners insurance claim, such as plumbers, roofers, window repair specialists, landscapers, carpenters, and restoration specialists.

Pros & Cons of Using Assignment of Benefits



It simplifies the claims process, reducing paperwork for policyholders.	Policyholders may have limited control over claims and disputes.
Service providers can bill insurance companies directly, ensuring timely payment.	With AOBs, the insurance company may not agree to cover the full cost, and the contractor may sue the insurance company. You may be dragged into litigation later.
It allows policyholders to access needed services, even when funds are limited.	Your lack of visibility into final bills may mean you’re surprised when your insurance premiums are raised.

Making Sure Your AOB Is Safe & Secure

To ensure the safety of an AOB:

Check the reputation of the service provider and seek multiple quotes for services.[4]
Carefully examine the AOB terms, ensuring clarity and alignment with your insurance policy.
Beware of high-pressure tactics and take your time to decide.
Confirm the provider’s licensing and insurance.
Get multiple estimates in writing for the needed work.
Consult an attorney or insurance advisor if you have concerns.
Keep records of communication and contracts.
Inform your insurer about the AOB and their requirements.
After services, check the results against AOB terms and your satisfaction.

Assignment of Benefits Being Abused: What Are My Options?

While an AOB can offer convenience, the process may be susceptible to misuse by those who would take advantage of the insurance company and overcharge for services or claim to have provided services that they did not actually perform.

If you suspect AOB abuse, consider these options:

Contact Your Insurer

If you suspect AOB abuse, promptly reach out to your insurance company. Express your concerns and provide any evidence you have to support your concerns. Insurers have units dedicated to investigating potential fraud or AOB misuse.

Report Fraud

If you suspect fraudulent activities, report the issue to your state’s insurance fraud bureau or department, which investigates such cases and takes legal action when appropriate. However, fraud is generally difficult to prove.

Seek Legal Counsel

Get advice from an attorney who is experienced in insurance claims to navigate your specific situation. Be aware that pursuing legal action can be costly and lengthy, so it generally won’t be your first course of action. But if the process gets complicated, it’s helpful to have a legal professional on your side.

Know About Potential Litigation

If the contractor or service provider isn’t paid by your insurance company, they might pursue legal action against your provider, leading to a dispute that may require your action or response.

Frequently Asked Questions About Assignment of Benefits (AOB) for Homeowners

We have compiled some of the most frequently asked questions about AOBs and how to use them most effectively, so you can make the most informed decisions about your situation.

An assignment of benefits, also referred to as an AOB, in homeowners insurance is when you allow a contractor or service provider to take over your insurance claim process. They deal directly with the insurance company for tasks like repairs or damage assessments. This can simplify and expedite the process since the service provider is dealing directly with your insurance company without you serving as the intermediary.

All parties must agree to the process. As the policyholder, you’ll sign off on the process, and both the services provider and your insurance company must also agree to the process.

Using an AOB can be beneficial if it is used wisely and for the purposes of working with reputable service providers. It streamlines claims, but it also comes with potential risks like fraud. Proceed with caution and agree to an AOB only if you feel confident that you are working with trusted parties. Also, be aware that not all insurance companies allow AOBs. Consult your insurance provider to ensure they do before proceeding.

In recent years, AOBs have been the target of fraud. Some service providers have inflated their invoices, billing for work that wasn’t performed. In some cases, claimants sue the insurance company, resulting in higher premiums for the policyholder down the road.

An AOB simplifies the insurance claims process for policyholders, letting service providers handle the work of getting paid for their services. This reduces responsibility and stress for policyholders and can often serve the best interests of all parties.

An AOB on a claim form is a line item where you authorize a service provider to receive insurance benefits for a specific claim. It lets that provider directly bill and get paid by the insurance company, simplifying the process for you. Make sure to understand the terms before signing it.[2] In some cases, it could mean you are responsible for any fees billed by your service provider if your insurance company doesn’t pay the full amount.

The Do’s & Don’ts of Submitting a Homeowners Insurance Claim
How Long Will My Homeowners Insurance Claim Take?
How to File a Homeowners Insurance Claim
How to Document Property Damage for Your Claim
How to Speed Up Your Homeowners Insurance Claim
Insurance Claims & Appeals

Post Disaster Claims Guide . National Association of Insurance Commissioners.

Assignment of Benefits . Department of Health and Human Services – North Dakota.

Understanding Dental Assignment of Benefits . West Virginia Offices of the Insurance Commissioner.

Assignment of Benefits: Consumer Beware . (April 2020). National Association of Insurance Commissioners.

Practice Areas
Terminology
Entrepreneurship
Medical Billing
Healthcare Conferences

What is Assignment of Benefits in Medical Billing?

doctor sitting at his desk on his laptop

An assignment of benefits is the act of signing documentation authorizing a health insurance company to pay a physician directly. In other words, the insurance company can pay claims without the direct involvement of the patient in the process. There are other situations where AOBs can be helpful, but we’ll focus on their use in relation to medical benefits.

If there isn’t an assignment of benefits agreement in place, the patient would be responsible for paying the other party directly from their own pocket, then filing a claim with their insurance provider to receive reimbursement. This could be time-consuming and costly, especially if the patient has no idea how to file a claim.

The document is typically signed by patients when they undergo medical procedures. The purpose of this form is to assign the responsibility of payment for any future medical bills that may arise after the procedure. It’s important to note that not all procedures require an AOB.

An assignment of benefits agreement might be utilized to pay a medical practitioner the patient didn’t choose, like an anesthesiologist. The patient may have picked a surgeon, but an anesthesiologist assigned on the day of the procedure might issue a separate bill. They’re, in essence, signing that anyone involved in their treatment can receive direct payment from the insurance carrier. It doesn’t have to go through the patient.

This document can also eliminate service fees surrounding processing. As a result, the patient can focus on medical treatment and recovery without being bogged down with the complexities of paying medical bills. The overall intent of an assignment of benefits agreement is to make the process more manageable for the patient, as they don’t need to haggle directly with their insurer.

List of Providers and Services

When the patient signs an AOB agreement, they give a third party right to obtain payment for services the provider performed, and medical billing services are a prime example of where they may sign an AOB agreement.

Ambulance services
Medical insurance claims
Drugs and pharmaceuticals
Diagnostic and clinical lab services
Emergency surgical center services
Dialysis supplies and equipment used in the home
Physician services for Medicare and Medicaid patients

Services of professionals other than a primary care physician, which includes:

Physician assistants
Clinical nurse specialists
Clinical social workers
Clinical psychologists
Certified registered nurse anesthetists

doctor at desk filling out forms on clipboard

Information Commonly Requested on Assignment of Benefits Form:

Signature of patient or person legally responsible
Signature of parent or legal guardian

How AOBs Affect the Medical Practitioner

A medical provider or their administrative staff may feel overwhelmed by the sheer number of forms patients must fill out prior to treatment. Demanding more paperwork from patients may be seen as an added burden on the managerial staff, as well as the patient. However, getting a signed AOB is vital in preserving the interests of everyone involved.

In addition to receiving direct payment from the insurance company without needing to go through the patient, a signed assignment of benefits form will help medical providers appeal denied and underpaid claims. They can ask that payments be made directly to them rather than through the patient. This makes the process more manageable for both the doctors and the patient.

Things to Bear in Mind

The patient gives their rights and benefits to third parties under their current health plan. Depending on the wording in the AOB, their insurer may not be allowed to contact them directly about their claims. In addition, the patient may be unable to negotiate settlements or approve payments on their behalf and enable third parties to endorse checks on behalf of the patient. Finally, when the patient signs an AOB, the insurer may sue the third parties involved in the dispute.

Looking for a qualified medical billing service?

By taking just 1 minute to provide some basic information about your practice, you can get up to 5 pre-screened companies competing for your business.

What Is Cosmetic Dermatology? Your Guide to Treatments, Costs, and More

What is a clia number in medical billing, healthcare revenue cycle management explained, leave a reply.

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

Here’s What the Court’s Chevron Ruling Could Mean in Everyday Terms

The decision is expected to prompt a rush of litigation challenging regulations across the entire federal government, from food safety to the environment.

Share full article

Gray columns and a white flag on the front of a the Environmental Protection Agency building.

By Coral Davenport , Christina Jewett , Alan Rappeport , Margot Sanger-Katz , Noam Scheiber and Noah Weiland

June 28, 2024

The Supreme Court’s decision on Friday to limit the broad regulatory authority of federal agencies could lead to the elimination or weakening of thousands of rules on the environment, health care, worker protection, food and drug safety, telecommunications, the financial sector and more.

The decision is a major victory in a decades-long campaign by conservative activists to shrink the power of the federal government, limiting the reach and authority of what those activists call “the administrative state.”

The court’s opinion could make it easier for opponents of federal regulations to challenge them in court, prompting a rush of new litigation, while also injecting uncertainty into businesses and industries.

“If Americans are worried about their drinking water, their health, their retirement account, discrimination on the job, if they fly on a plane, drive a car, if they go outside and breathe the air — all of these day-to-day activities are run through a massive universe of federal agency regulations,” said Lisa Heinzerling, an expert in administrative law at Georgetown University. “And this decision now means that more of those regulations could be struck down by the courts.”

The decision effectively ends a legal precedent known as “Chevron deference,” after a 1984 Supreme Court ruling. That decision held that when Congress passes a law that lacks specificity, courts must give wide leeway to decisions made by the federal agencies charged with implementing that law. The theory was that scientists, economists and other specialists at the agencies have more expertise than judges in determining regulations and that the executive branch is also more accountable to voters.

Since then, thousands of legal decisions have relied on the Chevron doctrine when challenges have been made to regulations stemming from laws like the 1938 Fair Labor Standards Act, the 1970 Clean Air Act , the 2010 Affordable Care Act and others.

We are having trouble retrieving the article content.

Please enable JavaScript in your browser settings.

Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.

Thank you for your patience while we verify access.

Already a subscriber? Log in .

Want all of The Times? Subscribe .

What Does the End of Chevron Deference Mean for Federal Health Care Programs?

On June 28, 2024, the Supreme Court rejected the doctrine of Chevron deference in the closely watched case of Loper Bright Enterprises v. Raimondo . [1] In a 6-3 decision, the Court held that Chevron ’s rule that courts must defer to federal agencies’ interpretation of ambiguous statutes gave the executive branch interpretive authority that properly belonged with the courts. Moreover, the Court concluded that Chevron deference was inconsistent with the Administrative Procedure Act (APA), holding that the APA requires courts to exercise independent judgment when deciding legal issues in the review of agency action.

Loper will have significant and immediate implications for the U.S. Department of Health and Human Services (HHS), the federal agency charged with the administration of the federal health care programs, including Medicare and Medicaid. As detailed below, the Court’s decision sets a more exacting standard for courts to apply when reviewing HHS’s regulations and legal positions.

What Was Chevron Deference?

The doctrine of Chevron deference was established in 1984 by the Supreme Court in Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc. [2] In that case, the Court held when a “statute is silent or ambiguous with respect to the specific issue” raised regarding a statute that the agency administers, “the question for the court is whether the agency’s answer is based on a permissible construction of the statute.” [3]

Although scholars have debated Chevron ’s rationale at length, it generally was read to require deference based upon agencies’ presumed subject matter expertise and an assumption that Congress delegated authority to agencies—rather than courts—to fill in gaps in statutory schemes. Notably, the Supreme Court had not itself invoked Chevron deference since 2016, although lower courts have continued to rely on it regularly. [4]

What Did Loper Decide?

Loper involved two New England fishing companies appealing the D.C. Circuit’s ruling that applied Chevron deference to uphold the National Marine Fisheries Service’s interpretation of the Federal Magnuson-Stevens Act (the “Act”) as requiring fishermen to pay for the use of compliance monitors on certain fishing boats, even though the federal law is silent on who must pay. Petitioners used the case as a vehicle to present a broader challenge to Chevron , arguing that the doctrine has led to excessive deference to federal agencies, resulting in overregulation, the abdication of judicial responsibility to interpret statutes, and the unwarranted imposition of regulatory enforcement costs.

The Loper majority firmly rejected Chevron and held that the APA requires courts to exercise their independent judgment in deciding legal questions that arise in reviewing agency action. As the majority held, “courts need not and under the APA may not defer to an agency interpretation of the law simply because a statute is ambiguous.” [5]

Importantly, however, Loper noted that deference may still be afforded agencies in certain instances. First, the Court observed that the APA expressly mandates a deferential standard of review for agency policy-making and fact-finding. [6] Second, Loper explained that some statutes are best read to “delegate[] discretionary authority to an agency,” in which case a court’s role is to merely ensure the agency “engaged in ‘reasoned decisionmaking’” within that authority. [7] Lastly, Loper reaffirmed that an agency’s “expertise” remains “one of the factors” that may make an agency’s interpretation persuasive. [8]

How Will Loper Impact Federal Health Care Programs?

Loper ’s directive that courts should construe statutes independently and not defer to agencies’ positions has enormous implications for providers and suppliers that participate in federal health care programs. Much of today’s health care landscape is governed by HHS’ regulations, impacting many Americans and much of the federal budget. For example, Medicare currently covers more than 67 million beneficiaries, and Medicare spending comprised 12% of the federal budget in 2022 and 21% of national health care spending in 2021 . [9]

Federal health care programs like Medicare and Medicaid are established by statutes that set forth myriad requirements regarding the coverage of items and services, and how, when, and by whom those items and services may be furnished. [10] HHS’s various components—most notably the Centers for Medicare and Medicaid Services (CMS)—have issued numerous, detailed regulations to implement these statutes. HHS’s components also include FDA, CDC, HRSA, AHRQ, OCR, NIH, and many others that intersect with health care providers and suppliers regularly.

Going forward under Loper , future challenges to agency regulations will take place upon a much different playing field. This has several important implications:

More Legal Challenges: We expect to see more legal challenges brought against HHS’s regulations as they are issued. Loper expressly stated that it “does not call into question prior cases that relied on the Chevron framework,” so prior decisions affirming regulations should be stable. [11] But going forward, Loper means that courts have no “thumb on the scale” in favor of HHS’s legal positions, and so litigants may view Loper as increasing their odds of success. At the same time, this may create more uncertainty for providers and suppliers who must determine how to comply with new regulations under challenge.
Less Ability for HHS to Create New Programs or Impose New Requirements: Especially where HHS imposes new substantive requirements that are not clearly authorized by statute, HHS’s regulations may be vulnerable. For example, the challengers to CMS’s minimum-staffing requirements for nursing homes are sure to cite Loper . [12] Likewise, when HHS creates new programs or initiatives by regulation based on broad statutory language ( e.g. , HHS’s recent creation of rural emergency hospital regulations [13] ), the regulations may be more vulnerable to challenges. As another example, legal challenges to FDA’s new rule on Laboratory Developed Tests are pending and will likely invoke Loper. [14]
More Incentive to Challenge Reimbursement Rules: Legal challenges are frequently brought to CMS’s rules governing reimbursement, which often have complicated statutory formulas subject to differing interpretations. Whereas in the past, courts often deferred to CMS’s interpretations, [15] Loper now creates more potential for providers and suppliers to seek more favorable legal interpretations to enhance reimbursement.
Slower and More Cautious Rulemaking: As HHS promulgates new regulations, it will now have to consider the enhanced litigation risk that Loper creates. This may lead to agencies slowing and proceeding more cautiously in rulemaking as agencies seek to craft defensible regulations.
Inconsistent Decisions by Courts: Because Loper directs courts to exercise independent judgment rather than defer to HHS’s interpretations, we expect that courts in different areas of the country may reach differing conclusions regarding HHS regulations. This may make certain geographic locations more advantageous for provider and supplier operations or expansions.

Going forward, courts will be more amenable than ever to siding with challenges to HHS regulations. This creates both challenges and opportunities for providers and suppliers who should carefully assess the legal basis for all new regulations.

The authors acknowledge the contributions of Callie Ericksen, a student at the University of California Davis Law School and 2024 summer associate at Foley & Lardner LLP.

[1] Loper Bright Enterprises v. Raimondo , No. 22-451 (June 28, 2024), together with Relentless, Inc. v. Department of Commerce , No. 22-1219, available here .

[2] 467 U.S. 837 (1984).

[3] Id. at 843 (emphasis added).

[4] See Am. Hosp. Ass’n (“AHA”) v. Becerra , 142 S. Ct. 1896, 1904 (2022) (determining that HHS’s preclusion of judicial review “lacks any textual basis,” remaining silent with respect to Chevron ); Becerra v. Empire Health Found. , 142 S. Ct. 2354, 2362 (2022) (illustrating that HHS’s reading aligns with the statute’s “text, context, and structure” in calculating the Medicare fraction for purposes of Medicare Part A benefits, without any mention of Chevron ); Vanda Pharms., Inc. v. Ctrs. for Medicare & Medicaid Servs. ,98 F.4th 483 (2024) (holding that CMS’s definitions of “line-extension” and “new formulation” did not conflict with the Medicaid statute).

[5] Loper Bright Enterprises v. Raimondo , No. 22-451, slip op. 35 (June 28, 2024).

[6] Id. at slip. op. 14 (citing 5 U.S.C. §§ 706(2)(A), (E)).

[7] Id. at slip op. 18.

[8] Id. at slip op. 25 (citing Skidmore v. Swift & Co. , 323 U.S. 134 (1944).

[9] See KFF, Medicare 101 (published May 28, 2024), available here .

[10] See 42 U.S.C. §§ 1395–1395lll.

[11] Loper Bright Enterprises v. Raimondo , No. 22-451, slip op. 34 (June 28, 2024).

[12] See Am. Health Care Ass’n v. Becerra , No. 24-cv-114 (N.D. Tex) (challenging the rule issued at 89 Fed. Reg. 40876 (May 10, 2024).

[13] Conditions of Participation, 42 C.F.R. §§ 485.500-485.546 (Subpart E), and Payments, §§ 419.90-419.95 (Subpart J), 87 Fed. Reg. 71748, 72292-93 (Nov. 23, 2022),

[14] 21 C.F.R. § 809, 89 Fed. Reg. 37286 (May 6, 2024).

[15] See, e.g. , Baptist Mem’l Hosp. – Golden Triangle, Inc. v. Azar , 956 F.3d 689 (5th Cir. 2020) (deferring to CMS’s rule addressing “costs incurred” for calculating Medicaid Disproportionate Share Hospital payments).

Matthew D. Krueger

Judith A. Waltz

Jarrod S. Brodsky

Ilana Meyer

Law Graduate

Related Insights

Hipaa: amendments to protect reproductive health care information can now be implemented with ocr’s final rule, episode 32: let’s talk compliance: what the ftc’s ban on non-competes means for the health care industry, episode 31: health care philanthropy: navigating the hurdles, rules, and restrictions.

High Court Magnifies Biden’s Misery by Kneecapping Policy Agenda

By Courtney Rozen

The US Supreme Court’s sweeping decision slashing the power of the executive branch, coming hours after President Joe Biden ‘s poor debate performance, makes it harder for his administration to accomplish his biggest policy ambitions ahead of November’s election.

By saying that regulatory agencies don’t have leeway to interpret the meaning of ambiguous laws, the court made it tougher for the administration to defend regulations it issued in recent months to tackle climate change, forgive student debt, and crack down on so-called “junk fees.” All are among Biden’s key pitches to voters in his re-election campaign.

The decision eliminated a 40-year-old court precedent known as Chevron deference, building on a series of earlier opinions limiting agencies’ policymaking power. Many of Biden’s policy aims depend on interpretations of executive power under older laws, or writing rules where Congress called for standards but left it up to agencies to create them.

“This is as extreme an overruling of Chevron as anybody could have anticipated,” said Sharon Block, a former leader of Biden’s Office of Information and Regulatory Affairs, which oversees the White House’s rulemaking process. “I don’t see really any remaining respect for the expertise of agencies.”

The ruling came the morning after Biden repeatedly stumbled through his responses in the first presidential debate of the general election. The performance, punctuated by flubbed lines and coughing, intensified allies’ worries that he will lose to former President Donald Trump in November and sparked some calls for him not to run again.

“While this decision undermines the ability of federal agencies to use their expertise as Congress intended to make government work for the people, the Biden-Harris Administration will not relent in our efforts to protect and serve every American,” Press Secretary Karine Jean-Pierre said in a statement.

“The President has directed his legal team to work with the Department of Justice and other agency counsel to review today’s decision carefully and ensure that our administration is doing everything we can to continue to deploy the extraordinary expertise of the federal workforce to keep Americans safe and ensure communities thrive,” the statement said.

Biden has pursued an ambitious regulatory agenda throughout his presidency. His most recent to-do list, published in December, included 2,524 items—40% of which the administration expected to finalize, according to Bloomberg Government’s analysis of the list.

“The courts have been saying we need to follow express congressional authorization language at a time when Congress is the weakest and is either not legislating or keeping statutes ambiguous,” said Marc J. Scheineson, a partner at Alston & Bird LLP that represents companies before the Food and Drug Administration, said ahead of the decision.

Climate Change

The Environmental Protection Agency’s proposed rules cracking down on power-plant emissions hinge on the extent of its authority to set pollution standards under the Clean Act. More than two dozen states joined rural power companies and coal advocates in challenging the rule, calling it an unlawful effort to remake the nation’s electricity system.

Biden’s signature climate law, the Inflation Reduction Act ( Public Law 117-169 ), separately imposes fines on the oil and gas industry for methane emissions. Lawmakers left it up to the EPA to decide how to calculate the penalties and what companies can do to avert charges. Methane is the second-largest contributor to global warming after carbon dioxide.

The EPA in January proposed charging energy producers $900 per ton of excess methane emitted this year, with fees rising to $1,500 per ton by 2026.

Senate Energy Committee Chair Joe Manchin (D-W.Va.) said in March that the proposals are “inconsistent with congressional intent” and called on the administration to make the charges more flexible. The EPA has yet to finalize the fees.

Student Loans

Alleviating student debt is part of Biden’s pitch to younger voters. He wants to leverage the Higher Education Act ( Public Law 89-329 ) to slash student debt for as many as 26 million Americans, after the Supreme Court in 2023 blocked his initial plan to use pandemic emergency powers to forgive loans for more borrowers.

Friday’s decision gives Republicans another tool to stop future rounds of debt cancellation by arguing that the actions overstep the authority Congress gave to the Education Department.

Two federal judges on Monday temporarily halted Biden’s plan to quicken forgiveness for certain borrowers, one of the administration’s most recent moves to cut down on student debt.

The Biden administration does not have “clear congressional authorization,” to implement the plan, Judge Daniel D. Crabtree of the US District Court for the District of Kansas wrote.

The IRS is writing a proposal for the Corporate Alternative Minimum Tax, known as CAMT. The plan will spell out how the tax will be calculated, after Congress directed the agency to make that decision.

The law requires companies to pay tax at a rate of at least 15% of their financial-statement income if they aren’t already doing so. The agency said in June it would provide a waiver for penalties for underpayments of the tax, after companies struggled to calculate their liability.

Taxpayers are waiting on more details.

Agency attorneys have cited years-old laws to justify the effort to eliminate junk fees, Biden’s term for hidden charges,rather than waiting for Congress to pass bills targeting specific costs.

Bank overdraft fees would drop to as low as $3 under a January proposal from the Consumer Financial Protection Bureau. Agency attorneys invoked a 1978 law to protect the rights of customers that transfer money electronically. The banking industry responded with a 21-page letter arguing that Congress didn’t give the agency permission to force the sector to cut fees.

In Friday’s Supreme Court decision, Associate Justice Neil Gorsuch echoed similar language, writing that the Biden administration can’t write rules without express permission from Congress.

Opponents of regulatory action will have an easier time overturning rules not specifically mandated in law, forcing agencies to slow down and be more cautious in formulating policy, left-leaning administrative law attorneys said.

“It’s creating a green light for any aggrieved corporation to bring a suit to get rid of an inconvenient regulation,” said K. Sabeel Rahman, a professor at Cornell Law School and also a former leader of Biden’s OIRA.

—With assistance from Jennifer A. Dlouhy and Caleb Harshberger

— With assistance from Caleb Harshberger .

To contact the reporter on this story: Courtney Rozen in Washington at [email protected]

To contact the editors responsible for this story: Bernie Kohn at [email protected] ; Cheryl Saenz at [email protected] ; Keith Perine at [email protected]

Learn more about Bloomberg Law or Log In to keep reading:

Learn about bloomberg law.

AI-powered legal analytics, workflow tools and premium legal & business news.

Already a subscriber?

Personalize Your Experience

Already have an account? Log In

Free standard shipping is valid on orders of $45 or more (after promotions and discounts are applied, regular shipping rates do not qualify as part of the $45 or more) shipped to US addresses only. Not valid on previous purchases or when combined with any other promotional offers.

Register for an enhanced, personalized experience.

Receive free access to exclusive content, a personalized homepage based on your interests, and a weekly newsletter with topics of your choice.

Home / Living Well / Health benefits of semaglutide — Beyond weight loss

Health benefits of semaglutide — Beyond weight loss

Please login to bookmark.

Username or Email Address

Remember Me

When the Food and Drug Administration (FDA) approves new medications, few receive as much news — and social media — coverage as semaglutide. You may be more familiar with the common brand names of this drug, Ozempic and Wegovy. This medication, initially approved as a new option for the management of type 2 diabetes (Ozempic), gained significant attention for its weight-loss benefits, which led to the approval of Wegovy. In addition to those uses, you may be surprised to learn that semaglutide has several other health benefits, as well.

What is semaglutide and how does it work?

Semaglutide is a medication that belongs to a class of drugs called GLP-1 receptor agonists. These drugs mimic the effects of a natural hormone called glucagon-like peptide-1 (GLP-1). Semaglutide stimulates the pancreas to produce insulin and reduces the hunger hormone ghrelin, which can decrease your appetite and slow down the rate of stomach emptying. As a result, semaglutide helps lower blood sugar levels and promotes weight loss. The medication is most commonly injected once a week under the skin.

What are the benefits of semaglutide beyond weight loss?

While weight loss is probably the most talked about reason to use semaglutide, it was not the medication’s first, and far from only, benefit. Potential benefits include:

Semaglutide was initially approved in 2017 as a new treatment option for type 2 diabetes. Clinical trials found that semaglutide lowered the diabetes management marker hemoglobin A1C , on average, by up to 2 percentage points. People taking semaglutide also were more likely to achieve an A1C treatment goal of less than 7% compared with using other medicines. These initial studies also showed evidence of weight loss and cardiovascular risk reduction. Semaglutide also may protect the kidneys from damage caused by high blood sugar levels, which can lead to chronic kidney disease and kidney failure. A study looking at semaglutide’s ability to delay progression to chronic kidney disease in people with type 2 diabetes was recently stopped early because interim data demonstrated the medication’s clear effect.

Cardiovascular disease

Studies have found that semaglutide reduces the risk of major cardiovascular events, including heart attack and stroke, in adults with overweight or obesity who have known cardiovascular disease, both with and without diabetes. A large clinical trial in people with diabetes found semaglutide can reduce the risk of major cardiovascular events or death by 26% compared with placebo. A similar trial in people without diabetes found a 20% reduction in similar outcomes.

Heart failure

Semaglutide also has been studied in individuals with certain types of obesity-related heart failure, both with and without diabetes. Studies suggest that semaglutide may help improve heart failure-related symptoms, such as tiredness, shortness of breath and swelling. Additionally, improvements in physical limitations and exercise tolerance, along with weight loss, also were seen.

Potential future uses

Multiple studies are in progress or being planned to examine if semaglutide will be helpful for other conditions. These include polycystic ovary syndrome (PCOS), addiction, Alzheimer’s disease, Parkinson’s disease, sleep apnea, and the liver condition previously called nonalcoholic fatty liver disease (NAFLD) and now known as metabolic dysfunction-associated steatotic liver disease (MASLD).

What side effects and risks are associated with semaglutide?

Semaglutide may cause some mild to moderate side effects, which often decrease over time, such as nausea, vomiting, diarrhea, constipation and abdominal pain.If using semaglutide with certain other medications for diabetes, low blood sugar also may result.In clinical trials, approximately 20% of people discontinued the medication due to side effects. To help improve tolerability, the dose is gradually increased over several weeks.

Semaglutide is not recommended for people with type 1 diabetes, diabetic ketoacidosis, or a history of pancreatitis or a certain type of thyroid cancer. It also is not advised for people who are pregnant or breastfeeding, or for children under 18 years of age.

Due to the delay of stomach emptying caused by semaglutide, the absorption of other oral medications administered at the same time may be affected, so monitoring the effects of those medications is important.

How do I know if semaglutide is right for me?

If you want to try semaglutide, talk to your healthcare team about whether it is suitable for you. Also ask about its potential benefits and risks. Currently, there are two potential barriers to starting or continuing semaglutide: cost and availability. The average retail cost of a 28-day supply of semaglutide is over $1,000. Your cost will vary depending on your insurance coverage, dosage and the specific brand prescribed. Discounts, coupons and assistance programs may be available. Due to the overwhelming popularity of the medication, pharmacies have had difficulty keeping the medication in stock.

If you and your healthcare team decide semaglutide is right for you, you will receive a prescription for the appropriate dose. Your care team may also teach you how to correctly inject the medication and monitor for side effects and effectiveness. Semaglutide may offer potential benefits for many people; however, it is not a cure-all. Following a healthy diet and exercising regularly remain important for overall health.

Relevant reading

Mayo Clinic Family Health Book, Fifth Edition

By Scott C. Litin, M.D. As a busy adult, you may have difficulty tracking down information about living a healthy lifestyle. In addition to outlining medical guidance concerning vaccinations, nutrition, managing stress, and overcoming unhealthy behaviors, Mayo Clinic Family Health Book explains diseases and disorders that can develop as people…

Discover more Living Well content from articles, podcasts, to videos.

You May Also Enjoy

by Jamie M. Bogle, Au.D., Ph.D., Sophie J. Bakri, M.D.

by Brent A. Bauer, M.D., Cindy A. Kermott. M.D., M.P.H., Martha P. Millman, M.D., M.P.H.

by Francis A. Farraye, M.D., M.Sc., Sunanda V. Kane, M.D., M.S.P.H.

Privacy Policy

We've made some updates to our Privacy Policy. Please take a moment to review.

Subscriptions

By clicking Sign In, you agree to our Terms and Conditions and that you have read our Privacy Policy .

We won't post to any of your accounts

Your password must include:

Min 8 characters
Min 1 lowercase character
Min 1 uppercase character
Min 1 number

Get Woman's World Magazine

Save up to 65%.

Woman's World

Privacy Policy
Cookie Policy
Cookie Preferences
Do Not Sell

From Prime Produce to Cooking Tips to Social Ties, an Expert Shares the Benefits of Farmers Markets

Never been? No problem! See our top tips for navigating a farmers market as a newcomer

The benefits of farmers markets

Never visited your local farmers market? Here are just a few of the perks you can expect:

1. Nutrient-rich produce

Farmers markets are treasure troves of fresh fruits and vegetables, harvested at the peak of ripeness. Unlike supermarket produce, which often travels long distances, local offerings retain higher levels of nutrients. According to Mackenzie Sehlke , Executive Director at Boulder County Farmers Markets , “fruits and vegetables at farmers markets are typically harvested just hours before they are sold. This means you are getting produce that is not only packed with flavor, but also with vitamins, minerals and antioxidants that are essential for a healthy diet and immune system.”

Research published in Food Chemistry supports this, highlighting that antioxidant levels can significantly decline during transportation and storage. That means locally-grown produce, picked and sold shortly after harvest, provides a superior nutritional punch. Sehlke also points out that farmers markets offer unique regional delicacies and heirloom varieties rich in nutrients specific to local soils and climates.

Need another reason to shop your local farmers market? Studies show that eating more fruits and vegetables is linked to a reduced risk of chronic diseases like heart disease , stroke, type 2 diabetes and certain cancers.

Related: Pro Tricks to Keep Your Produce Fresh For Longer

2. Social connections

One of the greatest benefits of shopping at farmers markets is the direct connection with the people who grow your food. “Farmers markets are some of the last, best ‘third spaces’ [social places other than your home or work]. I like to think about them like a shared kitchen table with plenty to eat and a seat for everyone,” says Sehlke. Engaging with farmers allows you to learn about their growing methods and make more informed choices about what ends up on your plate.

3. Community support

people shopping outside at local farmers markets to enjoy health and nutrition benefits

When you shop at your local farmers market, you’re not just boosting your health but also supporting your community. “By purchasing local, you are supporting farmers and small businesses, which helps to strengthen your local economy and community across the board,” explains Sehlke. This support helps keep local farmland thriving and ensures the continuous availability of fresh, high-quality produce in your area.

How to boost the benefits of shopping at farmers markets

For the best farmers market experience, plan your meals around what’s in season. Seasonal produce is at its peak ripeness, boasting the highest concentration of nutrients. And Sehlke encourages newcomers to take their time exploring the market, too.

“There is no wrong way to explore,” she notes. “Market vendors are typically very excited to talk to you about their unique products. Come with questions, a shopping list, a friend and enough time to enjoy.” (See more of our favorite farmers markets tips and tricks .)

Find something you’re interested in? Don’t hesitate to ask for tips on storing and preparing different varieties of produce. “Markets are a sensory experience — don’t be afraid to smell, touch and try a sample when offered,” Sehlke says. “Try something new! I’ve found some of my favorite foods, brands and small businesses by taking home something new to me, with a recipe or recommendation from a market vendor.”

iRobot® Roomba Combo® i3+ (3574) Self-Emptying Robot Vacuum & Mop

Deal of the Day

More tips on how to boost your health through fresh foods:

Paleo vs. Mediterranean Diet: Colorful Foods with Varying Flexibilities

Experts Share the 8 Best Brain Foods to Boost Focus, Prevent Memory Loss and More

Hybrid Fruits Are the Trendy Treats Nutritionists Are Raving About — Here’s Why

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .

More in Health

FDA Bans Brominated Vegetable Oil: Learn About the Additive and What This Means for Foods and Beverages

Oatmeal Drinks for Weight Loss: Experts’ Yummy Upgrade of TikTok’s ‘Oatzempic’ Trend Can Triple Fat Burn

An image of a woman wearing a Lilly Pulitzer dress next to text that reads 'Lilly Pulitzer Dresses under $100'

14 Lilly Pulitzer Dresses Under $100 That Are Perfect for Summer

Two women laughing together on a hammock

You Deserve a LOL Break: How Laughter Improves Your Mood, Health and Alleviates Aches

A mature woman doing an indoor walking workout in front of a TV wearing colorful clothes

Get Your Steps in Rain or Shine With These Beginner-Friendly Indoor Walking Workout Routines

White plate with pink glitter confetti, golden and black fork and knife, yellow alarm clock over pink background. Concept of nutrition and dieting.

The Intermittent Fasting Diet: Is It All It’s Cracked Up to Be?

How To Get a Free Amazon Prime Subscription: Sign Up for a Trial Ahead of Prime Day 2024!

mature woman looking at her eyes in the mirror for symptoms of thyroid eye disease

What Doctors Want Women Over 50 to Know About Thyroid Eye Disease Symptoms and the Link to Menopause

Is Backwards Walking a Secret Weight-Loss Hack? Inside the Viral TikTok Trend

Open container with colostrum powder with measuring scoop. Colostrum benefits for immune system and gut health

What Is Colostrum and Why Are Celebrities Using It to Boost Their Health? A Closer Look

An image of the iRobot Roomba mop next to green text that reads 'iRobot Flash Sale.'

iRobot Vacuum Sale: Save Up to $100 on the Roomba and More!

A plate of meat is the perfect carnivore diet meal.

Is the Carnivore Diet Better Than Keto for Weight Loss? For Women Over 50, It May Be!

The Daily Show Fan Page

Explore the latest interviews, correspondent coverage, best-of moments and more from The Daily Show.

The Daily Show

S29 E68 • July 8, 2024

Host Jon Stewart returns to his place behind the desk for an unvarnished look at the 2024 election, with expert analysis from the Daily Show news team.

Extended Interviews

The Daily Show Tickets

Attend a Live Taping

Find out how you can see The Daily Show live and in-person as a member of the studio audience.

Best of Jon Stewart

The Weekly Show with Jon Stewart

New Episodes Thursdays

Jon Stewart and special guests tackle complex issues.

Powerful Politicos

The Daily Show Shop

Great Things Are in Store

Become the proud owner of exclusive gear, including clothing, drinkware and must-have accessories.

About The Daily Show

IMAGES

Assignment Of Benefits Form
Assignment Of Benefits Form
Assignment Of Benefits Form Template
Health Policy Analysis Paper Example Free Essay Example
HealthSafety Policy
Assignment Of Benefits Form printable pdf download

VIDEO

PAD 253
Class Assignment Benefits of Yoga
What You Need to Know About the WSIB's Assignment of Benefit Policy
Getting started with Azure Policy by Akash Jain
Can you accept Long Term Care Insurance? Can you also do an assignment of benefits?
Health insurance Policy

COMMENTS

Assignment of Benefits: What You Need to Know
With an assignment of benefits, you can designate your healthcare provider as your insurance claimant. Then, your healthcare provider can request insurance payouts from your healthcare insurance provider directly. Through this system, the health insurance provider directly pays your physician or hospital rather than paying you.
What is an assignment of benefits (AOB)?
An AOB is a legal agreement that allows your insurance company to directly pay a third party for services performed on your behalf. In the case of health care, it could be your doctor or another ...
What Should An Assignment of Benefits Form Include?
An assignment of benefits form (AOB) is a crucial document in the healthcare world. It is an agreement by which a patient transfers the rights or benefits under their insurance policy to a third-party - in this case, the medical professional who provides services. This way, the medical provider can file a claim and collect insurance payments.
What is assignment of benefits, and how does it impact insurers?
Assignment of benefits, widely referred to as AOB, is a contractual agreement signed by a policyholder, which enables a third party to file an insurance claim, make repair decisions, and directly ...
Assignment of benefits explained
An assignment of benefits (or AOB for short) is an agreement that gives your claims benefits, and in some instances complete control of your claim, to someone else. It's usually used so that a contractor can "stand in your shoes" and file a claim, make decisions about repairs, and collect insurance payments from your insurance company ...
What is an Assignment of Benefits?
Assignment of benefits is legal, thanks to a concept known as freedom of contract, which says two parties may make a private agreement, including the forfeiture of certain rights, and the government may not interfere. There are exceptions, making freedom of contract something less than an absolute right.
All You Need to Know About Assignment of Benefits
When you sign an assignment of benefits agreement, you bypass dealing with an insurance company's claims department and allow the benefits to be paid directly to the provider. For example, the assignment of benefits medical definition is when you sign a form that requires your health insurance provider to pay the hospital or physician directly.
Assignment Of Benefits
Assignment of benefits is a document that directs payment to a third party at the insured's request. It becomes legitimate once both the insured party and their insurer have signed the AOB form. AOB is used in a number of insurance contexts, such as paying physicians or clinics through health insurance or paying contractors for repairs ...
What is an assignment of benefits?
An assignment of benefits (AOB) is a legal agreement you sign that lets a third party negotiate, bill, and receive payment from your insurance provider.
Can You Assign Your Insurance Benefits to Someone Else?
The assignment of benefits clause transfers a patient's right to collect benefits under his or her health policy to the provider. By signing the document, the patent agrees that payments will be made directly to the provider for the services rendered. The clause states that the patient is ultimately responsible for the charges if the insurer ...
Assignment of Benefits: Consumer Beware
An Assignment of Benefits, or an AOB, is an agreement signed by a policyholder that allows a third party—such as a water extraction company, a roofer or a plumber—to act on behalf of the insured and seek direct payment from the insurance company. An AOB can be a useful tool for getting repairs done, as it allows the repair company to deal ...
Recent Case Law Regarding Health Plan Assignment of Benefits
Accordingly, health plans and employers that sponsor health plans should be sure to review and incorporate strong anti-assignment language to prevent third parties from bringing lawsuits against the plan. It is possible that the anti-assignment can be waived depending on the actions of the parties.
Assignment of benefits
Assignment of benefits is a fundamental concept in healthcare revenue cycle management. It enables healthcare providers to receive payment directly from the insurance company, reducing the financial burden on patients and streamlining the billing process. By understanding the assignment of benefits, patients can make informed decisions about ...
Assignment of Benefits (Health Care) Law and Legal Definition
Assignment of benefits in the context of health care refers to an agreement or arrangement between a beneficiary and an insurance company, by which a beneficiary requests the insurance company to pay the health benefit payment directly to the physician or medical provider. The patient or guardian signs the assignment of benefits form so that ...
Assignment of benefits: A growing concern
The precedent established by this 100-year-old case continues to make it very difficult for an insurance company to prohibit the assignment of benefits in Florida. In addition to this case, Florida Statute §627.428 governing payment of attorneys' fees related to insurance practices requires that insurance companies pay legal fees to third ...
Assignment of Benefits: What It Is, and How It Can Affect your ...
this policy does not allow the unrestricted assignment of post-loss insurance benefits. by selecting this policy, you waive your right to freely assign or transfer the post-loss property insurance benefits available under this policy to a third party or to otherwise freely enter into an assignment agreement as the term is defined in section 627 ...
PDF Assignment of Benefits Guide
Assignment of Benefits. A procedure whereby a beneficiary/patient authorizes the administrator of the program to forward payment for a covered procedure directly to the treating dentist. This is done using box #37 on the ADA claim form. The below image shows the specific instructions for how to complete box #37 for use with assignment of benefits.
Assignment Of Benefits Flashcards
1.Assignment Of Benefits. Authorization by policyholder that allows a health plan to pay benefits directly to a provider. 2. Benefits. The amount of money a health plan pays for services covered in an insurance policy. 3.Coinsurance. The portion of charges that an insured person must pay for health care services after payment of the deductible ...
Assignment of Benefits
Assignment of benefits is not authorization to submit claims. It is important to note that the beneficiary signature requirements for submission of claims are separate and distinct from assignment of benefits requirements except where the beneficiary died before signing the request for payment for a service furnished by a supplier and the supplier accepts assignment for that service.
Top 9 Techniques of Writing An Assignment of Benefits of a Health Policy
Here are the 9 key points to craft an assignment of benefits of a health policy: Understand the basic requirements of the paper. Write a strong thesis statement for the assignment. Start writing the first draft of your work. Provide context of research in the introduction. The main body should be structured.
Assignment of Benefits (AOB)
An assignment of benefits (AOB) is a contractual agreement that enables a third party to access insurance benefits on behalf of the policyholder. [1] When the policyholder signs an AOB agreement, it grants the third party the authority to initiate an insurance claim and receive reimbursement directly from the insurance company.
What is Assignment of Benefits in Medical Billing?
An assignment of benefits is the act of signing documentation authorizing a health insurance company to pay a physician directly. In other words, the insurance company can pay claims without the direct involvement of the patient in the process. There are other situations where AOBs can be helpful, but we'll focus on their use in relation to ...
6 Health Policy Provisions Flashcards
Entire Contract. The Entire Contract provision states that the health insurance policy, together with a copy of the signed application and attached riders and amendments, constitutes the entire contract. An assignment of benefits of a Health Policy. Transfers payments to someone other than the policy owner. Because an assignment of benefits of ...
Colorado Medicaid Adds Doula Services as a Benefit
About the Colorado Department of Health Care Policy & Financing: The Department administers Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus, and other programs for Coloradans who qualify.These health care programs now cover about one in four Coloradans. For more information about the Department, please visit hcpf.colorado.gov.
What the Chevron Ruling Means for the Federal Government
Kristi Hamrick, a strategist for Students for Life of America, an anti-abortion organization, said in a statement that such a case was likely to get a better reception "when the F.D.A. is no ...
What Does the End of Chevron Deference Mean for Federal Health Care
Loper will have significant and immediate implications for the U.S. Department of Health and Human Services (HHS), the federal agency charged with the administration of the federal health care programs, including Medicare and Medicaid. As detailed below, the Court's decision sets a more exacting standard for courts to apply when reviewing HHS ...
High Court Magnifies Biden's Misery by Kneecapping Policy Agenda
The US Supreme Court's sweeping decision slashing the power of the executive branch, coming hours after President Joe Biden 's poor debate performance, makes it harder for his administration to accomplish his biggest policy ambitions ahead of November's election.. By saying that regulatory agencies don't have leeway to interpret the meaning of ambiguous laws, the court made it tougher ...
Health benefits of semaglutide
This medication, initially approved as a new option for the management of type 2 diabetes (Ozempic), gained significant attention for its weight-loss benefits, which led to the approval of Wegovy. In addition to those uses, you may be surprised to learn that semaglutide has several other health benefits, as well.
Benefits of Farmers Markets: Nutrient-Rich Produce and Social Ties
These lively community hubs offer a bounty of benefits, from peak-freshness produce to sustainable practices, making them the ultimate health hack for a thriving summer. We spoke to experts to learn more about the benefits of farmers markets and how shopping there can improve your health. The benefits of farmers markets
The Daily Show Fan Page
The source for The Daily Show fans, with episodes hosted by Jon Stewart, Ronny Chieng, Jordan Klepper, Dulcé Sloan and more, plus interviews, highlights and The Weekly Show podcast.

Practice Areas

What Is an Assignment of Benefits?

What Does an Assignment of Benefits Mean?

What Types of Insurance Qualify for an Assignment of Benefits?

Who Uses Assignments of Benefits?

Advantages of Using an Assignment of Benefits

Risks of Using an Assignment of Benefits

How To Make Sure an Assignment of Benefits Is Safe

Can You Sue a Party for Abusing an Assignment of Benefits?

Assignment of Benefits FAQs

Can You Revoke an Assignment of Benefits?

Contact Schwartzapfel Lawyers Today

Related Posts

What Is A Letter Of Protection In A Personal Injury Case?

Do I Need Uninsured Motorist Coverage?

We'll Fight For You

What is an assignment of benefits?

What is an assignment of benefits?

How an AOB works

Example of an assignment of benefits

When would you need to use an assignment of benefits?

Assignment of benefits for health insurance

Assignment of benefits for car owners

Assignment of benefits for homeowners

The fraud factor

Pros and cons of an assignment of benefits

The takeaway

About the contributors

Caring ‣ Urgent ‣ Aggressive

(201) 261 - 1700

Leave a Reply

Assignment of benefits

What is an assignment of benefits?

Why do homeowners agree to an assignment of benefits?

Assignment of benefits in Florida: a case of rampant fraud

What responsibilities does the AOB contractor have?

How assignment of benefits impact homeowners

Protecting yourself in an assignment of benefits agreement

Related Posts: Keep exploring

What is an Assignment of Benefits?

Assignment Of Benefits

Insuranceopedia Explains Assignment Of Benefits

Related Definitions

Entertainment

New on Yahoo

Yahoo Finance

How an AOB works

Example of an assignment of benefits

When would you need to use an assignment of benefits?

Assignment of benefits for health insurance

Assignment of benefits for car owners

Assignment of benefits for homeowners

The fraud factor

Pros and cons of an assignment of benefits

Pros of assignment of benefits

Cons of assignment of benefits

The takeaway

Can You Assign Your Insurance Benefits to Someone Else?

Anti-Assignment Clause

Post-Loss Assignments Permitted

Problems With Assignments of Benefits

Avoiding Problems With AOBs

AOBs in Health Insurance

Search NAIC

Consumer Insight

Assignment of Benefits: Consumer Beware

Assignment of benefits

What is Assignment of Benefits?

Understanding Assignment of Benefits

Difference between Assignment of Benefits and Power of Attorney

Examples of Assignment of Benefits

Get paid in full by bringing clarity to your revenue cycle

Subscribe to the

Healthcare Clarified newsletter

Assignment of benefits: A growing concern

Factors that affect profitability

What is assignment of benefits?

What are the concerns with assignment of benefits?

How has this issue escalated?

How is ISO responding?