Insurance Commons^™

The Back Page Commentary: Care For Special Needs Patients: We Must Do Better, Craig C. Spangler Dds, Fscda

The Journal of the Michigan Dental Association

Despite strides in providing resources for neurodivergent and geriatric patients, access to suitable dental care remains a challenge. A survey revealed finding capable dentists as the primary barrier to care for special needs individuals. Transitioning from pediatric to adult care lacks continuity, highlighting gaps in predoctoral dental education. Challenges include inadequate training, limited opportunities for continuing education, and reimbursement issues. Collaboration between medical and dental leaders is crucial for addressing these pressing issues and ensuring equitable access to care.

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Staff Matters: How Can We Be More Creative With Our Benefits?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

As open enrollment for health benefits approaches, this column discusses creative and cost-effective benefit offerings to attract and retain employees. The focus is on innovative benefits beyond traditional health, life insurance, and retirement plans. Suggestions include pet insurance, paid volunteer time, lunch and learn sessions, and flexible scheduling to accommodate employees' needs, particularly working parents and those with caregiving responsibilities. The importance of seeking employee input in benefit planning is emphasized for discovering practical, employee-desired options.

Modelling Climate Litigation Risk For (Re)Insurers, Martin Lockman

Sabin Center for Climate Change Law

In response to the growing threat of climate change, the insurance industry has made significant investments in modelling and quantifying physical climate risks. However, the emerging risk of climate litigation has proven particularly difficult to model. In 2015 Mark Carney, then-Governor of the Bank of England and Chairman of the Financial Stability Board, warned that climate litigation poses “long-tail risks” for insurers that may be “significant, uncertain and non-linear.” Since that warning, the number of climate-related cases has more than doubled, and the scope and financial significance of climate litigation has become increasingly clear. However, insurers and regulators still struggle …

Doj Withdraws Healthcare Antitrust Protections, Lance Plunkett Jd, Llm

The New York State Dental Journal

DOJ has withdrawn longstanding antitrust guidance that provided safe harbors for specific conduct in the healthcare marketplace.

Improving Access For Children And Adults With Disabilities Through Enhanced Commercial Benefits, Holli Seabury Edd, Jeff Johnston Dds, Ms

The Journal of the Michigan Dental Association

This article explores the critical issue of accessibility to oral healthcare for people with disabilities in the United States. Delta Dental of Michigan, Ohio, and Indiana has taken a step by providing enhanced commercial benefits to children and adults with disabilities. The article delves into the challenges faced by this vulnerable population, including cost barriers and transition issues, and discusses how expanded benefits and coding, along with special dental care provisions, aim to improve access. It emphasizes the importance of proper benefits verification and presents a case study illustrating the utilization of these benefits. The article highlights the need for …

J Mich Dent Assoc March 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members across the state. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on canceling provider agreements with dental plans.
• A clinical update on when and how to use Silver Diamine Fluoride to manage carious lesions
• News from Delta Dental on efforts to address access to care for disabled individuals through enhanced commercial dental benefits.
• The value of focused counsel from a …

Insurance And Enterprise: Cyber Insurance For Ransomware, Tom Baker, Anja Shortland

All Faculty Scholarship

Selling insurance gives insurers an incentive to manage insured risks. The “insurance as governance” literature demonstrates that insurers often make insurance conditional on ex ante risk reduction or mitigation. But insurance governs in support of enterprise, not security for its own sake. Tight underwriting inhibits enterprise – not only for insured businesses but also the business of insurance. This paper highlights ex post loss reduction as a form of insurance-based governance. Drawing on interviews with industry insiders, we explore how insurers addressed the evolving problems of moral hazard, uncertainty, and correlated losses since the 1990s. We find that cyber insurance …

Let It Burn: A Case Study On The Risk Management Practices Of Burning Man Project, Ethan S. De La Torre

Experience Industry Management

Risk management can be defined as a decision-making process of planning, identifying, analyzing, developing a response for, and controlling potential risks with the goal of minimizing the negative impacts of those risks. Risk management is an essential practice for all events, especially large-scale, live entertainment events. The purpose of this study was to examine the risk management practices for Burning Man. The instrument utilized in this study was a best practices guide developed by the researcher. Data were collected prior to, during, and following Burning Man 2022: Waking Dreams. Sources of data include printed material and online sources published by …

Life's Not Fair. Is Life Insurance?, Mark A. Sayre

Privacy Certificate Student Publications

The rapid adoption of artificial intelligence by life insurance companies increases the risk that such practices may unfairly discriminate against insurance applicants based on race. The article briefly discusses the history of racial discrimination in life insurance pricing, followed by a summary of current antidiscrimination law. Next, proposed state legislation to address discrimination risks posed by artificial intelligence is discussed. Finally, the article discusses the potential that professional standards may provide a faster way to mitigate discrimination risk in a nationally uniform manner.

Dentistry And The Law: Can Dental Plan Ratings Be Defamatory?, Dan Schulte Jd

The Journal of the Michigan Dental Association

This article discusses the legal implications of dental plan ratings for dentists. If a dental plan assigns a rating to dentists and publishes it to patients without providing specific information about the rating's basis or an opportunity for dentists to contest it, legal recourse may be limited. Currently, no statutory law regulates such ratings, leaving dentists potentially vulnerable to defamatory ratings. Under Michigan law, dentists could sue for defamation, but proving the rating's falseness and the resulting loss of patients may be challenging. Federal regulation is suggested to ensure fairness, transparency, and protection for dentists subjected to involuntary ratings.

Negotiating Reimbursement Rates With A Ppo Plan, Dana Moss

The Journal of the Michigan Dental Association

Dentists often struggle to negotiate reimbursement rates with dental insurance companies. This article discusses the importance of managing reimbursement from benefit plans and highlights the advantages and disadvantages of participating in insurance networks. It provides a step-by-step guide to negotiating insurance allowances effectively, emphasizing the need for preparation, data analysis, and communication skills. The article suggests ways to maintain profitability in practices with a significant PPO patient base. It includes recommendations for keeping fees balanced, choosing negotiation plans, and building relationships with insurance representatives. The emotional aspects of negotiation are also addressed, promoting a respectful and collaborative approach.

Where The Rainbow Ends: The Hidden Humanitarian Crisis For Members Of The Lgbtqia+ Community In International Business, John R. Krendel

Senior Honors Projects, 2020-current

Before pursuing an international career, members of the LGBTQIA+ community must be aware of the hardship that may be exacerbated by living and working abroad. This study addresses the trends in laws, including employment and anti-discrimination laws, that provide and restrict certain rights of members of the LGBTQIA+ community in eight countries. These nations, both progressive and discriminatory, include the United States, England, Switzerland, Germany, Taiwan, China, the Philippines and Kazakhstan. Eight LGBTQIA+ business professionals spoke on their experiences living and working in each of these countries and provided advice to members of the community wishing to pursue an international …

What Is Insurance? An Analysis Of The Tax Deductibility Of Captive Insurance Premiums, John D. Patten

Honors Capstones

What is insurance for the purposes of a tax deduction? The Internal Revenue Code does not define insurance. Without this definition, taxpayers using alternative insurance products to manage their risks must look to case law to determine whether their arrangements count as tax deductible insurance or non-deductible self-insurance. This paper dives into the four prongs of insurance: insurance risk, risk shifting, risk distributing, and commonly accepted notions of insurance. This paper looks to cases that have dealt with the deduction of captive insurance premiums to provide better insight into the practical application of this test. After discussing the evolution of …

News You Need: Reminder: What You Must Know About Antitrust Law, Dan Schulte Jd

The Journal of the Michigan Dental Association

This reminder emphasizes the critical importance for dentists, particularly members of organizations like the Michigan Dental Association, to understand antitrust laws and their implications. The U.S. Justice Department and Federal Trade Commission actively pursue antitrust violations among physicians and dentists. The article outlines key aspects of the Sherman Antitrust Act, emphasizing that joint activities among independent dentists that restrain competition may lead to violations. The concept of joint action and the restraint on competition are explored, with a focus on potential pitfalls, such as price-fixing and group boycotts. Dentists are urged to stay informed to avoid legal consequences.

Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd

The Journal of the Michigan Dental Association

This Dentistry and the Law column addresses a dentist's concern about being reported to the National Practitioner Data Bank (NPDB) during a billing dispute. The dentist questions the validity of such a report, considering no issues with treatment quality are raised. The response emphasizes that adverse actions based solely on billing practices may not be reportable to the NPDB. Additionally, it clarifies that a dental plan administrator may not be eligible to make a Data Bank report, offering guidance on informing the plan about rights and potential contestation.

Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd

The Journal of the Michigan Dental Association

The ADA Lobbyist Conference highlighted crucial issues in dentistry, including Medicare reform, teledentistry, workforce concerns, and insurance challenges. State dental associations collaborated on building advocacy partnerships and shared successful grassroots engagement strategies. Medicare reform discussions focused on the ADA's opposition to Plan B inclusion and the impact of constituent outreach. State associations addressed Medicaid reform, emphasizing personal stories to convey the need for change. Teledentistry legislation and insurance company relationships were also key topics. The insights gained will shape the MDA's advocacy strategy for 2022.

Third Party Moral Hazard And The Problem Of Insurance Externalities, Gideon Parchomovsky, Peter Siegelman

All Faculty Scholarship

Insurance can lead to loss or claim-creation not just by insureds themselves, but also by uninsured third parties. These externalities—which we term “third party moral hazard”—arise because insurance creates opportunities both to extract rents and to recover for otherwise unrecoverable losses. Using examples from health, automobile, kidnap, and liability insurance, we demonstrate that the phenomenon is widespread and important, and that the downsides of insurance are greater than previously believed. We explain the economic, social and psychological reasons for this phenomenon, and propose policy responses. Contract-based methods that are traditionally used to control first-party moral hazard can be welfare-reducing in …

J Mich Dent Assoc October 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story, “Welcoming Colleagues from Different Practice Models”.
• A feature article from the Journal’s DEI series, “Diversity, Equity, and Inclusion: Perspectives from an LGBTQ Dentist”.
• A feature article, “Congratulations, 2021 MDA Life Members!”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news. …

J Mich Dent Assoc September 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story with “Reports from the Dental School Deans”, Dr. Mert Aksu and Dr. Laurie McCauley.
• A feature article from the Journal’s DEI series, “Building a Culturally Competent Practice”.
• A feature article, “Disability Insurance: 10 Things You Need to Know”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and …

The Rescue Of American International Group Module F: The Aig Credit Facility Trust, Alec Buchholtz, Aidan Lawson

Journal of Financial Crises

In September 2008, American International Group, Inc. (AIG) experienced a liquidity crisis. To avoid the insurance giant’s bankruptcy, the Federal Reserve Bank of New York (FRBNY) extended an $85 billion emergency secured credit facility to AIG. In connection with the credit facility, AIG issued 100,000 shares of preferred stock, with voting rights equal to and convertible into 79.9% of the outstanding shares of AIG common stock, to an independent trust (the Trust) set up by the FRBNY. Three trustees held the stock for the sole benefit of the US Treasury, exercised the rights, powers, authorities, discretions, and duties of the …

The Rescue Of American International Group Module A: The Revolving Credit Facility, Alec Buchholtz, Aidan Lawson

Journal of Financial Crises

On September 15, 2008, the big three rating agencies downgraded AIG’s credit ratings multiple levels, exacerbating liquidity strains that the company was experiencing due to increasing cash demands by securities borrowers and collateral calls by credit default swap (CDS) customers. To prevent AIG from filing for bankruptcy, the Federal Reserve (the Fed) announced on the following day that, pursuant to its emergency powers, it would provide the company with an $85 billion Revolving Credit Facility (RCF). The RCF was secured by AIG assets and interests in its subsidiaries and required AIG to grant the US Department of the Treasury a …

J Mich Dent Assoc April 2021

The Journal of the Michigan Dental Association

In the April 2021 issue of the Journal of the Michigan Dental Association, we offer a comprehensive range of original feature content showcasing the latest developments in dental practice and knowledge, including:

1. AI in Dental Care Delivery: Explore the groundbreaking role of Artificial Intelligence (AI) and Machine Learning in dental care, revolutionizing efficiency, safety, care outcomes, and treatment planning consistency.
2. AI in Dental Claims Processing: Discover how AI is employed by third-party payers to streamline dental claims processing, resulting in cost containment and the proactive identification of potential fraud, waste, and abuse.
3. Evidence-Based Dentistry: As part of …

Uncertainty > Risk: Lessons For Legal Thought From The Insurance Runoff Market, Tom Baker

All Faculty Scholarship

Insurance ideas inform legal thought: from tort law, to health law and financial services regulation, to theories of distributive justice. Within that thought, insurance is conceived as an ideal type in which insurers distribute determinable risks through contracts that fix the parties’ obligations in advance. This ideal type has normative appeal, among other reasons because it explains how tort law might achieve in practice the objectives of tort theory. This ideal type also supports a restrictive vision of liability-based regulation that opposes expansions and supports cutbacks, on the grounds that uncertainty poses an existential threat to insurance markets.

Prior work …

J Mich Dent Assoc December 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Related Breathing Disorders: A Two-Part Series”.
• The “2020 Author/Title Index to the Journal of the Michigan Dental Association”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes three articles reprinted …

J Mich Dent Assoc November 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Feature articles on how “Routine Blood Lead Testing During Pregnancy Empowers Future Dental Caries and Neurotoxicity Research”, how to “Recoup Your Dues and More with MDA-Endorsed Programs”, and your “2021 MDA Membership Benefits Guide”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, 10-Minute EBD, Headquarters …

J Mich Dent Assoc May 2020

The Journal of the Michigan Dental Association

Every month,The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on Michigan Dentistry in the COVID-19 Pandemic
• A message from the MDA President
• “Severe Acute Respiratory Syndrome Coronavirus-2: What Dental Professionals Need to Know” a feature on protecting the health of your patients and your dental team.
• “Keep the Lights On: Protecting the Health of Your Practice During the Economic Downturn” a …

The Paradox Of Insurance, Gideon Parchomovsky, Peter Siegelman

All Faculty Scholarship

In this Article, we uncover a paradoxical phenomenon that has hitherto largely escaped the attention of legal scholars and economists, yet it has far-reaching implications for insurance law: loss-creation by uninsured parties caused by the presence of insurance. Contrary to the conventional wisdom, we show that insurance can create significant negative externalities by inducing third parties to engage in antisocial, illegal and unethical activities in order to extract money from insureds or insurers. Moreover, as the amount and scope of insurance grows, so does its distortionary effect on third parties. We term this phenomenon the paradox of insurance. The risk …

Private Equity Value Creation In Finance: Evidence From Life Insurance, Divya Kirti, Natasha Sarin

All Faculty Scholarship

This paper studies how private equity buyouts create value in the insurance industry, where decentralized regulation creates opportunities for aggressive tax and capital management. Using novel data on 57 large private equity deals in the insurance industry, we show that buyouts create value by decreasing insurers' tax liabilities; and by reaching-for-yield: PE firms tilt their subsidiaries' bond portfolios toward junk bonds while avoiding corresponding capital charges. Previous work on affiliated or "shadow" reinsurance and capital management misses the important role that private equity buyouts play as recent drivers of these phenomenon. The trend we document is of growing importance in …

J Mich Dent Assoc February 2020

The Journal of the Michigan Dental Association

Every month,The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on the 2020 MDA Annual Session
• A feature covering student perspectives on the Opioid Crisis
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, Headquarters Report, and component news

This issue also includes articles reprinted with permission:

• “Muscle Deprogramming: A Source of Confusion”, …