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Full-Text Articles in Insurance Law

Erisa And Graham-Cassidy: A Disaster In Waiting For Employee Health Benefits And For Dependents Under 26 On Their Parents’ Plans, Leslie Francis Sep 2017

Erisa And Graham-Cassidy: A Disaster In Waiting For Employee Health Benefits And For Dependents Under 26 On Their Parents’ Plans, Leslie Francis

Utah Law Faculty Scholarship

Graham Cassidy § 105 would repeal the ACA “employer mandate”. Although its sponsors claim that the bill will give states a great deal of flexibility, it will do nothing to help states ensure that employers provide their employees with decent health insurance; quite the reverse. It will also give employers the freedom to ignore the popular ACA requirement that allows children up to age 26 to receive coverage through their parent’ plans, at least when their parents get health insurance from their employers. Here’s why.


Regulating Robo Advice Across The Financial Services Industry, Tom Baker, Benedict G. C. Dellaert Aug 2017

Regulating Robo Advice Across The Financial Services Industry, Tom Baker, Benedict G. C. Dellaert

Faculty Scholarship

Automated financial product advisors – “robo advisors” – are emerging across the financial services industry, helping consumers choose investments, banking products, and insurance policies. Robo advisors have the potential to lower the cost and increase the quality and transparency of financial advice for consumers. But they also pose significant new challenges for regulators who are accustomed to assessing human intermediaries. A well-designed robo advisor will be honest and competent, and it will recommend only suitable products. Because humans design and implement robo advisors, however, honesty, competence, and suitability cannot simply be assumed. Moreover, robo advisors pose new scale risks that are different ...


The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue Jul 2017

The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue

Faculty Scholarship

In liability insurance, the duty to defend is broader than the duty to cover. Thus it is possible that an insurer that has a duty to defend a suit may not have the duty to cover the policyholder's liabilities in the suit. However, if the penalty for a breach of the duty to defend is limited to actual legal costs spent by the defendant, the insurer may have an incentive to refuse to defend, even when the duty to defend is clear. This occurs because the insurer will not internalize the consequences of an inadequate defense when it ultimately ...


Murder For Life Insurance Money: Protecting The Children, Johnny C. Chriscoe Jul 2017

Murder For Life Insurance Money: Protecting The Children, Johnny C. Chriscoe

Johnny C. Chriscoe

Children are being murdered for life insurance proceeds. Of course, if a beneficiary murders a child for the recovery of life insurance money and if he is apprehended, he will surely face numerous legal consequences. He will not recover the insurance money, he will be prosecuted and likely sentenced to life imprisonment or execution, he may be sued for the wrongful death of the child and he may be prosecuted for insurance fraud. However, all of these legal responses are triggered by the death of the child and, therefore, do not serve to protect the child from being murdered in ...


The Perfect Storm Is Brewing Once Again: What Scaling Back Dodd-Frank Will Mean For The Credit Default Swap, Daniel Isaacson Jul 2017

The Perfect Storm Is Brewing Once Again: What Scaling Back Dodd-Frank Will Mean For The Credit Default Swap, Daniel Isaacson

The Journal of Business, Entrepreneurship & the Law

The current presidential administration has expressed a concerted desire to “scale back” and even “get rid of” the Dodd–Frank Wall Street Reform and Consumer Protection Act (Dodd–Frank). Focusing specifically on Dodd–Frank’s regulation of the credit default swap (CDS), this Article explores two timely queries. First, whether Dodd–Frank’s regulatory response to these financial instruments is a justifiable one, and second, what effect a repeal may have. This Article will show that the “perfect storm” CDS—which contributed so significantly to the 2007–2010 financial crisis—flourished in a regulatory environment that contained two key weaknesses ...


Draft Protection Insurance: Elite Athlete Loss-Of-Value Policies And The Emerging Wave Of Coverage Litigation, Daniel J. Kain, C. Scott Toomey, Robert L. Joyce May 2017

Draft Protection Insurance: Elite Athlete Loss-Of-Value Policies And The Emerging Wave Of Coverage Litigation, Daniel J. Kain, C. Scott Toomey, Robert L. Joyce

Jeffrey S. Moorad Sports Law Journal

No abstract provided.


Hurricanes, Fraud, And Insurance: The Supreme Court Weighs In On, But Does Not Wade Into, The Concurrent Causation Conundrum In State Farm Fire And Casualty Company V. Rigsby, Chris French May 2017

Hurricanes, Fraud, And Insurance: The Supreme Court Weighs In On, But Does Not Wade Into, The Concurrent Causation Conundrum In State Farm Fire And Casualty Company V. Rigsby, Chris French

Christopher C. French

In the December 6, 2016 Supreme Court decision, State Farm v. Rigsby, a homeowner’s house was damaged by Hurricane Katrina. The homeowner had homeowners insurance with State Farm and a flood insurance policy that was administered by State Farm on behalf of the federal government. The claims adjusters assigned by State Farm to handle the homeowner’s claim allegedly were instructed by State Farm to misclassify wind damage as flood damage in order to shift State Farm’s own liability for the loss to the federal government. The claims handlers filed a lawsuit against State Farm under the False ...


Deference To The Agency Is The Best Policy: The D.C. Circuit Applies Chevron In Denying Additional Medicare Reimbursements To Provider Hospitals In Washington Regional Medicorp, Brandon Curtin May 2017

Deference To The Agency Is The Best Policy: The D.C. Circuit Applies Chevron In Denying Additional Medicare Reimbursements To Provider Hospitals In Washington Regional Medicorp, Brandon Curtin

Boston College Law Review

On December 29, 2015, in Washington Regional Medicorp v. Burwell, the U.S. Court of Appeals for the District of Columbia Circuit held that the Secretary of Health and Human Services (“HHS”) correctly interpreted the Tax Equity and Fiscal Responsibility Act of 1982 (“TEFRA”) in calculating Medicare reimbursements for a provider hospital based on the capped target amount from the previous year. In agreeing with the Secretary, the D.C. Circuit joined the U.S. Courts of Appeals for the Third and Sixth Circuits in holding that the statute and its implementing regulations supported the Secretary. The U.S. Court ...


Can You Keep It? An Examination Of The Individual Health Insurance Market, Rachael Carnale May 2017

Can You Keep It? An Examination Of The Individual Health Insurance Market, Rachael Carnale

Honors Scholar Theses

The passage of the Patient Protection and Affordable Care Act (PPACA, ACA, or Obamacare) in 2010 significantly altered the structure of the individual health insurance market. The new regulatory environment and establishment of the health insurance exchanges forced insurers to adopt to be successful in the reformed individual market. However, the complexity of the law and uncertainty surrounding both the law itself and the newly insured have threatened the stability of the individual market. This thesis will explore the history of the individual health insurance market, the issues that current afflict the exchanges, and viability of possible solutions. Special attention ...


Unemployment Compensation, Rev. Austin P. Bennett Apr 2017

Unemployment Compensation, Rev. Austin P. Bennett

The Catholic Lawyer

No abstract provided.


Unemployment Compensation, Ted During Apr 2017

Unemployment Compensation, Ted During

The Catholic Lawyer

No abstract provided.


Unemployment Compensation, Gerald C. Tobin Apr 2017

Unemployment Compensation, Gerald C. Tobin

The Catholic Lawyer

No abstract provided.


New Threats To Vehicle Safety: How Cybersecurity Policy Will Shape The Future Of Autonomous Vehicles, Caleb Kennedy Apr 2017

New Threats To Vehicle Safety: How Cybersecurity Policy Will Shape The Future Of Autonomous Vehicles, Caleb Kennedy

Michigan Telecommunications and Technology Law Review

This note assesses the threat that hacking and related cybersecurity issues will pose to autonomous vehicles. Given the sweeping safety benefits autonomous vehicles will potentially bring to society, protecting against hacking and cyber-threats must be one of the top priorities for industry and public safety officials if autonomous vehicles are to gain widespread acceptance in the market. It proposes a framework for how these concerns should be addressed and how we can mitigate the risks. It addresses both proactive and reactive measures that can be taken by manufacturers, how to incentivize these measures, and the role cyber-insurance can play in ...


Dinner For Two: Employer Mandate, Meet Erisa; How Dave & Buster’S Response To The Affordable Care Act’S Employer Mandate May Open The Door For Employees To Seek Erisa Relief, Kendall Victoria Dacey Mar 2017

Dinner For Two: Employer Mandate, Meet Erisa; How Dave & Buster’S Response To The Affordable Care Act’S Employer Mandate May Open The Door For Employees To Seek Erisa Relief, Kendall Victoria Dacey

Pepperdine Law Review

When the Affordable Care Act (ACA) became law in late March, 2010, Dave & Buster’s (D&B) had a choice: it could either comply and offer its full-time employees the minimum health insurance coverage required by the new “employer mandate” or it could ignore the new requirements and incur a penalty. Dissatisfied with either option, D&B made the drastic decision to circumvent the ACA entirely, and reduced its full-time staff below the ACA’s employee threshold so as to avoid triggering any penalty or having to pay increased health care costs. However, by dodging the employer mandate, D&B ...


Carpooling Liability?: Applying Tort Law Principles To The Joint Emergence Of Self-Driving Automobiles And Transportation Network Companies, Jacob D. Walpert Mar 2017

Carpooling Liability?: Applying Tort Law Principles To The Joint Emergence Of Self-Driving Automobiles And Transportation Network Companies, Jacob D. Walpert

Fordham Law Review

Self-driving automobiles have emerged as the future of vehicular travel, but this innovation is not developing in isolation. Simultaneously, the popularity of transportation network companies functioning as ride-hailing and ride-sharing services have altered traditional conceptions of personal transportation. Technology companies, conventional automakers, and start-up businesses each play significant roles in fundamentally transforming transportation methods. These transformations raise numerous liability questions. Specifically, the emergence of self-driving vehicles and transportation network companies create uncertainty for the application of tort law’s negligence standard. This Note addresses technological innovations in vehicular transportation and their accompanying legislative and regulatory developments. Then, this Note discusses ...


Joinder, Conspiracy, And Racketeering: Charging Issues Arising In The Prosecution Of Staged-Accident Insurance Schemes, Michael C. Kovac Mar 2017

Joinder, Conspiracy, And Racketeering: Charging Issues Arising In The Prosecution Of Staged-Accident Insurance Schemes, Michael C. Kovac

Nevada Law Journal

No abstract provided.


Mutually Assured Protection Among Large U.S. Law Firms, Tom Baker, Rick Swedloff Feb 2017

Mutually Assured Protection Among Large U.S. Law Firms, Tom Baker, Rick Swedloff

Faculty Scholarship

Top law firms are notoriously competitive, fighting for prime clients and matters. But some of the most elite firms are also deeply cooperative, willingly sharing key details about their finances and strategy with their rivals. More surprisingly, they pay handsomely to do so. Nearly half of the AmLaw 100 and 200 belong to mutual insurance organizations that require member firms to provide capital; partner time; and important information about their governance, balance sheets, risk management, strategic plans, and malpractice liability. To answer why these firms do so when there are commercial insurers willing to provide coverage with fewer burdens, we ...


The Cost Of High Prices: Embedding An Ethic Of Expense Into The Standard Of Care, Isaac D. Buck Jan 2017

The Cost Of High Prices: Embedding An Ethic Of Expense Into The Standard Of Care, Isaac D. Buck

Boston College Law Review

In the midst of rapid and radical change of America’s health care system, the country’s crown jewel public health insurance program, Medicare, faces an intensifying cost crisis due to a past of uncontrolled prices and a future of booming enrollment. A cost challenge garnering particular media attention is pharmaceutical drug pricing for Medicare Part B. Historically, congressional action has hamstrung Medicare’s ability to limit costs, and as a result, the program is increasingly forced to pass on drug costs—through copays and coinsurance—to its elderly beneficiaries. Public outrage has followed recent stories of pharmaceutical companies seeking ...


Opinion: The Mental Health Parity And Addiction Equity Act: What Parity Means For New Hampshire, Lucy C. Hodder Jan 2017

Opinion: The Mental Health Parity And Addiction Equity Act: What Parity Means For New Hampshire, Lucy C. Hodder

Legal Scholarship

[Excerpt] "New Hampshire lawyers can help clients and colleagues with mental health or substance use disorders by advising individuals how to overcome barriers to insurance coverage for treatment, and encouraging them to pursue state and federally mandated internal, external and expedited appeal opportunities when denied coverage."


Newsroom: Undocumented Licenses, Safer Roads 01-05-2017, Roger Williams University School Of Law Jan 2017

Newsroom: Undocumented Licenses, Safer Roads 01-05-2017, Roger Williams University School Of Law

Life of the Law School (1993- )

No abstract provided.


Hurricanes, Fraud, And Insurance: The Supreme Court Weighs In On, But Does Not Wade Into, The Concurrent Causation Conundrum In State Farm Fire And Casualty Company V. Rigsby, Chris French Jan 2017

Hurricanes, Fraud, And Insurance: The Supreme Court Weighs In On, But Does Not Wade Into, The Concurrent Causation Conundrum In State Farm Fire And Casualty Company V. Rigsby, Chris French

Journal Articles

In the December 6, 2016 Supreme Court decision, State Farm v. Rigsby, a homeowner’s house was damaged by Hurricane Katrina. The homeowner had homeowners insurance with State Farm and a flood insurance policy that was administered by State Farm on behalf of the federal government. The claims adjusters assigned by State Farm to handle the homeowner’s claim allegedly were instructed by State Farm to misclassify wind damage as flood damage in order to shift State Farm’s own liability for the loss to the federal government. The claims handlers filed a lawsuit against State Farm under the False ...


2015-2016 Legislative Summary, Assembly Committee On Insurance Jan 2017

2015-2016 Legislative Summary, Assembly Committee On Insurance

California Agencies

No abstract provided.


Challenging Nonbank Sifi Designations: Ge, Metlife, And The Need For Reform, Drita Dokic Jan 2017

Challenging Nonbank Sifi Designations: Ge, Metlife, And The Need For Reform, Drita Dokic

Brooklyn Journal of Corporate, Financial & Commercial Law

The Dodd-Frank Wall Street Reform and Consumer Protection Act created, among other things, the Financial Stability Oversight Council (FSOC), an entity within the U.S. Department of the Treasury tasked with assessing and mitigating financial risk. Financial institutions with over $50 billion in assets are automatically deemed “systemically important.” However, under the Dodd-Frank Act, FSOC has the authority to designate non-bank companies engaged in financial activity as systemically important as well. Once designated as a systemically important financial institution (SIFI), these companies are subject to enhanced regulation and supervision by the Federal Reserve. Because the costs associated with such enhanced ...


Computer Systems Fraud - Computer Systems Fraud In The Era Of Big Data And Ehrs, John Sepulveda Jan 2017

Computer Systems Fraud - Computer Systems Fraud In The Era Of Big Data And Ehrs, John Sepulveda

Touro Law Review

No abstract provided.


Salvaging The Term "Suitor": How The Declaratory Judgment Act Has Commandeered Congressional Intent, Brett P. Hargaden Jan 2017

Salvaging The Term "Suitor": How The Declaratory Judgment Act Has Commandeered Congressional Intent, Brett P. Hargaden

Roger Williams University Law Review

No abstract provided.


Rising To The Level Of Climate Science: Rhode Island, The National Flood Insurance Program, And Sea Level Rise Projections, Nicole E. Rohr Jan 2017

Rising To The Level Of Climate Science: Rhode Island, The National Flood Insurance Program, And Sea Level Rise Projections, Nicole E. Rohr

Roger Williams University Law Review

No abstract provided.


Compulsory Corporate Cyber-Liability Insurance: Outsourcing Data Privacy Regulation To Prevent And Mitigate Data Breaches, Minhquang N. Trang Jan 2017

Compulsory Corporate Cyber-Liability Insurance: Outsourcing Data Privacy Regulation To Prevent And Mitigate Data Breaches, Minhquang N. Trang

Minnesota Journal of Law, Science & Technology

No abstract provided.


Consumer Financial Protection In Health Care, Erin C. Fuse Brown Jan 2017

Consumer Financial Protection In Health Care, Erin C. Fuse Brown

Washington University Law Review

There are inadequate consumer protections from harmful medical billing practices that result in unavoidable, unexpected, and often financially devastating medical bills. The problem stems from the increasing costs shifting to patients in American health care and the inordinate complexity that makes health care transactions nearly impossible for consumers to navigate. A particularly outrageous example is the phenomenon of surprise medical bills, which refers to unanticipated and involuntary out-of-network bills in emergencies or from out-of- network providers at in-network facilities. Other damaging medical billing practices include the opaque and à la carte nature of medical bills, epitomized by added “facility fees ...


From The Technical To The Personal: Teaching And Learning Health Insurance Regulation And Reform, Allison K. Hoffman, Whitney A. Brown, Lindsay Cutler Jan 2017

From The Technical To The Personal: Teaching And Learning Health Insurance Regulation And Reform, Allison K. Hoffman, Whitney A. Brown, Lindsay Cutler

Faculty Scholarship

In the Fall of 2016, I taught Health Law and Policy for the fourth consecutive semester. Over time, one thing has become increasingly clear: the aspect of this course that I work with most closely as a scholar—the regulation of health care financing and insurance, including the Patient Protection and Affordable Care Act (ACA)—is also the material that I find the most challenging to teach. Every time I reflect on teaching this material, and hear from students about how they learn this material, the thing that stands out is how critical it is that my students understand the ...


Murder For Life Insurance Money: Protecting The Children, Johnny C. Chriscoe Jan 2017

Murder For Life Insurance Money: Protecting The Children, Johnny C. Chriscoe

Scholarly Works

Children are being murdered for life insurance proceeds.

Of course, if a beneficiary murders a child for the recovery of life insurance money and if he is apprehended, he will surely face numerous legal consequences. He will not recover the insurance money, he will be prosecuted and likely sentenced to life imprisonment or execution, he may be sued for the wrongful death of the child and he may be prosecuted for insurance fraud. However, all of these legal responses are triggered by the death of the child and, therefore, do not serve to protect the child from being murdered in ...