Insurance Law Commons^™

Insurance Classification: Too Important To Be Left To The Actuaries, Leah Wortham

University of Michigan Journal of Law Reform

This Article classifies most of the public debate about classification as coming from one of two perspectives labeled traditional fair discrimination and antidiscrimination. Proponents of the status quo in classification and its regulation justify that status quo as fair discrimination. They argue that fair discrimination is both desirable and a reflection of a long-standing public policy judgment embodied in state law.

Corporate Indemnification Of Directors And Officers: Time For A Reappraisal, K.G. Jan Pillai, Craig Tractenberg

University of Michigan Journal of Law Reform

This Article evaluates the benefits and burdens of shifting litigation risk from management to the enterprise. The Article begins by considering the nature of the legal risks confronting the corporate executive, and the principles of common law that developed to counter those risks. The Article proceeds to assess the two statutory responses to threats of personal liability against the corporate executive: indemnification statutes, and director and officer insurance. Finally, after comparing the effective absolute immunity available to corporate executives with the qualified immunity enjoyed by high-level government officials, the Article concludes that indemnification practices have overinsulated the corporate officer from …

The Nonprofit Health Care Corporation Reform Act Of 1980, David L. Hollister, Patience A. Drake

University of Michigan Journal of Law Reform

In recent years, Blue Cross/Blue Shield has been the subject of considerable controversy. Its critics charge the non-profit, tax-exempt corporation with being unduly secretive, arrogantly unresponsive to consumer interest and not vigorous in its cost containment efforts. These criticisms, along with a variety of other factors, led to the legislative reform I am here to talk to you about this evening.

Regulation Through The Looking Glass: Hospitals, Blue Cross, And Certificate-Of-Need, Sallyanne Payton, Rhoda M. Powsner

Michigan Law Review

A clear focus on the commitment of the public health and hospital establishments to the large teaching hospital and their belief in rationalizing the health care system through community-based planning allows us to understand the ideas and institutions that have produced our present system of hospital regulation. It can also help us to understand the structure and behavior of the hospital industry and can illuminate current controversies over health care policy.

What follows is a narrative account of the development of regional planning and certificate-of-need legislation. As part of that story, we trace the evolution of the Blue Cross, explain …

A Reasonable Approach To The Doctrine Of Reasonable Expectations As Applied To Insurance Contracts, Karen K. Shinevar

University of Michigan Journal of Law Reform

Part I of this article examines standard insurance contract analysis and the existing confusion within that analysis. Part II examines the doctrine of reasonable expectations. In Part Ill, Professor Keeton's expansion of the reasonable expectations doctrine is explained and analyzed. This article concludes in Part IV that Keeton's expanded doctrine has the effect of confusing most courts, which continue to discuss reasonable expectations in relation to conventional rules of contract construction. The article proposes that the reasonable expectations doctrine be limited to contractual language and surrounding circumstances in order to establish clearer guidelines for insurers and consumers.

Federal Taxation Of The Assignment Of Life Insurance, Douglas A. Kahn, Lawrence W. Waggoner

Articles

The most litigated estate tax issue concerning life insurance is whether the proceeds should be included in the insured's gross estate. This question usually is governed by section 2042 of the Internal Revenue Code of 1954, the estate tax provision directed specifically at life insurance. While the Tax Reform Act of 1976 wrought enormous changes in many areas of estate taxation, Congress did not change section 2042. Thus the several unresolved questions concerning the interpretation of that section remain unsettled. But the question of the includability of life insurance proceeds in the gross estate of the insured is not always …

Imposters And Fictitious Payees, James J. White

Other Publications

Uniform Commercial Code section 3-405. I. Basic Liabilities II. Defense and Miscellaneous Issues

No-Fault Auto Reparation In Florida: An Empirical Examination Of Some Of Its Effects, Joseph W. Little

University of Michigan Journal of Law Reform

This article discusses certain aspects of reparations systems that can be described by statistical parameters, but it does not attempt to evaluate whether or not pervasive sociological changes may result from legal modifications of the concept of fault. It may be that any erosion of fault as a legal concept will result in a decline in individual responsibility. The fact that some members of the bar and some members of the medical profession allegedly regularly engage in conspiracies to defeat the $1,000 medical expense threshold of the Florida statute could be cited as evidence of such deterioration. Nevertheless, this writer …

The Impact Of Michigan's Health Maintenance Organization Act, Roger Alan Petzke

University of Michigan Journal of Law Reform

Growing dissatisfaction with the shortcomings of the traditional system of health care has led to renewed interest in the Health Maintenance Organization (HMO) concept in recent years. Although some HMO's have been operating in the United States for over forty years, conditions have been less than favorable to their growth and development. Major obstacles have been opposition from the medical profession, lack of public understanding about the nature and function of HMO's, and state laws restricting or prohibiting the establishment of HMO's. In order to create a more favorable legal climate and encourage HMO development, a number of states, including …

Due Process Problems Of Property Damage No-Fault Insurance, Stephen L. Jones

University of Michigan Journal of Law Reform

Michigan, Florida, and Massachusetts have recently enacted automobile property damage no-fault legislation. Similar to the concept of personal injury no-fault plans, the property damage legislation bars tort recovery for damage to vehicles involved in collisions and substitutes a system of insurance protection that would compensate the vehicle's owner for these losses without regard to fault. There are, however, two essential differences between the property damage and personal injury proposals. First, because property damage claims have been minor as compared to those for personal injuries, the property damage proposals have permitted the vehicle owner to self-insure for the former losses by …

Compulsory No-Fault Medical Insurance For Automobile Owners, William L. Schlosser

University of Michigan Journal of Law Reform

The enactment of the Massachusetts compulsory no-fault insurance bill, and Senator Phillip Hart's recent introduction of national no-fault insurance legislation, indicate the serious consideration no-fault insurance is receiving as a method of reforming the existing auto accident compensation system. The current tort system of recovery of auto accident medical expenses is inefficient, and, in many cases, does not adequately compensate the injured parties. Compulsory no-fault insurance is well suited to remedy these deficiencies. Under a no-fault insurance plan, benefits would be paid without regard to the question of fault; consequently, every accident victim would receive compensation without first having to …

A Proposed Cure For The Intervention Blues, Lawrence E. Hard

University of Michigan Journal of Law Reform

This article does not purport to provide a study of the doctrine of subrogation and the merits of that doctrine in the context of insurance coverage. There are several difficult questions which could be raised as to the proper role of subrogation in insurance litigation. This article assumes the propriety of extending the right of subrogation to the type of medical and hospital payment plans offered by the Services and analyses the device of intervention as a method of enforcing the Services' right to contractual subrogation.

Financial Statement Insurance: A New Approach To Ivestor Protection, Stephen Z. Surridge

University of Michigan Journal of Law Reform

The accounting profession rapidly is moving toward a crisis in liability. Members of the investing public are suing accountants with mounting frequency and success. This article will analyze briefly the origin and present dimensions of the crisis, and then propose a plan for replacing court-imposed liability with insured liability through the offering of financial statement insurance. The essentials of the plan can be simply stated. Insurance would be offered by accountants to investors on a voluntary basis in conjunction with purchases and sales of corporate stock and securities. Individual investors would be able to purchase from the auditors of a …

Estate Tax--Life Insurance--Section 2035 As A Basis For Including Life Insurance Proceeds In The Gross Estate Of An Insured Who Paid Premiums On A Policy Owned By Another Person, Michigan Law Review

Michigan Law Review

If a decedent possessed any of the incidents of ownership of a life insurance policy, or if the policy proceeds were payable to his executor, the entire amount of the insurance proceeds is included in his estate for estate tax purposes under section 2042 of the Internal Revenue Code of 1954 (Code). However, if the decedent had transferred ownership of the policy to another person in a transaction that both met the requirements of section 2042 and was not regarded as "in contemplation of death," but continued to pay the insurance premiums until his death, it is unclear whether any …

Secured Transactions-Insurance-A Security Interest In The "Proceeds" Of Secured Collateral Does Not Include Insurance Proceeds-Universal C.I.T. Corp. V. Prudential Investment Corp., Michigan Law Review

Michigan Law Review

In return for a loan, a debtor executed a promissory note to codefendant, Prudential Investment Corporation, and entered into a written agreement to secure this note, designating as collateral a semi-tractor and the proceeds therefrom. Under this type of arrangement, Prudential's security interest would attach automatically to any property received from a sale, exchange, or other disposition of the tractor. Petitioner, Universal C.I.T. Corp., held the conditional sales contract which was executed in financing the purchase of the tractor and was named as loss payee in the insurance contract covering the tractor. When the tractor was totally destroyed, petitioner collected …

Horn: Subrogation In Insurance Theory And Practice, Spencer L. Kimball

Michigan Law Review

A Review of Subrogation in Insurance Theory and Practice By Ronald C. Horn.

Judgment Against Insured Is Conclusive Proof Of Amount Of Claim Against Dissolved Insurer- Commonwealth Ex Rel. Woodside V. Seaboard Mut. Cas. Co., Michigan Law Review

Michigan Law Review

Plaintiffs, injured in an automobile accident, brought suits against an insured taxicab company. Before the case came to trial, the insurance commissioner found the insurer insolvent. In a separate proceeding he obtained a court order dissolving the insurer, enjoining the prosecution of any legal action against the insurer's assets, and providing for the filing of proof of claims with the insurance commissioner. The insurer's attorney, who had entered an appearance on behalf of the taxicab company, withdrew, and in an undefended action the plaintiffs recovered judgments against the cab company totalling nineteen thousand dollars. Unable to obtain execution on these …

The Expanding Jurisdiction Of The Securities And Exchange Commission: Variable Annuities And Bank Collective Investment Funds, John W. Erickson

Michigan Law Review

The Securities and Exchange Commission is presently attempting to assert jurisdiction over certain aspects of two industries traditionally exempt from federal securities regulation-insurance and banking. The SEC claims that two recently developed investment vehicles-variable annuities in the insurance field and pooled funds of managing agency accounts in the banking field-are virtually the same as mutual funds, which are subject to SEC regulation under the Investment Company Act of 1940. (A mutual fund is essentially a fund (usually in corporate form), the participants' contributions to which are collectively invested in a portfolio of securities, each participation representing a pro rata interest …

Automobile Accident Costs And Payments: Studies In The Economics Of Injury Reparation, Alfred F. Conard, James N. Morgan, Robert W. Pratt Jr, Charles E. Voltz, Robert L. Bombaugh

Michigan Legal Studies Series

The report is presented as a pool of data which will serve many purposes. First of all, the report furnishes a perspective on the largeness and the smallness of the reparation process, and of its many parts. Second, the report supplies much more specific information than has ever before been available on many points, such as the high or low level of reparation in relation to losses; the number of people who get paid, and those who receive nothing; the levels of legal expense, including attorneys' fees. Third, it will furnish a guide for future research directed to narrower questions, …

Private Insurance As A Solution To The Driver-Guest Dilemm, Harvey R. Friedman

Michigan Law Review

The duty of the driver of an automobile to his nonpaying passenger, and liability arising from the breach of that duty, has long presented a troublesome area of litigation for the courts and the parties involved. Application of standards unsuited for the peculiar risks of automotive transportation has produced inadequate compensation in some cases and excessive recoveries in others. Meanwhile, trial calendars are overcrowded with personal injury litigation, and insurance companies must bear the awards of sympathetic juries and those resulting from collusion between passenger and driver. The over-all expense of this method of determination of liability, far too little …

The Regulation Of Specialty Policies In Life Insurance, Spencer L. Kimball, Jon S. Hanson

Michigan Law Review

Every entrepreneur is vitally concerned with selling methods. Success depends upon sales. Sales depend upon desire for the product. Desire for most products, including life insurance, is not inherent but is created by the efforts of the entrepreneur. In the case of life insurance, an effective job of creating the desire, i.e., of selling, is usually necessary to convince a prospective insurance buyer that over a long period he should allocate a significant portion of his income to the purchase of an intangible such as life insurance.

Insurance-Variable Annuities-Application Of Investment Company Act Of 1940, William C. Brashares

Michigan Law Review

Anticipating the sale of variable annuity contracts as a part of its regular business, Prudential, a life insurance company, applied to the Securities and Exchange Commission for complete exemption from the requirements of the Investment Company Act of 1940. Prudential claimed that it qualified for exemption as an insurance company under the definition of "insurance company" in the Investment Company Act ("a company ... whose primary and predominant business activity is the writing of insurance . . . and which is subject to supervision by the insurance commissioner or a similar official or agency of a state"). In the alternative, …

Insurance-State Regulation-Surplus Line Insurance, James C. Lockwood S.Ed.

Michigan Law Review

Plaintiff, a New York corporation doing business in Texas, purchased insurance covering risks located in Texas from insurers not licensed to do business in that state. The entire insurance transaction was consummated outside Texas, and any adjustment for losses was to be made outside the state. Pursuant to a Texas statute, plaintiff was taxed an amount equal to five percent of its gross premiums. Plaintiff instituted the present suit in a state court in Texas to recover the tax, which had been paid under protest. The trial court's decision for plaintiff was affirmed by the court of civil appeals, and …

Foreign Investment Protection: A Reasoned Approach, Earl Snyder

Michigan Law Review

The main purpose in protecting private foreign investment is to encourage capital to move to newly developing nations in spite of serious, existing non-business risks. These risks are (1) the political risk (outright and "creeping" expropriation), (2) the transfer risk ( currency controls and inconvertibility of funds), and (3) the calamity risk (insurrection, revolution, war, etc.). But why encourage this? Why should an affluent, powerful nation seek, in effect, to transport overseas some of its affluence and power? Why--in the case of the United States-should encouragement be given to that which may, according to some, tend to tip still more …

The Extension Of Insurance Subrogation, Spencer L. Kimball, Don A. Davis

Michigan Law Review

When an insured loss occurs under circumstances that make a third person liable to reimburse the insured, there are various possible ways to adjust the loss among the three persons involved. One solution would permit the policyholder to recover both on the insurance and from the third person, i.e., would permit double recovery for the loss. A second solution would give the third person the benefit of the insurance by denying recovery from him. A third solution would subrogate the insurer to the policyholder's rights against the third person. Combinations of these three solutions are possible by applying sometimes …

Insurance-Rate Regulation-Construction And Effect Of Guaranty Bond Agreement, Robert L. Harmon

Michigan Law Review

Plaintiff, an insurance agents' association and several other insurance companies and associations, instituted an action attacking an order of the State Board of Insurance. The order approved a guaranty bond form, together with rates and rules, which had been submitted to ,the Board pursuant to statute by the defendant insurance company. The guaranty agreement was an arrangement whereby defendant guaranteed payment of losses under fire insurance policies of other insurers in the event the latter should be unable to pay. Although the bond form was not restricted to any specific original insurers, it was contemplated that defendant would use ,the …

Taxation-Federal Income Tax-Strike Insurance Agreements, Robert A. Butler S.Ed.

Michigan Law Review

Contracts indemnifying persons or corporations for losses and damage resulting from an interruption of business due to strikes have existed at least since the beginning of this century. The Mutual Security Company of Connecticut, for example, wrote such a policy for the Buffalo Forge on April 9, 1906. In more recent times, strike insurance agreements have been instituted in major industries, and their impact on collective bargaining has been the subject of some controversy. The purpose of this comment is to consider the federal income tax questions which arise from such arrangements. Specifically, attention is directed to the deductibility of …

Insurance Law - Recovery - Action For Wrongful Refusal To Settle Claim Precluded By Bankruptcy Of Insured, James A. Mcdermott

Michigan Law Review

The plaintiff, as trustee in bankruptcy of the insured, sued the defendant insurer to recover damages resulting from a judgment entered against the insured in a personal injury suit. This judgment subjected the insured to a liability of 89,000 dollars in excess of the 10,000 dollar automobile liability_ coverage carried with the insurer. The insurer, pursuant to its policy, had undertaken the insured's defense and had failed, allegedly in bad faith, to settle the suit for an amount within the limits of its coverage. Before judgment was entered in the personal injury suit the insured was insolvent; six months following …

Insurance-State Regulation-Unauthorized Insurers False Advertising Process Act, Chester A. Skinner

Michigan Law Review

Recent Illinois legislation subjects foreign insurers who are not authorized to do business in Illinois and who circulate false advertising there to the jurisdiction of the state courts and the State Insurance Commissioner. When the Insurance Commissioner is informed of false or misleading advertising, he is to notify the supervisory insurance official of the domicile state of the foreign insurer. If this notice does not result in the cessation of the activity, the Commissioner may proceed against the insurer under the state's Unfair Trade Practice Act. Since the typical mail order insurer will not have agents or property within the …

Labor Law-Duty To Bargain-Disclosure To Union Of Costs Of Noncontributory Group Insurance, Burton L. Raimi

Michigan Law Review

In the course of bargaining for a new contract with an employer, the union requested information regarding the costs and benefits of a noncontributory group health insurance program which the employer provided for its employees. Petitioner provided a breakdown of the plan's benefits but refused to disclose its cost. Charging that this refusal amounted to a violation of the employer's statutory duty to bargain in good faith about "wages,'' the union procured the issuance of a complaint by the National Labor Relations Board. The trial examiner concluded that such costs were costs of production rather than wages and consequently did …