Insurance Law Commons^™

Enterprise Without Entities, Andrew Verstein

Michigan Law Review

Scholars and practicing lawyers alike consider legal entities to be essential. Who can imagine running a large business without using a business organization, such as a corporation or partnership? This Article challenges conventional wisdom by showing that vast enterprises—with millions of customers paying trillions of dollars—often operate without any meaningful use of entities.

This Article introduces the reciprocal exchange, a type of insurance company that operates without any meaningful use of a legal entity. Instead of obtaining insurance from a common nexus of contract, customers directly insure one another through a dense web of bilateral agreements. While often overlooked or …

Comparative Effectiveness Research As Choice Architecture: The Behavioral Law And Economics Solution To The Health Care Cost Crisis, Russell Korobkin

Michigan Law Review

With the Patient Protection and Affordable Care Act (“ACA”) set to dramatically increase access to medical care, the problem of rising costs will move center stage in health law and policy discussions. “Consumer directed health care” proposals, which provide patients with financial incentives to equate marginal costs and benefits of care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of health care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated …

Outsourcing Regulation: How Insurance Reduces Moral Hazard, Omri Ben-Shahar, Kyle D. Logue

Michigan Law Review

This Article explores the potential value of insurance as a substitute for government regulation of safety. Successful regulation of behavior requires information in setting standards, licensing conduct, verifying outcomes, and assessing remedies. In various areas, the private insurance sector has technological advantages in collecting and administering the information relevant to setting standards and could outperform the government in creating incentives for optimal behavior. We explore several areas that are regulated more by private insurance than by government. In those areas, the role of the law diminishes to the administration of simple rules of absolute liability or no liability, and affected …

Shareholder Compensation As Dividend, James J. Park

Michigan Law Review

This Article questions the prevailing view that securities-fraud actions suffer from a circularity problem. Because shareholder plaintiffs are owners of the defendant corporation, it is commonly argued that shareholder compensation is a payment from shareholders to themselves with substantial transaction costs in the form of attorney fees. But shareholder compensation is no more circular than a dividend, which is a cash payment to shareholders from the company they own with substantial transaction costs in the form of taxes. In fact, shareholder compensation is less circular than a dividend because it is a transfer to shareholders who purchased stock when the …

Patients As Consumers: Courts, Cotnracts, And The New Medical Marketplace, Mark A. Hall, Carl E. Schneider

Michigan Law Review

The persistent riddle of health-care policy is how to control the costs while improving the quality of care. The riddle's oncepromising answer-managed care-has been politically ravaged, and consumerist solutions are now winning favor This Article examines the legal condition of the patient-as-consumer in today's health-care market. It finds that insurers bargain with some success for rates for the people they insure. The uninsured, however, must contract to pay whatever a provider charges and then are regularly charged prices that are several times insurers'pricesa nd providers' actual costs. Perhaps because they do not understand the healthcare market, courts generally enforce these …

Offsetting Risks, Ariel Porat

Michigan Law Review

Under prevailing tort law, an injurer who must choose between Course of Action A, which creates a risk of 500 (there is a probability of .1 that a harm of 5000 will result), and Course of Action B, which creates a risk of 400 (there is a probability of.] that a harm of 4000 will result), and who negligently opts for the former will be held liable for the entire harm of 5000 that materializes. This full liability forces the injurer to pay damages that are five times higher than would be necessary to internalize the risk of 100 that …

The Fair Housing Act And Disparate Impact In Homeowners Insurance, Dana L. Kaersvang

Michigan Law Review

This Note argues that because homeowners insurance is central to homeownership, the FHA applies to insurance underwriting policies, such as those mentioned above, that have a disparate impact on minority potential homeowners. Part I considers whether the FHA applies to homeowners insurance and concludes that homeowners insurance is covered by the Act. Part II goes on to argue that the FHA applies to homeowners insurance even where the discrimination results from disparate impact, rather than from disparate treatment. Finally, Part III analyzes the above-mentioned policies of the insurance industry under the FHA disparate impact standard.

Contra Proferentem: The Allure Of Ambiguous Boilerplate, Michelle E. Boardman

Michigan Law Review

Bad boilerplate can shake one' s faith in evolution; not only does it not die away, it multiplies. The puzzle is why. Much of boilerplate is ambiguous or incomprehensible. This alienates consumers and is i ncreasingly punished by courts construing the language against the drafter. There must, therefore, be some hidden allure to ambiguous boilerplate. The popular theory is trickery: drafters lure consumers in with promising language that comes to nothing in court. But this trick would require consumers to do three things they do not do-read the language, understand it, and take comfort in it. There is a hidden …

Daedalean Tinkering, Sean J. Griffith

Michigan Law Review

Part I of this Review describes Skeel's account of corporate scandal, focusing on the central theme of excessive risk-taking. Part II examines Skeel's most original policy proposal-the creation of an investor insurance scheme to protect against excessive risk. Although the proposal takes up only a few pages of the book, it targets the books' core concern-the risk of corporate fraud. In evaluating the proposed investor insurance regime, this Review raises a set of objections based on cost and administrability and argues that an insurance regime would be duplicative of existing mechanisms that effectively spread the risk of financial fraud. Part …

Word Games: Raising And Resolving The Shortcomings In Accident-Insurance Doctrine That Autoerotic-Asphyxiation Cases Reveal, Sam Erman

Michigan Law Review

This Note argues that autoerotic asphyxiation deaths are accidents and not the results of intentionally self-inflicted injuries. Part I formally analyzes accident-insurance case law to show that current, viable approaches to accident insurance indicate that autoerotic asphyxiation deaths are accidental. Part II claims autoerotic asphyxiation deaths should not trigger intentionally self-inflicted injury exclusion clauses because the practice does not intentionally injure. This Note concludes beneficiaries should recover when accident-insurance policyholders die during autoerotic asphyxiation.

Chicago Hope Meets The Chicago School, Gail B. Agrawal

Michigan Law Review

Twenty-five years after the enactment of the Federal Health Maintenance Organization Act and nearly five years after the failure of proposed federal health care reform, managed care has come to dominate the medical marketplace. As a result, the relationships among patients, payers, and physicians have changed fundamentally and dramatically. In this market-driven environment, health care - how much it costs, who receives treatment, and who pays for it - may have surpassed the weather as a topic of everyday conversation at dinner tables and water coolers across the country. In the popular press, reports concerning managed care, usually derogatory, are …

A Theory Of Insurance Policy Interpretation, Kenneth S. Abraham

Michigan Law Review

The first principle of insurance law is captured by the maxim contra proferentem, which directs that ambiguities in a contract be interpreted "against the drafter," who is almost always the insurer. Yet given the modern recognition that language is an inherently imperfect instrument for communicating meaning, insurance policy provisions are in a sense always ambiguous. Moreover, in addition to contra proferentem, policyholders may invoke such allied doctrines as waiver, estoppel, and the rule that the reasonable expectations of the insured should be honored even if those expectations are unambiguously contradicted by fine-print provisions in the policy. Contra proferentem and these …

The Public Policy Exclusion And Insurance For Intentional Employment Discrimination, Sean W. Gallagher

Michigan Law Review

This Note argues that courts choosing to apply the public policy exclusion to insurance for intentional employment discrimination liability should nevertheless permit employers to enforce insurance covering negligent supervision liability and liability imputed to an employer as a result of the intentional discrimination committed by its employees. Part I establishes a framework for understanding the cases in which courts have invoked public policy to refuse enforcement of insurance contracts, arguing that the rationale behind the public policy exclusion is utilitarian and that courts refuse to enforce insurance for liability arising out of intentional wrongdoing on the grounds that such insurance …

Voluntary Intoxication: A Defense To Intentional Injury Exclusion Clauses In Homeowner's Policies?, Tracy E. Silverman

Michigan Law Review

This Note argues that the current voluntary intoxication defense to the intentional injury exclusion clause should be modified to allow insurers subrogation rights against insureds who commit intentional acts while voluntarily intoxicated, subject to an exception for alcoholic insureds who successfully complete alcohol treatment programs. Part I discusses the public policy concerns of victim compensation and deterrence and how they influence courts deciding between the three traditional approaches to "intent." Part II analyzes the impact of these intent standards on courts' decisions to allow a voluntary intoxication defense and concludes that the defense as currently formulated promotes victim compensation at …

Insurance Law Out Of The Shadows, Kent D. Syverud

Michigan Law Review

A Review of Insurance Law and Regulation: Cases and Materials by Kenneth S. Abraham

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 …

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 …

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, …

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 …

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 …

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 …