Insurance Law Commons^™

Insurance, Stephen L. Cotter, C. Bradford Marsh

Mercer Law Review

Although last year the Georgia General Assembly actively worked on managed care and the appellate courts stymied subrogors, legislation was light and appellate litigation routine this survey year. Many appellate opinions were reminders of coverage processing requirements (send the sixty-day "bad faith" demand for payment). Other opinions applied established insurance law principles to particular fact patterns (does every road wreck in Georgia have an appellate coverage decision?). All concerned are having some difficulty adjusting to Georgia's gradual departure from the traditional "four corners" coverage test analysis. The supreme court did breathe life into the hope for liability coverage for sexual …

What's Half A Lung Worth? Civil Jurors' Accounts Of Their Award Decision Making, Nicole L. Mott, Valerie P. Hans, Lindsay Simpson

Cornell Law Faculty Publications

Jury awards are often criticized as being arbitrary and excessive. This paper speaks to that controversy, reporting data from interviews with civil jurors' accounts of the strategies that juries use and the factors that they consider in arriving at a collective award. Jurors reported difficulty in deciding on awards, describing it as "the hardest part" of jury service and were surprised the court did not provide more guidance to them. Relatively few jurors entered the jury deliberation room with a specified award figure in mind. Once in the deliberation room, however, they reported discussing a variety of relevant factors such …

Post Claim Underwriting, Thomas C. Cady, Georgia Lee Gates

West Virginia Law Review

No abstract provided.

Bad Fath Claims Against Insurers: The State Of Utah Law Fifteen Years After Beck V. Farmers Insurance Exchange, William Kevin Tanner

Brigham Young University Journal of Public Law

No abstract provided.

Whipped By Whiplash? The Challenges Of Jury Communication In Lawsuits Involving Connective Tissue Injury, Valerie P. Hans, Nicole Vadino

Cornell Law Faculty Publications

No abstract provided.

Unraveling The Lining Of Erisa Health Insurer Pockets-A Vote For National Federal Common Law Adoption Of The Make Whole Doctrine, David M. Kono

BYU Law Review

No abstract provided.

Protecting Patient Rights Despite Erisa: Will The Supreme Court Allow States To Regulate Managed Care?, Donald T. Bogan

Donald T. Bogan

No abstract provided.

Insurance: How It Matters As Psychological Fact And Political Metaphor, Thomas Morawetz

Faculty Articles and Papers

No abstract provided.

A Realistic Consensus Approach To The Insurance Law Doctrine Of Reasonable Expectations, Peter N. Swisher

Law Faculty Publications

This article's fundamental premise is that, over the past three decades, despite all the debate and confusion surrounding the underlying theory and practice of the insurance law doctrine of reasonable expectations, a modem consensus approach has finally emerged within the academic community and the courts and among insurance law practitioners involving a realistic and viable application of the doctrine to the needs of contemporaryground" synthesis of traditional, objective, and contractually based reasonable expectations principles grafted onto elements of the more modem Keeton formulation of the doctrine. Moreover, this realistic consensus approach to the doctrine of reasonable expectations is both theoretically …

Insurance And The Utopian Idea, Carol Weisbrod

Faculty Articles and Papers

No abstract provided.

., Administrative Channeling Under The Medicare Act Clarified: Illinois Council, Section 45(H), And The Application Of Congressional Intent, John Aloysius Cogan, Jr., Rodney A. Johnson

Faculty Articles and Papers

In non-legal terms, subject matter jurisdiction is much like your American Express card. You cannot "leave home without it." This is especially true if you represent a Medicare provider or supplier and intend to sue on a Medicare claim. To be sure, your well-pleaded complaint alleges several bases for the federal district court's subject matter jurisdiction, including, but not limited to, 28 U.S.C. § 1331 (federal question jurisdiction), 28 U.S.C. § 1346 (federal defendant jurisdiction), 28 U.S.C. § 1361 (mandamus), and 5 U.S.C. § 702 (the Administrative Procedures Act). Perhaps, your complaint is brought in the context of an adversary …

Avoiding The Intentional Acts Exclusion In Casualty Insurance, Greg Munro

Faculty Journal Articles & Other Writings

This article examines public policy that forbids the use of insurance to indemnify willful wrongdoing by an insured. The article notes that this policy against insuring the intentional wrongdoer is expressed in casualty insurance policies in which the basic insuring agreements restrict coverage to an "occurrence" which is defined in the policies as an "accident." The article discusses the importance of knowing how to plead and develop the facts so that the claim comes within the coverage of an "occurrence" so as to avoid the intentional acts exclusion of the policy.

Development And Status Of Insurance Bad Faith In Montana, Greg Munro

Faculty Journal Articles & Other Writings

This article outlines the development of the tort of bad faith as it applies to insurance in Montana ending with particular attention to the issue of the existence now of bad faith tort outside the Unfair Claim Settlement Practices Act. The article concludes that the tort of insurance bad faith and the attendant potential for punitive damages are potent weapons in the fight to make insurance companies honor their promises and duties to claimants and insureds.

Insurance-Weight Of Evidence-Construction Of Policy-Proximate Cause

Indiana Law Journal

No abstract provided.

The Insurer's Right To Reimbursement Of Defense Costs, Robert H. Jerry Ii

Faculty Publications

This Article examines the theoretical justification for the insurer's asserted right to reimbursement of defense costs incurred in defending noncovered claims. Part I sketches some details about the duty to defend which are necessary prerequisites to exploring any claim to a right of reimbursement. Part II discusses the rationale offered by most courts and commentators for recognizing the right to reimbursement: under the law of restitution, the insurer who defends a noncovered claim bestows a benefit on the policyholder which, in justice, ought to be returned. This Part concludes that a reasoned argument can be made in support of the …

The "Household" Or "Family" Exclusion In Auto Policies, Greg Munro

Faculty Journal Articles & Other Writings

This article examines the household or family exclusion in casualty policies and how the Montana Supreme Court has responded to challenges to the exclusion. The article concludes that if attorneys adequately prepare the challenge, the courts in Montana will scrutinize the exclusion carefully.

Securing Insurance Coverage Of Medical Expense And Avoiding Subrogation, Greg Munro

Faculty Journal Articles & Other Writings

This article explores some of the law that will control issues encountered in pursuing payment of medical expenses under insurance policies and programs. The article concludes that attorneys must analyze the situation in light of statutes and case law and utilize useful techniques for avoiding the insurer's subrogation, offsets and limitations when making claims to secure payment of medical expenses.

Insurance Contracts And Judicial Decisions Over Whether Insurers Must Defend Insureds That Violate Constitutional And Civil Rights: An Historical And Empirical Review Of Federal And State Court Declaratory Judgments 1900-2000, Willy E. Rice

Faculty Articles

Empirical findings suggest that extralegal factors, such as geographic location, ethnicity, gender, disability, perceived sexual orientation, and age of third-party victims, influence judicial decisions as to whether liability carriers must defend or reimburse the costs of defending various lawsuits. After the introduction, Part II of this article presents a brief discussion of state and federal declaratory judgment statutes and of the public policy behind liability and indemnification insurance contracts. Part III examines the origin and scope of insurers’ duty to defend, duty to pay legal expenses, and duty to reimburse litigation costs when third-party victims sue policyholders. Part IV argues …

Department Of Insurance, Ashley F. Hall-Hicklin, Michelle J. Hubbard, Jenny K. Li, J. D. Fellmeth

California Regulatory Law Reporter

No abstract provided.

Planning For High Net-Worth U.S. Persons Through The Use Of Offshore Life Insurance, J. Richard Duke

Richmond Journal of Global Law & Business

Sophisticated planning for the high net-worth United States citizens often includes the use of offshore variable life insurance. Such leading edge planning is accomplished through structures that provide income, gift, estate, and generation-skipping transfer tax planning not available domestically. In addition to providing sophisticated tax and estate planning benefits, variable life insurance policies issued by foreign-based carriers have numerous economic advantages.

University Of Richmond Law Review

University of Richmond Law Review

No abstract provided.

The Value Of Life In Legal Contexts: Survey And Critique, W. Kip Viscusi

Vanderbilt Law School Faculty Publications

Value of life issues traditionally pertain to insurance of the losses of accident victims, for which replacement of the economic loss is often an appropriate concept. Deterrence measures of the value of life focus on risk-money tradeoffs involving small changes in risk. Using market data for risky jobs and product risk contexts often yields substantial estimates of the value of life in the range of $3 million to $9 million. These estimates are useful in providing guidance for regulatory policy and assessments of liability. However, use of these values to determine compensation, known as hedonic damages, leads to excessive insurance.

Recent Case Developments, Jeffrey W. Stempel

Scholarly Works

Recent case developments in Insurance Law in the years 1999 and 2000.

Annual Survey Of Virginia Law: Insurance Law, Terrence L. Graves, J. Douglas Cuthbertson

University of Richmond Law Review

This article reviews the changes in Virginia insurance law that have occurred in the past two years. Most of the developments have been in motor vehicle liability and uninsured/underinsured motorist ("VM/UIM") coverage. But the article also surveys cases on bad faith, fire insurance, insurance regulation, life insurance, motor vehicle medical expense insurance, and waiver and estoppel.

Securitizing Insurance Risks, Tamar Frankel, Joseph W. Laplume

Faculty Scholarship

This Article analyzes and evaluates the legal problems that have arisen in connection with this rapidly developing insurance risk securitization. The first part of the Article deals with legal issues concerning the SPVs that undertake insurance and reinsurance contracts with ceding insurers and the other parties to the transaction. The Article addresses the dilemma in choosing the laws applicable to SPVs, the bonds they issue, and the persons and entities that form part of the securitization transaction. These laws involve state insurance laws, bankruptcy and tax laws, the Investment Company Act of 1940 and the Commodity Exchange Act of 1934, …

Becoming Visible: The Ada's Impact On Healthcare For Persons With Disabilities, Mary Crossley

Articles

This Article will adopt the perspective of individuals with disabilities in their encounters with the health care finance and delivery system in the United States, and will pose the question of what the past decade has shown the ADA to mean (or not mean) for those individuals' ability to seek, receive, and pay for effective health care services. To that end, this Article will provide an overview of three broad areas on which the ADA has had varying degrees of impact.

Part II of the Article will examine how the ADA has affected the rights of an individual with a …

Recent Case Developments, Jeffrey W. Stempel

Scholarly Works

Recent case developments in Insurance Law in the years 1999 and 2000.

The Insurer's Right To Reimbursement Of Defense Costs, Robert H. Jerry Ii

UF Law Faculty Publications

This article examines the theoretical justification for the insurer's asserted right to reimbursement of defense costs incurred in defending noncovered claims. It sketches some details about the duty to defend which are necessary prerequisites to exploring any claim to a right of reimbursement. It discusses the rationale offered by most courts and commentators for recognizing the right to reimbursement: under the law of restitution, the insurer who defends a noncovered claim bestows a benefit on the policyholder which, in justice, ought to be returned. The article offers an alternative justification; it explains that the insurer's right should be analyzed in …

Pennsylvania's Reasonable Expectations Doctrine: The Third Circuit's Perspective, Thomas J. Rueter, Joshua H. Roberts

Villanova Law Review

No abstract provided.

Managed Care Issues, Chapter 14, § Viii (2008 Annual Update), Donald Bogan

Donald T. Bogan

No abstract provided.