Insurance Law Commons^™

A Pathway To Health Care Citizenship For Daca Beneficiaries, Medha D. Makhlouf, Patrick J. Glen

Faculty Scholarly Works

Since 2012, beneficiaries of Deferred Action for Childhood Arrivals (DACA) have enjoyed a certain normalization, however tenuous, of their status in the United States: they can legally work, their removal proceedings are deferred, and they cease to accrue unlawful presence. Regarding subsidized health coverage, however, DACA beneficiaries remain on the outside looking in. Although other deferred action beneficiaries are eligible for benefits through Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act, the Obama Administration specifically excluded DACA beneficiaries. This decision undermines DACA’s goal of legitimizing beneficiaries’ presence in the United States. From a health policy perspective, it …

Finding Parity Through Preclusion: Novel Mental Health Parity Solutions At The State Level, Ryan D. Kingshill

Dickinson Law Review (2017-Present)

Recently, the federal government has taken numerous steps to promote the equal treatment (also known as parity) of mental and physical health issues. The two most impactful actions are the Mental Health Parity and Addiction Act of 2008 and the Affordable Care Act. These acts focus on the traditional avenue for parity change—insurance regulation. While these acts have improved parity, major gaps in coverage and treatment between mental health/substance use disorder treatment and medical/surgical treatment persist. ERISA Preemption, evasive insurer behavior, lack of enforcement, and lack of consumer education continue to plague patients and healthcare professionals. On its own, federal …

Ashes To Ashes: A Way Home For Climate Change Survivors, Kenneth S. Klein

Faculty Scholarship

In 2020, the United States suffered a record number of named storms, a record number of storms causing $1 billion or more in damage, a derecho that destroyed much of Iowa’s corn crop, and previously unheard-of levels of wildfire frequency and damage in California, Oregon, and Washington. The effects of climate change are causing a crisis of affordable, available homeowner insurance. As more and more homes in the United States are in high-risk areas for natural catastrophes, insurers increasingly choose not to offer insurance at all in some communities, exclude disaster risks from coverage in others, and dramatically raise prices …

Notpetya, Not Warfare: Rethinking The Insurance War Exclusion In The Context Of International Cyberattacks, Katherine S. Wan

Washington Law Review

When an insurer wants to avoid coverage of a specific type of loss, it must explicitly exclude the loss in its policy. The war exclusion is a typical exclusion found in insurance policies that excuses insurers from covering losses caused by war or warlike actions. Courts interpreting the exclusion have traditionally held that war must consist of hostilities between sovereign nations. Despite the rise of state-sponsored cyberattacks, the United States has been hesitant to officially declare war in response. Even still, insurers argue that their war exclusions should apply to these new cyber losses. Courts are now tasked with reanalyzing …

Private Insurance Limits And Responses, Elizabeth Weeks

Scholarly Works

The COVID-19 pandemic exposed a number of existing flaws in the United States’ patchwork approach to paying for and providing access to medical care. Shelter-in-place orders, social distancing, and other public health strategies employed to address the pandemic spawned a global recession, causing rapid and high unemployment rates in many countries. The U.S. unemployment rate peaked in April 2020 at 14.7%, higher than in any previous period since World War II. The United States has long hewed an anachronistic policy of relying heavily on private employers to provide health insurance to a substantial portion of the population. Those who are …

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 …

The Current System Of Resolving Insurance Disputes In Saudi Arabia: Its Weaknesses And Ways Of Developing It, Saleh Alsheha

Maurer Theses and Dissertations

Insurance industry generally revolves around financial risks, and the business of insurance companies is reliant on the resolution of claims that arise from these risks associated with insurance policies. In fact, insurance companies routinely adjust claims and provide indemnities to the insureds or beneficiaries. In some cases, however, the resolution of claims may falter, resulting in disputes that involve conflicting views between the insurer and insured on the eligibility of indemnity. Hence, this requires the existence of an effective and smooth mechanism that guarantees the end of such conflicts and protects the rights of the parties involved in insurance contracts. …

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 …

Forum Shopping Covid-19 Business Interruption Insurance Claims, Chris French

Journal Articles

Insurance disputes are typically governed by state law, and state insurance laws vary considerably, with some states being favorable to policyholders and others being unfavorable. With forum shopping, a plaintiff often has many choices regarding where it can bring a lawsuit, including multiple states in which to bring the case and whether to bring the case in federal or state court. Of the over 1000 COVID-19 business interruption insurance lawsuits filed thus far, more than 700 of them have been filed in, or removed to, federal court, with more than 250 of the cases filed as class actions. Many of …

America On Fire: Climate Change, Wildfires & Insuring Natural Catastrophes, Christopher French

Journal Articles

America is on fire. The damage, destruction, and loss of life caused by wildfires have exploded over the past few decades. Nine of the ten worst fire seasons have occurred in the past fifteen years, with 2017 and 2018 being the worst years ever. Despite spending approximately $3.7 billion annually on fire suppression, more than 35,000 structures were lost to wildfires in 2017 and 2018, approximately $32 billion in property losses occurred, and more than 100 people were killed. More than forty million homes worth approximately $187 billion in the U.S. are currently at a high risk of destruction due …

Cyber Insurance Today: Saving It Before It Needs Saving, Angela Nieves

Catholic University Journal of Law and Technology

Cyber insurance, which covers a company’s losses and costs stemming from a cyberattack, represents a nearly $5 billion global market. But have stakeholders shaped a sustainable model? This article analyzes contrasting claims about the viability of cyber insurance. It proposes measures to ensure the survival of the cyber insurance market, which should be immediately addressed given the current state of the world and the fact that even pre-COVID-19, businesses worldwide stood to lose over $5.2 trillion over the next five years due to cybercrimes. Unless action is taken to mitigate the fallout from cyber events, the cyber insurance market will …

Phishing For Computer Fraud Insurance Coverage, Stephen Swanson

Georgia State University Law Review

Accordingly, the following note discusses the disparity between the federal circuit courts regarding the proper insurance coverage for phishing-type attacks. Part I examines the cyber threats companies face when handling sensitive transactions and customer data, as well as the coverage gap between traditional crime insurance policies and the targeted cyber insurance policies that help prevent, detect, and ultimately mitigate the damages resulting from a cybersecurity breach. Part II analyzes the current circuit split and the various contract interpretation strategies, policy considerations, and tests employed in reaching a coverage decision. Part III proposes a resolution to the overarching circuit split that …

Remutualization, Erik F. Gerding

Publications

Policymakers need to rediscover the organizational form of business entity as a tool of financial regulation. Recent and classic scholarship has produced evidence that financial institutions organized as alternative entity forms – including investment bank partnerships and banks and insurance companies organized as mutual or cooperatives – tend to take less risk, exploit customers/consumer less, or commit less misconduct compared to counterparts organized as investor-owned corporations. This article builds off the work of Hill and Painter on investment banks organized as partnerships, Hansmann on the history and economics of banks and insurance companies organized as mutuals and cooperatives, and other …

Sb 18 - Direct Primary Care, Valentin H. Dubuis, Juliana Mesa

Georgia State University Law Review

This legislation allows physicians to offer specified care for a specific time pursuant to a fixed fee. The physician cannot require more than one year’s payment upfront, and the agreement has to be terminable by either party with thirty days’ notice. Physicians do not have to provide care if the fee has not been paid or the patient has committed fraud, failed to adhere to treatment, or is in physical danger.

Law School News: A Busy, Busy Time In Admiralty Law 10-18-2019, Michael M. Bowden

Life of the Law School (1993- )

No abstract provided.

Law School News: Inside Rwu Law's Small 'Admiralty Empire' 10-18-2019, Michael M. Bowden

Life of the Law School (1993- )

No abstract provided.

Bad Company? The Rise (Again) Of Association Health Plans, Brendan Williams

The Journal of Business, Entrepreneurship & the Law

This article first examines the rule adopted by the DOL and the criticism it has drawn. It then assesses the state of the small-group insurance market for small businesses, and the flawed approach that the ACA took to assisting them. Finally it takes a look at the uncertain future for small businesses and health insurance, and it suggests new approaches

Advancing The Aquaculture Industry Through The Federal Crop Insurance Program, Matthew H. Bowen

Ocean and Coastal Law Journal

In recent times, the aquaculture industry has experienced dramatic growth. The growth of the industry is a direct result of an increase in demand for seafood, and a decrease in supply from wild fisheries. The industry, however, is also experiencing growing pains. Aquaculture species, compared to their wild counterparts, are at a higher risk of catastrophic loss from a variety of different perils. These perils make investment in the aquaculture industry significantly risky. The federal crop insurance program could be a tool that mitigates these risks, but the program was designed around terrestrial agriculture, and while aquaculture may be covered …

Dual Regulation Of Insurance, Christopher French

Journal Articles

Since this country was created, the insurance industry has been principally regulated by the states with infrequent Congressional interventions. As the insurance industry has evolved in recent decades, however, individual states have become unable to adequately regulate some insurers, such as multinational insurers and foreign insurers, because they lack jurisdiction over such entities. Simply having the federal government assume responsibility for regulating insurers will not solve the current regulatory problems, however, because Congress’ past forays into regulating certain areas of insurance generally have yielded poor results. Consequently, this Article makes the novel proposal and argument that, with the creation of …

Terrorism Risk Insurance Act: Time To Renew . . . Or Rethink?, Jeffrey E. Thomas

Faculty Works

This paper summarizes the U.S. program for terrorism insurance, outlines its advantages and disadvantages, and describes the current proposals for extension of the program. The program, generally referred to as a “Federal Backstop,” functions in some ways that are similar to reinsurance, but it does not require participants to pay premiums ex ante. Instead uses an ex post recoupment mechanism to recover some or all of the Federal payments made under the program. This approach has the advantage of reducing the cost and increasing the availability of terrorism insurance. Some have criticized the program for its interference in market mechanisms, …

Dual Regulation Of Insurance, Christopher French

Christopher C. French

Holding Ridesharing Companies Accountable In Texas, Martha Alejandra Salas

St. Mary's Law Journal

Abstract forthcoming

Cross-Subsidies: Government's Hidden Pocketbook, John Brooks, Brian Galle, Brendan S. Maher

Faculty Scholarship

Governments can use regulation to pay for public goods out of the pockets of consumers, rather than taxpayers. For example, the Affordable Care Act underwrites care for women and the infirm through higher insurance premium payments by healthy men. Building on a classic article from Richard Posner, we show that these “cross-subsidies” between consumers are a common feature of modern law, ranging from telecommunications to intellectual property to employee benefits.

Critics of the ACA, and even some of its supporters, argue that taxes would be a better choice. Taxes are said to be more transparent, and to fit better with …

English Justice For An American Company?, Christopher French

Journal Articles

This Essay addresses the Halliburton Co. v. Chubb Bermuda Insurance Ltd. case, which is pending before England's Supreme Court. The issue before the Court is whether it is appropriate for the "neutral" arbitrator, who has a history of serving as a party-appointed arbitrator for Chubb, to serve as the "neutral" arbitrator in the matter while simultaneously serving as a party-appointed arbitrator for Chubb in another related arbitration proceeding involving the same insurance policy form and the same underlying Deepwater Horizon incident. The lower courts declined to remove the arbitrator. The Essay also addresses the question of whether London arbitration proceedings …

Insuring Against Cyber Risk: The Evolution Of An Industry (Introduction), Christopher French

Journal Articles

Cyber risks are the newest risks of the 21st century. The breadth and cost of cyber attacks are astonishing. Worldwide damages caused by cyber attack are predicted to reach $6 trillion by 2021. Between 2015 and 2017, ransomware damages alone increased from $325 million to approximately $5 billion. In 2017, WannaCry ransomware shut down over 300,000 computer systems across 150 countries.

On April 13, 2018, the Penn State Law Review held a symposium to discuss the evolution of cyber risks and cyber insurance. The symposium was comprised of an eclectic group of legal practitioners and scholars who presented four articles. …

The Promises And Pitfalls Of Harmonization: What Insurance Guarantee Schemes Tell Us About When Harmonization Works, Jordan Burton

Indiana Law Journal

In Part I, this Note considers the mechanisms of harmonization and the regulatory and fairness policy concerns that harmonization is designed to address. Part II explores some of the problems harmonization can create, with an eye toward how those problems manifest in the IGS context. Finally, Part III discusses how IGS address an urgent and inevitable problem that affects actors in the insurance market at every level. By analyzing comments on the Commission’s White Paper, Part III proposes that these three factors—convergence of stakeholder interest, inevitability, and urgency— are key to understanding when member states, EU citizens, and industry actors …

The Techno-Neutrality Solution To Navigating Insurance Coverage For Cyber Losses, Jeffrey W. Stempel, Erik S. Knutsen

Scholarly Works

Insurers currently constrict coverage for losses involving electronic information in traditional insurance product lines. As a result, insurance customers are driven to the brave new world of non-standardized varieties of cyber-risk insurance policies. That world abounds with coverage gaps as the market for cyber insurance sorts itself out. Until that synchronization of coverage for cyber losses occurs, litigation is bound to occur as the boundaries of coverage remain patchwork and uncertain.

This article examines the degree to which cyber losses differ from other insured losses. The cyber-loss insurance coverage jurisprudence reveals a mishmash of principles and coverage terms that are …

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

All 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 …

Minding The Protection Gap: Resolving Unintended, Pervasive, Profound Homeowner Underinsurance, Kenneth S. Klein

Faculty Scholarship

A significant majority of homeowners in the United States unwittingly have less insurance than necessary to rebuild their home in the event of a complete loss. This persistent, multibillion-dollar protection gap first emerged in the 1990s and has never resolved despite a desire by most homeowners to contract for full replacement coverage. While a great deal of academic and industry literature has addressed the issue of underinsurance, the work has been done without reference to two sources that unlock the conundrum. The first is the 1550+ page administrative rulemaking file of the California Department of Insurance collected in the wake …

Regulatory Fracture Plugging: Managing Risks To Water From Shale Development, Caroline Cecot

Texas A&M Law Review

Debates about the desirability of widespread shale development have highlighted outstanding uncertainty about its health, safety, and environmental impacts—most prominently, its water-contamination risks—and the ability of current institutions to deal with these impacts. States, the primary regulators of oil and gas extraction, face pressure from the energy industry, local communities, and, in some cases, the federal government to strike the right balance between energy production and the health and safety of individuals and the environment—an elusive balance given the ongoing risk uncertainty. This dynamic is not especially unique to fracking, or even oil and gas extraction; instead, this dynamic, characterized …