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The Law Of Health Insurer Claims Handling In Montana, Greg Munro 2018 Alexander Blewett III School of Law at the University of Montana

The Law Of Health Insurer Claims Handling In Montana, Greg Munro

Faculty Journal Articles & Other Writings

No abstract provided.


The Duality Of Provider And Payer In The Current Healthcare Landscape And Related Antitrust Implications, Julia Kapchinskiy 2018 University of San Diego

The Duality Of Provider And Payer In The Current Healthcare Landscape And Related Antitrust Implications, Julia Kapchinskiy

San Diego Law Review

Health care landscape has changed with the introduction of the ACA and will keep changing due to the proposed repeal. The only constant is the desire of health plans and providers to maximize profits and minimize costs, which is attainable through consolidation. This Comment advocates a revision of the existing antitrust guidelines that would (1) recognize unique nature of health care market, (2) be independent from the current or proposed legislation to the maximum possible extent, and (3) reflect the insurer-provider duality, which heavily influences the quality and accessibility of the healthcare for the consumer.


Department Of Insurance, J. D. Fellmeth 2018 University of San Diego

Department Of Insurance, J. D. Fellmeth

California Regulatory Law Reporter

No abstract provided.


Holding Ridesharing Companies Accountable In Texas, Martha Alejandra Salas 2018 St. Mary's University

Holding Ridesharing Companies Accountable In Texas, Martha Alejandra Salas

St. Mary's Law Journal

Abstract forthcoming


Taking Away The Tightrope: Fixing The National Flood Insurance Program Circus Via Eminent Domain, Alexander S. Mendelson 2018 Brooklyn Law School

Taking Away The Tightrope: Fixing The National Flood Insurance Program Circus Via Eminent Domain, Alexander S. Mendelson

Brooklyn Law Review

As Harvey, Irma, Maria and other major 2017 storms washed upon the shores of the United States, millions of people across the nation in major cities and rural areas alike found their possessions, their homes, and sadly in many cases their lives, washed away with the storms. The destructive hurricane season came just as Congress began to consider the reauthorization of the National Flood Insurance Program (NFIP), a federal system of subsidized flood insurance created to fill a void left by private insurers in the 1960s. Extreme weather events such as these illustrate the need for such a program and ...


How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver 2018 University of Pennsylvania Law School

How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver

Faculty Scholarship at Penn Law

Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact discourages providers from improving safety or encourages them to protect patients from avoidable harms is an empirical question that a survey ...


The Cost Of Legal Restrictions On Experience Rating, Levon Barseghyan, Francesca Molinari, Darcy Steeg Morris, Joshua C. Teitelbaum 2018 Cornell University

The Cost Of Legal Restrictions On Experience Rating, Levon Barseghyan, Francesca Molinari, Darcy Steeg Morris, Joshua C. Teitelbaum

Georgetown Law Faculty Publications and Other Works

We investigate the cost of legal restrictions on experience rating in auto and home insurance. The cost is an opportunity cost as experience rating can mitigate the problems associated with unobserved heterogeneity in claim risk, including mispriced coverage and resulting demand distortions. We assess this cost through a counterfactual analysis in which we explore how risk predictions, premiums, and demand in home insurance and two lines of auto insurance would respond to unrestricted multiline experience rating. Using claims data from a large sample of households, we first estimate the variance-covariance matrix of unobserved heterogeneity in claim risk. We then show ...


Playing With Fire? Testing Moral Hazard In Homeowners Insurance Valued Policies, Peter Molk 2018 SJ Quinney College of Law, University of Utah

Playing With Fire? Testing Moral Hazard In Homeowners Insurance Valued Policies, Peter Molk

Utah Law Review

Insurance policy design and regulation continually grapples with moral hazard concerns. Yet these concerns rest largely on theory-based assumptions about how rational economic actors will respond to financial incentives. Advances in behavioral economics call these assumptions into question.

This Article conducts an empirical test of moral hazard in homeowners insurance markets. Eighteen states’ “valued policy” laws require more generous compensation by insurers for certain total house losses. I test the moral hazard prediction that fire rates will consequently be higher in these states than in others. Using a private insurance database on the cause of loss for over four million ...


Nyimba Investments Limited Vs Nico Insurance Zambia Limited (Appeal No. 130/2016) [2017] Zmsc 32, Edward Sampa 2018 Chibesakunda & Company

Nyimba Investments Limited Vs Nico Insurance Zambia Limited (Appeal No. 130/2016) [2017] Zmsc 32, Edward Sampa

SAIPAR Case Review

No abstract provided.


Insurer Prejudice Analysis Of An Expanding Doctrine In Insurance Coverage Law, Richard L. Suter 2018 University of Maine School of Law

Insurer Prejudice Analysis Of An Expanding Doctrine In Insurance Coverage Law, Richard L. Suter

Maine Law Review

All contracts of insurance place certain requirements on the insured both before and after a covered loss has occurred. For example, all insurance policies require that an insured notify the insurer of a covered loss and cooperate with the insurer in the investigation of the loss and in the pursuit or defense of any claims arising out of the loss. Traditionally, if an insured failed to comply with such notification or cooperation requirements, the insurer could flatly deny coverage of the claim. Recently, however, an increasing number of courts are requiring that the insurer show that it has been prejudiced ...


"Thou Shalt Not Ration Justice": The Importance Of Autism Insurance Reform For Military Autism Families, And The Economic And National Security Implications Of Improving Access To Aba Therapy Under Tricare, Ariana Cernius 2018 Notre Dame Law School

"Thou Shalt Not Ration Justice": The Importance Of Autism Insurance Reform For Military Autism Families, And The Economic And National Security Implications Of Improving Access To Aba Therapy Under Tricare, Ariana Cernius

Journal of Legislation

No abstract provided.


Montana Law, Procedure And Practice For Enforcing Stipulated Judgements In Insurance Cases, Greg Munro 2018 Alexander Blewett III School of Law at the University of Montana

Montana Law, Procedure And Practice For Enforcing Stipulated Judgements In Insurance Cases, Greg Munro

Faculty Journal Articles & Other Writings

No abstract provided.


Sb 219 - Autonomous Vehicles, W. Perry Hicks, Alan J. Ponce 2018 Georgia State University College of Law

Sb 219 - Autonomous Vehicles, W. Perry Hicks, Alan J. Ponce

Georgia State University Law Review

The Act amends Georgia’s Motor Vehicles and Traffic Code to create a legal framework for autonomous vehicles to operate in Georgia. Persons responsible for operating fully autonomous vehicles are exempted from holding a driver’s license. In the event of an accident involving an autonomous vehicle, the vehicle must remain at the scene and the operator of the autonomous vehicle must provide necessary information to law enforcement. Minimum liability insurance requirements for autonomous vehicles will be the same as minimum coverages required for the taxi and limousine industry after January 1, 2020. Minimum coverages are set at 250 percent ...


Hb 1 - Space Flight, Malissa Caroline Barger, Ethan L. Smith 2018 Georgia State University College of Law

Hb 1 - Space Flight, Malissa Caroline Barger, Ethan L. Smith

Georgia State University Law Review

The Act limits the civil and criminal liability of a space flight entity for injuries sustained by space flight participants arising from ordinary negligence. The Act defines new terms and provides a statutory waiver form that participants with informed consent must sign. The Act mandates space flight participants sign the waiver before participating in any space flight activity. The Act does not limit the liability of space flight entities for gross negligence or intentional acts, nor does it prevent suits from anyone other than the space flight participant.


Bermuda: Public Health Insurance, Maxwell Mead 2018 Augustana College, Rock Island Illinois

Bermuda: Public Health Insurance, Maxwell Mead

Global Public Health

Bermuda, a British island territory located in the remote North Atlantic, remains a serviceable country to its citizens. However, it still lacks a national healthcare system: marking it as a difficult country to live in. Despite acknowledging this issue, Bermudan officials have made few attempts to fix the problem. This, in turn, has made Bermuda the highest annual spender on health per capita in the world at $11,952. As such, the cost of living is rather high in Bermuda, sitting at a full 94.86% higher than the cost of living in the United States. All of this makes ...


Harvey, Irma, And The Nfip: Did The 2017 Hurricane Season Matter To Flood Insurance Reauthorization?, Robin Kundis Craig 2018 S.J. Quinney College of Law, University of Utah

Harvey, Irma, And The Nfip: Did The 2017 Hurricane Season Matter To Flood Insurance Reauthorization?, Robin Kundis Craig

Utah Law Faculty Scholarship

The National Flood Insurance Program (NFIP) has become a coastal hurricane insurance program—a fact that is bankrupting it. As a result of climate change, the ocean surrounding the United States is both rising and becoming warmer, and hurricanes and other coastal storms are projected to become both more frequent and more destructive. While no particular hurricane can yet be blamed exclusively on climate change, these projections nevertheless have real implications for the future of the NFIP.

In 2017, Congress was gearing up to reauthorize the NFIP just as the United States entered its worst hurricane season in over a ...


Rhode Island's Voluntary Restructuring Of Solvent Insurers Law And Similar Efforts In Other States, Matthew Gendron, Esq. 2018 Roger Williams University

Rhode Island's Voluntary Restructuring Of Solvent Insurers Law And Similar Efforts In Other States, Matthew Gendron, Esq.

Roger Williams University Law Review

No abstract provided.


2017 Survey Of Rhode Island Law: Cases And Public Laws Of Note, 2018 Roger Williams University

2017 Survey Of Rhode Island Law: Cases And Public Laws Of Note

Roger Williams University Law Review

No abstract provided.


Regulating Robo Advice Across The Financial Services Industry, Tom Baker, Benedict G. C. Dellaert 2018 University of Pennsylvania Law School

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

Faculty Scholarship at Penn Law

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 ...


Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Ellen Wright Clayton, Christine Y. Lu, Stephanie Loomer, et al. 2018 Harvard Medical School

Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Ellen Wright Clayton, Christine Y. Lu, Stephanie Loomer, Et Al.

Vanderbilt Law School Faculty Publications

Abstract: Insurance coverage policies are a major determinant of patient access to genomic tests. The objective of this study was to examine differences in coverage policies for guideline-recommended pharmacogenomic tests that inform cancer treatment. We analyzed coverage policies from eight Medicare contractors and 10 private payers for 23 biomarkers (e.g., HER2 and EGFR) and multi-gene tests. We extracted policy coverage and criteria, prior authorization requirements, and an evidence basis for coverage. We reviewed professional society guidelines and their recommendations for use of pharmacogenomic tests. Coverage for KRAS, EGFR, and BRAF tests were common across Medicare contractors and private payers ...


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