Law Commons^™

It’S A Mistake: Insurer Cost Cutting, Insurer Liability And The Lack Of Erisa Preemption Within The Individual Exchanges, Christopher R. Smith

Christopher R Smith

Within the new individual health insurance exchanges, ERISA preemption is inapplicable to State tort claims against individual exchange insurers, framing the question of whether or not individual exchange insurers, like employment-based insurers, should be protected from State tort liability. While there should be concern for an insurer’s ability to effectively manage costs and eliminate waste, beneficiaries should also have some sort of remedy against their insurer, when insurer cost cutting results in beneficiary harm. To balance the competing interests, a no-fault liability system should be adopted providing both limited liability for individual exchange insurers and preservation of injured beneficiaries’ remedies.