Law Commons^™

Health Care Law, Kathleen M. Mccauley, Kristi L. Vanderlaan

University of Richmond Law Review

No abstract provided.

Too Much Risk: The Impact Of Class Action Lawsuits On Claims Made Insurance Policies, Sean A. Smith

Missouri Law Review

The dispute between H & R Block and its excess policy insurers presented the United States Court of Appeals for the Eighth Circuit with an issue of national first impression: does the existence of a series of class action lawsuits prior to the enactment of a claims made insurance policy make it reasonably foreseeable that similar future claims will be filed? 14 The Eighth Circuit's ultimate decision in H & R Block, Inc. v. American International Specialty Lines Insurance Co. will impact insurance coverage of major corporations nationally, in both the narrow context of the upcoming wave of lawsuits against …

The Definition Of "Accident" In Canadian Coverage Cases And The Unspoken "Useful Purpose" Test, Eric J. Adams

Dalhousie Law Journal

Thispaper argues that courts tacitly weigh risks againstrewards when constructing the meaning of the term "accident." It suggests the phrase "courting the risk" takes on two distinct meanings. Firstly, at some point, the risks associated with an activity are said to be so substantial as to suggest an insured expected and, thus, courted any resulting losses.. Secondly, a party is deemed to court the risk of. loss if acting solely for the experience of risk, in and of itself,and not for any other redeeming benefit. The author outlines the evolution of the term "accident" in the case law and contrasts …

Climate Change Disclosure: Ensuring The Viability Of The Insurance Industry While Protecting The Investor, Kevin W. Weigand

William & Mary Environmental Law and Policy Review

No abstract provided.

Negotiating In The Shadow Of “Bad Faith” Refusal To Settle: A Game Theory Model Of Medical Malpractice Pre-Trial Settlements And Insurance Limits, Theodore H. Frank, Marie Gryphon

Theodore H. Frank

Recent empirical studies of Texas data by Hyman et al, Zeiler et al, and Silver et al suggest that insurance limits affect settlements of medical malpractice cases. Writing separately, Silver argues that insurance limits act as a de facto cap on malpractice payouts, that plaintiffs are being underpaid as a result, and that therefore legislative caps on damages are unnecessary. But this hypothesis is inconsistent with the data, which indicates that forty-seven percent of cases in which plaintiffs obtain verdicts above policy limits are subsequently settled above policy limits. We propose to reconcile the data by accounting for the effects …

Is Actuarially Fair Insurance Pricing Actually Fair? A Case Study In Insuring Battered Women, Deborah Hellman

Deborah Hellman

No abstract provided.

Terrorism Risk In A Post-9/11 Economy: The Convergence Of Capital Markets, Insurance, And Government Action, Robert J. Rhee

Robert Rhee

September 11 changed the American economy and the global insurance market. The insurance industry no longer covers terrorism risk for "free." The traditional insurance mechanism alone cannot spread the risk of repeated catastrophic losses. Beyond the Terrorism Risk Insurance Act of 2002 lingers the questions of a longterm solution and government's role therein. Government can assume different roles: reinsurer, wealth (re)distributor, regulator, or a combination thereof. This article suggests that the government should foster a regulatory and tax environment in which the private sector can develop a capital market solution for terrorism risk. Securitization is an alternative to reinsurance and …

Insurance For Acts Of Terrorism, Robert J. Rhee

Robert Rhee

This chapter discusses insurance case law arising from acts of terrorism, including those arising from the September 11 attacks. It analyzes the Terrorism Risk Insurance Act of 2002 (TRIA), as amended by the Terrorism Risk Insurance Act of 2005 and the Terrorism Risk Insurance Program Reauthorization Act of 2007, as well as the administrative program created by the legislation. Examples are provided and NAIC Policyholder Disclosure Notice forms are included. Policy considerations surrounding TRIA are also discussed including insurance industry strategies, the difficulties of assessing terrorism risks, the effect of TRIA subsidized insurance on the market, and the benefits and …

Lifting The Veil: Pressures Mount For Climate Change Disclosures, Richard Faulk

Richard Faulk

Measures from Sarbanes-Oxley to climate change legislation will pervasively transform the manner in which American businesses relate to shareholders and consumers. Capping a month of extraordinary changes, the National Association of Insurance Commissioners adopted a rule that mandates broad disclosures by insurance companies regarding the impact of climate change on their financial stability – thereby enlisting the insurance industry as a ‘‘partner’’ in the enforcement of global and national climate change policies.

The Constitutionality Of Mandates To Purchase Health Insurance, Mark A. Hall

O'Neill Institute Papers

Health insurance mandates have been a component of many recent health care reform proposals. Because a federal requirement that individuals transfer money to a private party is unprecedented, a number of legal issues must be examined.

This paper analyzes whether Congress can legislate a health insurance mandate and the potential legal challenges that might arise, given such a mandate. The analysis of legal challenges to health insurance mandates applies to federal individual mandates, but can also apply to a federal mandate requiring employers to purchase health insurance for their employees. There are no Constitutional barriers for Congress to legislate a …

The Purchase Of Insurance Across State Lines In The Individual Insurance Market, Stephanie W. Kanwit

O'Neill Institute Papers

Proposals to allow the purchase of insurance across state lines (PASL) have gained some support in recent years. Health insurers have traditionally been allowed to sell a policy only within the state that approved and regulates that particular policy. PASL would allow insurers to sell a policy approved in one state to people residing in any state.

Any federal legislation to enact PASL in an individual insurance market would have to address two main legal considerations: 1) the McCarran-Ferguson Act, which allows the states to retain their regulatory authority over insurance, and 2) a constitutional prohibition against the commandeering of …

Insurance Discrimination On The Basis Of Health Status: An Overview Of Discrimination Practices, Federal Law And Federal Reform Options, Sara Rosenbaum

O'Neill Institute Papers

Actuarial underwriting, or discrimination based on an individual’s health status, is a business feature of the voluntary private insurance market. The term “discrimination” in this paper is not intended to convey the concept of unfair treatment, but rather how the insurance industry differentiates among individuals in designing and administering health insurance and employee health benefit products.

Discrimination can occur at the point of enrollment, coverage design, or decisions regarding scope of coverage. Several major federal laws aimed at regulating insurance discrimination based on health status focus at the point of enrollment. However, because of multiple exceptions and loopholes, these laws …

Disability Rights, Disability Discrimination, And Social Insurance, Mark C. Weber

Georgia State University Law Review

No abstract provided.

Rethinking Support For Adoptive Parents, Mary Eschelbach Hansen

Mary Eschelbach Hansen

Since 1980, the U.S. government has offered subsidies to encourage surrogate parents to adopt children who are in foster care and cannot be reunited with their birth parents. Despite some success, the subsidy program has not attracted enough parents to meet the needs of the children. The critical problem is that the subsidy program does not adequately recognize the difficulty of assessing the child’s future needs; therefore, the subsidy does not adequately reduce the substantial financial risk associated with caring for a child adopted from foster care. A supplementary insurance program could attract new adoptive families and could also improve …

Are Insurance Policies Still Contracts, David F. Tavella

David F. Tavella

This article examines whether courts still treat insurance policies as contracts. Since the inception of insurance, policies have been deemed contracts, and general principles of contract interpretation have been used to interpret policies. However, more and more courts are abandoning contract principles when interpreting insurance policies, particularly using parol evidence to determine whether a policy provision is ambiguous, or even using parol evidence to interpret the meaning of unambiguous policy terms. My conclusion is that insurance policies, while still generally considered “contracts,” are treated differently then other contracts, and in reality are not seen as true contracts.

D&O Insurance In Bankruptcy: Just Another Business Contract, Elina Chechelnitsky

Fordham Journal of Corporate & Financial Law

No abstract provided.

The Development Of International Norms For Insurance Regulation, Elizabeth F. Brown

Elizabeth F Brown

The development of international norms for insurance has not progressed as far or as deeply as the development of international norms for banking. Several factors have affected this process. First, the efforts to develop such norms are relatively new. The International Association of Insurance Supervisors (“IAIS”) has existed for less than fifteen years while the Basel Committee on Banking Supervision has existed for over thirty years. Second, the membership of the IAIS makes it harder for that organization to achieve consensus on principles and standards than for the Basel Committee. The IAIS has members from almost 140 nations, including both …

Energy Policy, Intellectual Property And Technology Transfer To Address Climate Change, Prof. Elizabeth Burleson

Prof. Elizabeth Burleson

A weather beaten economy has become a wake up call. The International Energy Agency predicts that carbon emissions will rise 130 percent and oil demand will rise 70 percent by 2050. A sound energy policy that addresses climate change relies upon widespread transfer and implementation of environmentally sound technology. Multilateral cooperation can achieve environmentally sound technology transfer within in a meaningful time frame to address climate change.

The Court Of Appeals For The Fifth Circuit: A Review Of 2007-2008 Insurance Decisions, Willy E. Rice

Faculty Articles

The Fifth Circuit Court of Appeals decided a considerable number of insurance-related controversies between June 2007 and May 2008. Arguably, the most important, comprehensive decisions are discussed-nineteen insurance cases that originate in just five federal district courts. Generally, the Fifth Circuit decided familiar questions of law and fact. More specifically, the following types of procedural and substantive conflicts appear in the nineteen insurance decisions: (1) one case involving the constitutionality of a Texas insurance statute; (2) two federal preemption and removal controversies involving the Employee Retirement Income Security Act (“ERISA”); (3) two disagreements requiring the court of appeals to make …

Destroyed Community Property, Damaged Persons, And Insurers’ Duty To Indemnify Innocent Spouses And Other Co-Insured Fiduciaries: An Attempt To Harmonize Conflicting Federal And State Courts’ Declaratory Judgments, Willy E. Rice

Faculty Articles

Perhaps because of habit or a strong aversion to risks, consumers purchase a considerable amount of insurance generally, and consumers purchase property, indemnity, and liability insurance in particular. Typically, national property and casualty insurers sell property, indemnity, and liability insurance contracts. As a result, those insurers sales and revenues increase from year to year. At the dawn of the 21st century, foreign property and casualty insurers are realizing similar successes.

It is expected that anxious or prudent consumers would insure themselves and their various property interests against strangers, strange events, and perils over which consumers have little control or influence. …

Common-Sense Construction Of Unfair Claims Settlement Statutes: Restoring The Good Faith In Bad Faith, Victor Schwartz, Christopher E. Appel

American University Law Review

This Article proposes to balance the scale by providing principles for the reasonable construction of bad-faith and unfair claims settlement practices in statutes applicable to insurance. Part I examines the history and development of bad-faith law, and discusses the common structure of statutes giving rise to badfaith settlement claims. Part II presents general principles courts may apply to resolve an action alleging bad faith, and specific principles courts may apply to address common issues with many states’ statutes. Part III then evaluates the public policy involved in applying such principles to first-party claims where the insured suffers an injury and …

The Legacy Of The 9/11 Fund And The Minnesota I-35w Bridge-Collapse Fund: Creating A Template For Compensating Victims Of Future Mass-Tort Catastrophes, Michael K. Steenson

Faculty Scholarship

The purpose of this article is to analyze and compare the 9/11 Fund and the Minnesota bridge-collapse compensation scheme for purposes of illustrating the necessary components of any future compensation schemes legislatures consider adopting in cases involving other catastrophes. This article first sets out the primary issues that must be addressed when considering a compensation scheme. It then examines the choices made in the 9/11 Fund and Minnesota’s bridge-collapse compensation scheme. A brief comparison of the two compensation schemes follows to provide the framework for considering the components of future compensation schemes.

The Insurance Policy As Thing, Jeffrey W. Stempel

Scholarly Works

Insurance policies are a type of contract. But characterizing them only as contracts misses much of the richness of the insurance arrangement, policyholder-insurer relations, and the degree to which insurance policies, which are heavily standardized, are designed to perform a particular function. Because of their mass standardization and deployment to address particular risk management issues, insurance policies are in many respects like products or chattels. Insurers and the insurance trade press in fact frequently speak of a line of insurance "products" or a new "product" being introduced to address an emerging risk. Appreciating this aspect of the insurance policy can …

The Debt Financing Of Parenthood, Melissa B. Jacoby

Melissa B. Jacoby

In this contribution to the symposium Show Me the Money: Making Markets in Forbidden Exchange, I explore an under-appreciated participant in the assisted reproduction and adoption industries: consumer lenders. Through fertility clinics and other service providers, financial institutions market and distribute loans specifically to finance acquisition of treatments, drugs, and human eggs. Adoption foundations and agencies advertise for-profit loans to intended parents, while small foundations offer adoption loans that appear to be low-cost financially but may condition loan approval on intended parent characteristics such as religious observance, marital status, sexual orientation, and adherence to traditional gender roles. After discussing how …