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Articles 1 - 5 of 5
Full-Text Articles in Insurance Law
The Need For Revisiting The Imposition Of Bad Faith Liability: Industrial Indemnity Co. V. Kallevig, J. Benson Porter, Jr.
The Need For Revisiting The Imposition Of Bad Faith Liability: Industrial Indemnity Co. V. Kallevig, J. Benson Porter, Jr.
Seattle University Law Review
This Note posits two recommendations. First, in order to harmonize the bad faith standards applied in Kallevig and Gingrich, the Kallevig reasonable justification standard should be applied in situations involving questions similar to those confronted by the Gingrich court. Second, this Note contends that the Kallevig court's analysis imposing liability under the CPA was defective because it failed to take proper account of the frequency requirement within the unfair trade practices regulations. By ignoring the frequency provision, the Kallevig decision allows inconsistent treatment of similar factual situations depending on whether the decision is being made by an agency or …
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Seattle University Law Review
This Article is necessarily a rather selective (for reasons of brevity and reader tolerance) and even subjective attempt to summarize the experience under PPS to date and to suggest some lessons that might be drawn from that experience for the future reform of PPS itself and of payment systems generally. No attempt will be made here to be comprehensive, to explain all the technical details of an inherently and increasingly complex system, nor even to systematically survey the rapidly growing body of literature. But the few issues and themes that clearly stand out will be the focus of most of …
Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost
Policing Cost Containment: The Medicare Peer Review Organization Program, Timothy Stoltzfus Jost
Seattle University Law Review
This Article will first examine the problem of health care cost inflation and the payment strategies the Medicare program has adopted to address that problem. It will then discuss the perverse incentives that these payment strategies create, and the role of the PRO program in addressing harmful provider behavior encouraged by those perverse incentives. The Article examines evidence on whether the PRO program is succeeding or failing in this mission, and suggests possible means of improving the effectiveness of the PRO program in policing cost containment. Specifically, it recommends clarifying and strengthening the deterrent role of the PROs, crafting PRO …
Boeing Co. V. Aetna Casualty & Surety Co.: Cercla Response Costs Covered "As Damages" Under Comprehensive General Liability Insurance Policies , Kimberly A. Richter
Boeing Co. V. Aetna Casualty & Surety Co.: Cercla Response Costs Covered "As Damages" Under Comprehensive General Liability Insurance Policies , Kimberly A. Richter
Seattle University Law Review
This Comment will examine the CERCLA provisions that empower the government to clean up dangerous hazardous waste sites and to seek reimbursement of clean-up costs from polluters. It will then outline the standard provisions of CGL policies, which require insurers to indemnify insureds for all costs incurred "as damages" under the terms of the policy. Next, the Comment will set forth the two primary methods of interpretation employed by courts to determine whether CERCLA response costs are covered damages under CGL policies. The Comment will then set forth Washington law which provided the foundation for the Washington Supreme Court's decision …
Private Utilization Review, Marvis J. Oehm
Private Utilization Review, Marvis J. Oehm
Seattle University Law Review
This Article describes the history of private UR and provides illustrations of successes, problems and controversies. The Article concludes with some suggestions and prescriptive advice for those who are likely to encounter UR, either through work with particular clients or directly as part of a private benefit plan.