Insurance Law Commons^™

Ensuring Insurance: Adequate And Appropriate Coverage For Brady Claims In Illinois, Joe Delich

Northwestern University Law Review

The increase in wrongful conviction litigation has engendered a number of new doctrinal problems. This Note examines the existing rules governing insurance coverage for wrongful-conviction-related torts, in particular, due process claims for Brady violations. It then explores the rationale for the continuous trigger doctrine in the asbestos context, and argues that wrongful conviction claims call for a similar approach due to comparable latency concerns. There is a particular focus on Illinois law due to the state’s prevalence of wrongful conviction litigation and recent shifts in the law governing insurance triggers for malicious prosecution.

Insurance, Bradley S. Wolff, Stephen Schatz, Maren R. Cave

Mercer Law Review

Courts continue to address the unique issues that arise with respect to uninsured motorist (UM) coverage, often finding that coverage exists. In a case of first impression, the Georgia Supreme Court held that an insured may recover UM benefits from a policy, despite the partial sovereign immunity of the tortfeasor. An insured may be entitled to UM benefits after settling with the tortfeasor's liability carrier for the full policy limits, even though a limited liability release allocates the majority of the settlement amount to punitive damages. Further, courts continue to strictly adhere to the "case or controversy" requirement in order …

Spending Medicare’S Dollars Wisely: Taking Aim At Hospitals’ Cultures Of Overtreatment, Jessica Mantel

University of Michigan Journal of Law Reform

With Medicare’s rising costs threatening the country’s fiscal health, policymakers have focused their attention on a primary cause of Medicare’s high price tag—the overtreatment of patients. Guided by professional norms that demand they do “everything possible” for their patients, physicians frequently order additional diagnostic tests, perform more procedures, utilize costly technologies, and provide more inpatient care. Much of this care, however, does not improve Medicare patients’ health, but only increases Medicare spending. Reducing the overtreatment of patients requires aligning physicians’ interests with the government’s goal of spending Medicare’s dollars wisely. Toward that end, recent Medicare payment reforms establish a range …

Encouraging Insurers To Regulate: The Role (If Any) For Tort Law, Kyle D. Logue

Articles

Insurance companies are financially responsible for a substantial portion of the losses associated with risky activities in the economy. The more insurers can lower the risks posed by their insureds, the more competitively they can price their policies, and the more customers they can attract. Thus, competition forces insurers to be private regulators of risk. To that end, insurers deploy a range of techniques to encourage their insureds to reduce the risks of their insured activities, from charging experience-rated premiums to discounting premium rates for insureds who make specific behavioral changes designed to reduce risk. Somewhat paradoxically, however, tort law …

Policyholder Rights To Independent Counsel: Issues Remain Regarding Compensation, Supervision Of Counsel, Jeffrey W. Stempel

Scholarly Works

More than 30 years ago, a California appellate court decision (San Diego Navy Federal Credit Union v. Cumis Insurance Society, 162 Cal. App. 3d 358 (4th Dist. 1984)) worked a revolution of sorts by ruling that, in cases of conflict between an insurer and a policyholder defending against a plaintiff's claim, the insurer was obligated to permit the policyholder to select its own defense counsel rather than having the case defended by an attorney selected by the insurer. The Cumis movement was more evolutionary than revolutionary in Nevada. Until State Farm Mutual Automobile Ins. Co. v. Hansen, …

Rodney Dangerfield No More: The American Law Institute's Coming Restatement Of The Law Of Liability Insurance, Jeffrey W. Stempel

Scholarly Works

In a casebook I co-author, "Principles of Insurance Law," with Peter Swisher and Erik Knutsen, we refer to insurance as "the Rodney Dangerfield of law." It just does not (to paraphrase the words of the late comedian), get enough respect. Lawyers are familiar with (and have been since perhaps the fourth week of law school), the American Law Institute's Restatements of the Law, particularly widely cited restatements, such as those governing torts and contracts (and, to a lesser extent, judgments, conflict of laws, restitution, suretyship and others). Despite the importance of insurance in the civil justice system, it has been …

Case Law Developments Addressing The Consequences Of A Liability Insurer’S Breach Of Its Duty To Defend, Michael A. Haskel

Pace Law Review

In pursuit of a greater understanding of this controversial subject, this article will: (1) explore the contract principles and public policy considerations that are implicated by an insurer’s breach of its defense duty; (2) consider recent case law addressing relevant issues; and (3) recommend a comprehensive approach that accommodates competing interests. Ultimately, the author concludes that in most circumstances an insurer that wrongfully disclaims its duty to defend should be precluded from raising defenses as to coverage in an action to indemnify the insured for monies paid out by the insured.

Death Of A Salesman: The Rise & Unfortunate Potential Demise Of The Full-Time Life Insurance Salesman, Robert M. Rosh

St. John's Law Review

(Excerpt)

This Article traces the economic and regulatory rise and potential future regulatory demise of the full-time life insurance salesman. It outlines why these salesmen and many of the products that they offer are beneficial to American society, and why public policies should promote both the profession and the products sold by full-time life insurance salesmen. Finally, it suggests some modest regulatory reforms that would promote life insurance sales and the salesmen who make them.

Adjusting The Benefits And Burdens Of Economic Life For The Public Good: The Aca's Medical Loss Ratio As A Constitutional Regulation Of Health Insurance Companies, Susanne Cordner

William & Mary Bill of Rights Journal

No abstract provided.

Three Words And The Future Of The Affordable Care Act, Nicholas Bagley

Articles

As an essential part of its effort to achieve near universal coverage, the Affordable Care Act (ACA) extends sizable tax credits to most people who buy insurance on the newly established health care exchanges. Yet several lawsuits have been filed challenging the availability of those tax credits in the thirty-four states that refused to set up their own exchanges. The lawsuits are premised on a strained interpretation of the ACA that, if accepted, would make a hash of other provisions of the statute and undermine its effort to extend coverage to the uninsured. The courts should reject this latest effort …

The Unintended Effects Of Government-Subsidized Weather Insurance, Omri Ben-Shahar, Kyle D. Logue

Articles

Catastrophes from severe weather are perhaps the costliest accidents humanity faces. While we are still a long way from technologies that would abate the destructive force of storms, there is much we can do to reduce their effect. True, we cannot regulate the weather, but through smart governance and correct incentives we can influence human exposure to the risk of bad weather. We may not be able to control wind or storm surge, but we can prompt people to build sturdier homes with stronger roofs far from floodplains. We call these catastrophes "natural disasters," but they are the result of …

State Farm Mut. Auto. Ins. Co. V. Hansen, 131 Nev. Adv. Op. 74 (Sept. 24, 2015), Kristen Matteoni

Nevada Supreme Court Summaries

Under Nevada law, an insurer is required to provide independent counsel of the insured choosing when a conflict of interest arises between the insured and the insurer. A reservation of rights fails to create a per se conflict of interest. Instead, the courts must analyze on a case-by-case basis whether an actual conflict exists. Only if an actual conflict exists, must an insurer be obligated to provide the insured with independent counsel.

The Family Llc: A New Approach To Insuring Dynastic Wealth, Evan Michael Purcell

The Journal of Business, Entrepreneurship & the Law

This Article introduces the taxpayer to the basic background principles needed to understand the inner workings of the investment, then provides a guide to drafting considerations for the family's attorney, and concludes with a general plan to maintain business legitimacy and take advantage of tax-favored status, while retaining the flexibility essential to combating the unexpected. Part II addresses the historically favored tax treatment of life insurance products, as well as relatively recent restrictive reforms. Part III addresses the background foundation of the LLC entity and surveys its skeletal structure. Part IV introduces a practical example of how to create an …

The Personal Liability Of Insurance Claims Adjusters For Insurance Bad Faith, Chad G. Marzen

West Virginia Law Review

No abstract provided.

Insuring Floods: The Most Common And Devastating Natural Catastrophes In America, Christopher C. French

Villanova Law Review (1956 - )

No abstract provided.

Legal Regime Of Marine Insurance In Arctic Shipping: Safety & Environmental Implications, Proshanto K. Mukherjee, Huiru Liu

ShipArc 2015 Conference

No abstract provided.

Arctic Shipping & Liability For Harm To Natural Resources, Dominik Walkowski

ShipArc 2015 Conference

No abstract provided.

Uninsured Motorists Coverage Validity Of Other Insurance Provisions; Curran V. State Automobile Mutual Insurance Co., Dennis J. Fox

Akron Law Review

It was the contention of the defendant-appellant insurers that their liability was limited in both instances by the "other insurance" provisions of their respective policies. These provisions were both "excess insurance" clauses. The Ohio Supreme Court, in ruling upon what it considered to be the sole issue in this case, denied effectiveness to these clauses.

Uninsured Motorists Coverage Validity Of Other Insurance Provisions; Curran V. State Automobile Mutual Insurance Co., Dennis J. Fox

Akron Law Review

It was the contention of the defendant-appellant insurers that their liability was limited in both instances by the "other insurance" provisions of their respective policies. These provisions were both "excess insurance" clauses. The Ohio Supreme Court, in ruling upon what it considered to be the sole issue in this case, denied effectiveness to these clauses.

Uninsured Motorist Coverage - Scope Of The Term - "Uninsured Motorist"; Porter V. Empire Fire And Marine Insurance Co., Dennis J. Fox

Akron Law Review

The appellant, James T. Porter, was involved in an automobile accident in which he and four other persons were injured. The tortfeasor was insured to the extent of the statutory minimum ($10,000-$20,000) as provided for by the Arizona Financial Responsibility Act.' The appellant subsequently obtained a judgment against the tortfeasor for $10,000. He then entered into a proposed settlement with the tortfeasor's insurer under which he was to receive $2,500 of the $20,000 of insurance proceeds available for allocation among the injured parties. Mr. Porter notified his insurer (the appellee) of the proposed settlement and requested the appellee satisfy the …

Property Insurance For Ohio's Urban Areas, R. D. Welsh

Akron Law Review

Thirty-eight million dollars damage to property occurred in Watts in 1965, $49,000,000 in Detroit, and $10,000,000 in Newark, New Jersey in 1967, plus many others that have resulted in about $187,000,000 being paid in the five years ending in 1968. Until Watts, riot coverage was provided as an afterthought by the insurance industry with little or no additional charge. Besides this problem, insurers were faced with loss of reinsurance by foreign reinsurers alarmed by inability of Government authorities to maintain law and order.

Uninsured Motorist Coverage - Scope Of The Term - "Uninsured Motorist"; Porter V. Empire Fire And Marine Insurance Co., Dennis J. Fox

Akron Law Review

Absent a statutory definition of "uninsured motorist," the court under its powers of construction must, in a functional sense, legislate the gap-filling language. The outcome elsewhere on facts similar to those in Porter will depend, in part, on whether the legislature in adopting uninsured motorist statutes, have incorporated a definition of its terms.

Automobile Insurance Rates: Promulgation, Regulation, And Equal Protection, James J. Mcgraw

Akron Law Review

T HE INTEREST in the price one pays for automobile insurance continues to grow at a rapid pace. The reason for this growing consumer interest may be attributed to the equally increasing need for automobiles, the price paid for them, and consequently, the need for insurance protection. This insurance protection has developed into a matter of major economic consequence to the auto owner.....The key to improved and efficient rate-watching is in the good faith efforts and perseverance of the policyholders themselves. Accordingly, an examination of the effects of consumerism along with a discussion of modern rate and regulatory developments is …

Some Comments In Favour Of The Abolition Of Fault Law, William F. Foster

Akron Law Review

THE ALARMING NUMBER of automobile accidents resulting in death or injury to thousands of persons each year and the direct and indirect costs associated with these accidents is one of the more depressing features of modern life. Unfortunately, there is no reason to believe that there will be a dramatic improvement in this situation in the foreseeable future because: automobile transportation is central to the North American way of life, the majority of drivers have no competence in anything but routine driving situations, and often factors beyond a motorist's control cause or contribute to accidents. For these reasons it is …

Burglary Insurance Policies; Reasonable Expectations; Unconscionability; Application Of Implied Warranty Of Fitness; C & J Fertilizer, Inc. V. Allied Mutual Ins. Co., Janice Gui

Akron Law Review

THE IOWA SUPREME COURT handed down a landmark decision in C & I Fertilizer, Inc. v. Allied Mutual Ins. Co.', in holding that insurance policies carry implied warranties that they are fit for their intended use. The impetus for this decision was a clause in a burglary and robbery policy which defined "burglary" as . . . the felonious abstraction of insured property . . . from within the premises by a person making felonious entry therein by actual force and violence, of which force and violence there are visible marks made by tools, explosives, electricity or chemicals upon, or …

Petition For A Writ Of Certiorari. Rochow V. Life Insurance Company Of North America, 136 S. Ct. 480 (2015) (No. 15-163), 2015 U.S. S. Ct. Briefs Lexis 2657, Eric Schnapper, Erik W. Scharf, John J. Cooper

Court Briefs

QUESTION PRESENTED When a benefit plan, in violation of ERISA, wrongfully denies or delays payment of a benefit, the court may award relief because of the improper delay in the payment of that benefit. The question presented is: Should 'the amount of a remedy based on the improper delay in the payment of a benefit be based on: (1) only the amount needed to redress the loss that the beneficiary sustained as a result of the wrongful delay (the rule in the Sixth Circuit), (2) either the amount needed to redress the loss that the beneficiary sustained as a result …

In Rem Jurisdiction; Attachment Of Insurance Debts; State Statutes; O'Connorv. Lee-Hy Paving Corp., Eloise Lubbinge Mackus

Akron Law Review

The United States Court of Appeals, Second Circuit, in O'Connor v. Lee-Hy Paving Corp., upheld New York's insurance attachment procedure which serves as a vehicle for gaining personal jurisdiction over out-of-state defendants in causes of action that arise outside of New York. The court thereby determined that New York federal courts, in applying the procedures, had not violated defendant's due process because the minimum contacts requirement of the recent United Stated Supreme Court case, Shaffer v. Heitner, had been met.

Tortious Liability For Bad Faith Refusal To Pay, Jeffrey Schobert

Akron Law Review

In Hoskins v. Aetna Life Ins. Co., the Ohio Supreme Court imposed on insurers a good faith duty in any refusal to pay claims made by their insured. Its decision placed Ohio among a growing number of jurisdictions that have recognized this good faith duty. The court adopted its rationale by relying heavily on existing insurance case law in the refusal-to-settle third-party claims type actions. The court defined the standard of good faith in terms of a reasonable justification by the insurer in refusing to pay a claim "because it believed there was no coverage of the claim." The …

Uninsured Motorist Insurance Now Covers Punitive Award - Hutchinson V. J.C. Penny Casualty Insurance Company, Dale Katzenmeyer

Akron Law Review

A split of authority exists among the few states which have decided the issue In jurisdictions permitting recovery of punitive damages, uninsured motorist coverage is intended to place the insurer in the shoes of the uninsured tortfeasor. Since the insurer stands in the shoes of the tortfeasor, and since punitive damages could be covered if the tortfeasor had his own insurance, it is illogical to deny the victim punitive damages simply because the tortfeasor is uninsured. Other jurisdictions believe that punitive damages should not be awarded since that award would not operate to punish the tortfeasor and would therefore violate …

Unraveling The Underinsured Motorist Web: Ohio Underinsured Motorist Coverage, Amy J. Mckee

Akron Law Review

Understanding how to access underinsured motorist benefits involves a myriad of complex issues. This comment shall focus on two threshold areas of underinsured motorist coverage: the statutory definition of an underinsured motorist and contractual condition precedents enumerated in the insurance policy. If the tortfeasor meets the definition of an underinsured motorist, as defined in the statute, the insured must still comply with three provisions in the contract; the exhaustion clause, the subrogation clause and the consent to settle clause. An insured must first procure the consent of his insurer before he settles with the tortfeasor. However, the insurer will withhold …