Insurance Law Commons^™

Death From Autoerotic Asphysxiation And The Double Indemnity Clause In Life Insurance Policies: The Latest Round In Accidental Death Litigation, Francis Achampong

Akron Law Review

This paper examines the cases that have been decided on this issue, seeking to determine whether recovery under the double indemnity provision revolves around the type of clause used in the policy, or on the particular jurisdiction's stand on what is "accidental," regardless of policy language. The author seeks to determine whether any particular trend may be elicited from these cases that may shed light on the likely disposition of future cases

The Impact Of State Farm V. Alexander On Uninsured And Underinsured Motorist Coverage Generally, And In To Relation To The Owned-But-Not -Insured Exclusion, Shawn Gordon Lisle

Akron Law Review

The discussion contained herein will commence with a brief examination of the uninsured and underinsured motorist statute's purpose.

Following the discussion of the uninsured motorist statute's purpose, the discussion will proceed to survey all cases to date which have had occasion to deal with Alexander in a substantive manner. Nine of the twelve Ohio appellate districts have considered the Alexander decision in some respect. Likewise, the Ohio Supreme Court has cited to Alexander as authority for reversing appellate court decisions which upheld exclusions violative of R.C. § 3937.18's purpose. Each decision shall be presented and examined in turn, grouped either …

Girgis V. State Farm Mut. Auto. Ins. Co.: Rescinding The Physical Contact Requirement In Ohio Uninsured Motorist Claims, Dominick Cirelli Jr.

Akron Law Review

Nearly every state has a requirement concerning uninsured motorist coverage, although state statutes differ in their scope and language. There has been a great volume of literature discussing the applicability of uninsured motorist coverage in cases involving hit and run drivers. This casenote will set out the various state statutory approaches to hit and run vehicles under uninsured motorist coverage, as well as evaluate the Ohio Supreme Court's historical approach to the physical contact doctrine. The casenote will thoroughly address the Girgis opinion and its underlying rationale, as well as the repercussions of abrogating the physical contract doctrine. Finally, this …

Not Just Old Wine In New Bottles: Kentucky Ass'n Of Health Plans, Inc. V. Miller Bottles A New Test For State Regulation Of Insurance, Matthew G. Vansuch

Akron Law Review

For nearly two decades, the “regulating insurance” aspect of the savings clause was as confusing and convoluted as trying to distinguish between the casks of unlabeled barrels of old wine that all smelled horribly similar. Miller clarified the savings clause analysis by establishing a broad, two-step test for determining if a state law regulates insurance. However, the district courts have been sluggish in recognizing the differences between the tests. The Supreme Court did not even cite to or rely on Miller when it struck down Texas’ patient rights statute on the basis of ERISA preemption in Aetna Health Inc. v. …

Medicare At Fifty Needs To Grow, William H. Lane

English Faculty Publications

In America everybody has a healthcare story. A bill impossible to read, an inscrutable "additional" charge, trouble getting insurance, trouble keeping it, a friend or family member who's fallen between the coverage "cracks." [excerpt]

Dispute Resolution, Insurance, And Points Of Convergence, Robert H. Jerry Ii

Journal of Dispute Resolution

This essay explores the intersection of dispute resolution and insurance. I come to the intersection from the perspective of insurance law, where statutes, administrative rules, and common law regulate the industry and the policyholder-insurer relationship. At its core, the business of insurance offers individuals, businesses, and other kinds of organizations a risk management alternative which enables them to acquire some measure of control over an uncertain future. But when a loss occurs, the business of insurance becomes the business of claims processing and, when disagreements arise, dispute resolution. Surprisingly, the academic study of insurance law has not borrowed heavily from …

The Special Nature Of International Insurance And Reinsurance Arbitration: A Response To Professor Jerry, S. I. Strong

Journal of Dispute Resolution

No abstract provided.

Thicker Than Water: America’S Addiction To Cheap Flood Insurance, Jeffrey Valacer

Pace Law Review

This paper is broken down into three parts. Part I traces the history and evolution of flood insurance in the United States, including the establishment of federal flood insurance and key reforms over the 20th and 21st centuries. Part II discusses the 2012 flood insurance reform package, subsequent legal challenges to the reforms, and the government’s response to political pressure over the reform. Part III concludes discussing the continued need for flood insurance reform, especially in a world of rising sea levels and more frequent, stronger weather events.

Inference Under Stability Of Risk Preferences, Levon Barseghyan, Francesca Molinari, Joshua C. Teitelbaum

Georgetown Law Faculty Publications and Other Works

We leverage the assumption that preferences are stable across contexts to partially identify and conduct inference on the parameters of a structural model of risky choice. Working with data on households' deductible choices across three lines of insurance coverage and a model that nests expected utility theory plus a range of non-expected utility models, we perform a revealed preference analysis that yields household-specific bounds on the model parameters. We then impose stability and other structural assumptions to tighten the bounds, and we explore what we can learn about households' risk preferences from the intervals defined by the bounds. We further …

Judicial Deregulation Of Consumer Markets, Max N. Helveston

Cardozo Law Review

The dangers posed by insufficiently regulated consumer markets are both real and monumental. While the rights of consumers expanded drastically in the mid- to late twentieth century, these protections have weakened in the new millennium. One of the forces driving this change has been the judiciary, where an anti-consumer jurisprudence has taken root. This is surprising, given the courts' history of defending individuals' commercial rights and combating unfair market practices.

Despite the significant ramifications that the removal of consumer protections has for every individual, the evolution of anti-consumerism in the courts has received scarce attention from the academy. This Article …

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

Law & Economics Working Papers

This Article explores the role of insurance as a substitute for direct regulation of risks posed by severe weather. In pricing the risk of human activity along the predicted path of storms, insurance can provide incentives for efficient location decisions as well as for cost-justified mitigation effort in building construction and infrastructure. Currently, however, much insurance for severe weather risks is provided and heavily subsidized by the government. The Article demonstrates two primary distortions arising from the government’s dominance in these insurance markets. First, the subsidies are allocated differentially across households, resulting in a significant regressive redistribution, favoring affluent homeowners …

No Good Options: Picking Up The Pieces After King V. Burwell, Nicholas Bagley, David K. Jones

Articles

If the Supreme Court rules against the government in King v. Burwell, insurance subsidies available under the Affordable Care Act (ACA) will evaporate in the thirty-four states that have refused to establish their own health-care exchanges. The pain could be felt within weeks. Without subsidies, an estimated eight or nine million people stand to lose their health coverage. Because sicker people will retain coverage at a much higher rate than healthier people, insurance premiums in the individual market will surge by as much as fifty percent. Policymakers will come under intense pressure to mitigate the fallout from a government loss …

Real Arrow-Securities For All: Just And Efficient Insurance Through Macro-Hedging, Robert C. Hockett

Cornell Law Faculty Publications

As a new hurricane season opened in June of 2006, it emerged that a number of online gaming sites were offering bettors the opportunity to wager on whether New Orleans might suffer another Katrina calamity. Commentators condemned the announced practice with howls of disgust, labeling it both tasteless and heartless. Perhaps they were right. All I could think about as one who grew up in New Orleans, however, was how risk pools might hereby be broadened to include all the world’s bettors. We shouldn’t condemn these people; we should use them—while requiring that they maintain margin accounts at their betting …

Splitting The Bill: Creating A National Car Insurance Fund To Pay For Accidents In Autonomous Vehicles, Carrie Schroll

Northwestern University Law Review

While self-driving cars may seem like something that can exist only in a futuristic movie, the technology is developing rapidly, and many states already allow test runs of self-driving cars on state roads. Many car companies have announced that they will make self-driving cars available as early as 2020. However, several manufacturers of the self- driving car technology predict that personal ownership of vehicles will be replaced by a car-sharing system, where companies own the self-driving cars and rent them to consumers who pay per use. With more widespread introduction of this technology comes many questions about how to assess …

Coverage For Ill - Gotten Gains? Discussing The (Un)Insurability Of Restitution And Disgorgement, Katherine C. Skilling

Washington and Lee Law Review

No abstract provided.

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

Faculty Scholarship

Flooding is the most common natural catastrophe Americans face, accounting for 90% of all damage caused by natural catastrophes. Hurricanes Katrina and Sandy, for example, collectively caused over $160 billion in damage, but only approximately 10% of the Hurricane Katrina victims and 50% of the Hurricane Sandy victims had insurance to cover their flood losses. Consequently, both their homes and lives were left in ruins in the wake of the storms. Nationwide, only approximately 7% of homeowners have insurance that covers flood losses even though the risk of flooding is only increasing as coastal areas continue to be developed and …

Should The Law Preserve Party Control? Litigation Investment, Insurance Law, And Double Standards, Anthony J. Sebok

William & Mary Law Review

Litigation investment, sometimes known as litigation finance, is increasingly accepted around the world. Once prohibited as champerty, litigation investment is now embraced in England, Canada, and Australia, as well as in many civil law nations. In the United States, the development of a robust market for investment in litigation has been met by various objections. One objection is that litigation investment interferes with the autonomy of lawyers. A second objection is that it promotes frivolous litigation.

This Article takes up a popular argument against litigation investment: the legal system should not encourage parties to sell their control over litigation that …

Should The Law Preserve Party Control? Litigation Investment, Insurance Law, And Double Standards, Anthony J. Sebok

Articles

Litigation investment, sometimes known as litigation finance, is increasingly accepted around the world. Once prohibited as champerty, litigation investment is now embraced in England, Canada, and Australia, as well as in many civil law nations. In the United States, the development of a robust market for investment in litigation has been met by various objections. One objection is that litigation investment interferes with the autonomy of lawyers. A second objection is that it promotes frivolous litigation.

This Article takes up a popular argument against litigation investment: the legal system should not encourage parties to sell their control over litigation that …

Can Tribal Courts Issue Domestic Relations Orders That Will Be Honored By Pension Plan Administrators Under Erisa?, Colin Osiecki

Northwestern University Law Review

No abstract provided.

Future Harm As A Current Disability: Insurance Coverage For A Risk Of Substance Abuse Relapse Under Erisa, Jonah Kind

Northwestern University Law Review

No abstract provided.

Predicting The Fallout From King V. Burwell - Exchanges And The Aca, Nicholas Bagley, David K. Jones, Timothy Stoltzfus Jost

Articles

The U.S. Supreme Court's surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Cara Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA. The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased "through an Exchange established by the State." According to …

Big Storms, Big Debt, And Biggert-Waters: Navigating Florida's Uncertain Flood Insurance Future, Loren M. Vazquez

Student Works

The National Flood Insurance Program (NFIP) began with good intentions. It was first enacted for the purpose of making flood insurance reasonably affordable while protecting against losses after disasters. However,

Congress failed to accurately update the program in the face of climate change and new coastal development. Because of this oversight, the overall risk associated with the program outgrew the collection of premiums, which led to an enormous debt to be incurred by the federal government. Once changes did finally come, they led to massive increases in insurance rates and a massive public outrage. Residents of states like Florida faced …

Model All-Payer Claims Database Legislation, Lucy Hodder, Jo Porter, Ashley Peters

Law Faculty Scholarship

With support from the Gary and Mary West Health Policy Center, the APCD Council has developed model legislation guidance for states to develop all-payer claims database legislation.

The Option To Repair: Good Or Bad, Steven Silverberg

St. Thomas Law Review

Insurance companies that deal with homeowner's insurance strategize around not protecting the insured; unlike the commercials say, "you're in good hands." Rather, their strategy is to "delay, deny, and defend." This is never more prevalent than in the new option to repair provision in many property insurance policies. Due to the ever-evolving nature of insurance and its trying to find more ways to deny claims, insurance companies, such as People's Trust Insurance Company, are employing the option to repair provision, which is anything but trustworthy. Since this provision is new to the state of Florida, the courts have yet to …

The Uk Insurance Act 2015: A Restatement Of Marine Insurance Law, Attilio M. Costabel

St. Thomas Law Review

The doctrine of utmost good faith is a fundamental tenet of the law of marine insurance. In both Britain and the United States (majority view) the law of marine insurance imposes a duty of "utmost good faith," or uberrimae fidei. This duty sets a high standard: the to contracts of marine insurance must not only avoid fraud and misrepresentation, but they are required to disclose voluntarily "every material circumstance." This principle dates back to the seminal 1766 English case Carter v. Boehm, and has gradually been adopted by a majority of the American courts. However, something unusual happened in February …

Safeguarding State Interests In Health Insurance Exchange Establishment, Christine M. Monahan

Connecticut Insurance Law Journal

No abstract provided.

Adoption Disruption Insurance: A Policy That America Is Not Ready To Adopt, Gregory J. Chase

Connecticut Insurance Law Journal

No abstract provided.

The Aca, Provider Mergers And Hospital Pricing: Experimenting With Smart, Lower-Cost Health Insurance Options, Susan A. Channick

Faculty Scholarship

This paper addresses the issue of whether the recent significant uptick in provider mergers and the implementation of the Affordable Care Act have a particularly adverse effect on provider pricing in the commercial insurance market. Uncompetitive provider markets exacerbate already existing high cost issues such as lack of transparency in provider pricing, patient behavior that conflates reputation and quality, and payers’ inability, or at least reluctance, to exclude high-price providers from their networks. The ACA’s incentives for providers to coordinate patient care and hospitals’ revenue losses from reductions in Medicare reimbursement create further rationales for consolidation. The burden of finding …

Good Faith And Breach Of The Duty To Settle: Perspectives From The American Law Institute Principles/Restatement Project On Liability Insurance, Jeffrey E. Thomas

Faculty Works

This paper addresses the standard of good faith to be applied to the duty to settle. All insurance policies contain an implied covenant of good faith and fair dealing. This implied covenant has been applied by U.S. courts to an implied duty to settle contained in most liability insurance policies. The implied duty to settle arises from the insurers’ right to settle cases under terms of most liability policies. Because insurers have the duty to defend and the right to settle, courts have found that insurers have an obligation to act in good faith when considering a settlement offer within …

The Standard For Breach Of Liability Insurer's Duty To Make Reasonable Settlement Decisions: Exploring The Alternatives, Jeffrey E. Thomas

Faculty Works

This Article considers the standard to be applied to determine whether an insurer has breached its duty to make reasonable settlement decisions. It focuses primarily on two standards: the disregard the limits (“DTL”) standard endorsed by section 24 of the Restatement of the Law of Liability Insurance (hereinafter “Restatement” or “Discussion Draft”), and the equal consideration (“EC”) standard, which I consider to be the primary competitor to DTL. The DTL standard says an insurer’s behavior is evaluated from the standpoint of a person who faces the full exposure of potential liability from a claim; to do this, the insurer (and …