Insurance Law Commons^™

The Dsm-5: Implications For Health Law, Stacey A. Tovino

Faculty Articles

In May 2013, the American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ("DSM-5"). Among other changes, the DSM-5 includes new entries for hoarding disorder and premenstrual dysphoric disorder as well as a reclassified entry for gambling disorder. Using these changes as examples, this Article examines the implications of the DSM-5 for key issues in health law, including health insurance coverage, public and private disability benefit eligibility, and disability discrimination protection. As a descriptive matter, this Article illustrates how the addition of new disorders and the reclassification of existing disorders in the DSM-5 …

Federal Reverse Preemption Of Uninsured And Underinsured Motorist Coverage Offering In The Digital Age: E-Sign And Ueta Have Not Had A Significant Impact On State Offering Or Rejection Requirements, Steven Plitt, Daniel Maldonado, John Wittwer

Kentucky Law Journal

No abstract provided.

In Deep: Dilemmas Of Federal Flood Insurance Reform, Jennifer Wriggins

Faculty Publications

Floods are the most expensive form of natural disaster in the United States. Recent massive floods in Louisiana show the magnitude of the devastation floods can cause. Climate change and population growth are likely to lead in the coming decades to more severe, frequent, and costly floods. How we pay for flood losses is an urgent public policy issue. The National Flood Insurance Program (NFIP) provides most of the flood insurance policies on homes in the United States. The U.S. Flood Insurance Program is a complex scheme that uses insurance coverage subsidies, mandates, and other tools to support various policies …

Legalese To The Detriment Of Small Business: Midwest Family Mutual Insurance Co. V. Wolters, Andy Hofer

William Mitchell Law Review

No abstract provided.

Information & Equilibrium In Insurance Markets With Big Data, Peter Siegelman

Faculty Articles and Papers

Asymmetric information makes the behavior of insurance markets very difficult to predict. But this Article argues that the increasing use of Big Data by insurers will not result in forecasts of loss that are so accurate that they eliminate uncertainty, and with it, the possibility of insurance. Big Data techniques might lead to a 'flip" in informational asymmetry, resulting in a situation in which insurers know more about their customers than the latter know about themselves. But the effects of such a development could actually be benign. Finally, the Article considers the potential for Big (or at least, More) Data …

The Patient Protection And Affordable Care Act: What Does It Really Do?, John G. Day

Connecticut Insurance Law Journal

No abstract provided.

Even I Can’T Cover Me: Examining The Ncaa’S Effective Prohibition On “Loss Of Value” Insurance For Its Student-Athletes, Michael D. Randall

Connecticut Insurance Law Journal

No abstract provided.

Examining The Impact Of Florida's Non-Economic Damage Cap On Elderly Populations, Andrew W. Dodds

CMC Senior Theses

In this paper, I use data from the Florida Closed Claims Database to investigate how Florida’s 2003 non-economic damage cap legislation impacted elderly malpractice claimants. More specifically, I measure whether or not non-economic damage caps adversely impact claimants in counties with high elderly densities. To measure the effect of Florida’s non-economic damage caps, I look at multiple metrics that measure both elderly claimants’ monetary gains and their access to the justice system after the reform is passed. I find mildly conclusive evidence that counties with higher elderly density, and assumedly more elderly claimants, are more likely to settle cases before …

The Role Of The Profit Imperative In Risk Management, Christopher French

Faculty Scholarship

Risks in the world abound. Every day there is a chance that each of us could be in a car accident. Or, one of us could be the victim of a tornado, flood or earthquake. Every day someone becomes deathly ill from an insidious disease. Our properties are in constant peril—one’s house could catch fire at any time or a tree could fall on it during a storm. Any one of these events could have devastating financial consequences, and they are just a few of the many risks that impact our daily lives. One of the principal ways we manage …

"Least Restrictive Means”: Burwell V. Hobby Lobby, Noah Marks

Faculty Scholarship

No abstract provided.

The Macroprudential Turn: From Institutional 'Safety And Soundness' To Systematic 'Financial Stability' In Financial Supervision, Robert C. Hockett

Cornell Law Faculty Publications

Since the global financial dramas of 2008-09, authorities on financial regulation have come increasingly to counsel the inclusion of macroprudential policy instruments in the standard ‘toolkit’ of finance-regulatory measures employed by financial supervisors. The hallmark of this perspective is its focus not simply on the safety and soundness of individual financial institutions, as is characteristic of the traditional ‘microprudential’ perspective, but also on certain structural features of financial systems that can imperil such systems as wholes. Systemic ‘financial stability’ thus comes to supplement, though not to supplant, institutional ‘safety and soundness’ as a regulatory desideratum.

The move from primarily micro- …

America’S Growing Problem: How The Patient Protection And Affordable Care Act Failed To Go Far Enough In Addressing The Obesity Epidemic, Ashley A. Noel

Connecticut Insurance Law Journal

No abstract provided.

Everything’S Bigger In Texas: Except The Medmal Settlements, Tom Baker, Eric Hellan, Jonathan Klick

Connecticut Insurance Law Journal

No abstract provided.

Erie Denied: How Federal Courts Decide Insurance Coverage Cases Differently And What To Do About It, John L. Watkins

Connecticut Insurance Law Journal

No abstract provided.

Reference Pricing: A Small And Mighty Solution To Bend The Health Care Cost Curve, Srishti Miglani

Connecticut Insurance Law Journal

No abstract provided.

An Alternate Theory Of Burwell V. Hobby Lobby, Jessica L. Roberts

Connecticut Insurance Law Journal

No abstract provided.

Enhancing The Socially Instrumental Role Of Insurance: The Opportunity And Challenge Presented By The Ali Restatement Position On Breach Of The Duty To Defend, Jeffrey W. Stempel

Scholarly Works

The American Law Institute (ALI), in its current draft of the Restatement of the Law of Liability Insurance , has adopted the position that a liability insurer in breach of its duty to defend, but not acting in bad faith, forfeits the right to dispute coverage of the resulting judgment or reasonable, noncollusive settlement in a lawsuit. The ALI view is the minority rule in the courts in that most make bad faith a prerequisite for loss of a coverage defense but presumably will spur re-examination of the issue in many states. Unsurprisingly, insurers have opposed the ALI position with …

Medicaid At 50: No Longer Limited To The "Deserving" Poor?, David Orentlicher

Scholarly Works

Professor David Orentlicher considers the significance of the passage of the Affordable Care Act on the Medicaid program. He discusses the expansion of the program's recipients from merely children, pregnant women, single caretakers of children, and disabled persons to all persons up to 138% of the federal poverty level. Professor Orentlicher argues that the Medicaid expansion reflects concerns about the high costs of health care rather than an evolution in societal thinking about the "deserving" poor. As a result, the expansion may not provide a stable source of health care coverage for the expansion population.

Hobby Lobby, Birth Control And Our Ongoing Cultural Wars: Pleasure And Desire In The Crossfires, Robin West

Georgetown Law Faculty Publications and Other Works

Both sides of the birth control debate agree that birth control artificially prevents or interrupts conception, allowing women to control their own fertility and allowing heterosexual men and women to enjoy unconstrained sexual liberty. However, the decision in Hobby Lobby omitted all discussion of this central function of birth control, and contained no mention of arguments for or against birth control that assume it.

This piece examines and criticizes the two major arguments opposing and supporting birth control on this understanding of its function and core social meaning: first the neo-natural lawyers’ argument against birth control advanced in a papal …

You Get What You Pay For: The Nfip Is Underwater And Climate Change Adaptation Is Essential To Reach Dry Land, Alana Dietel

Florida A & M University Law Review

Climate change is a reality, and Florida is uniquely situated to feel its effects sooner than other states. This is due to the prediction of a substantially rising sea level and the fact that a majority of the most populated and popular areas in Florida are located along or near the coasts. Part I of this article examines the realities of climate change. Part II reviews the current state of the most significant attempt at flood insurance by the Federal government, the NFIP. Part II also reviews Florida’s statewide initiatives, as well as local initiatives of three distinct Florida counties. …

Will Neuroscience Redefine Mental Injury?: Disability Benefit Law, Mental Health Parity Law, And Disability Discrimination Law, Stacey A. Tovino

Faculty Articles

No abstract provided.

Wagering On The Lives Of Strangers: The Insurable Interest Requirement In The Life Insurance Secondary Market, Peter N. Swisher

Law Faculty Publications

The purpose of this article is to explore and analyze the crucial inter- relationship and the present tension existing between various life settlement alternatives and the insurable interest requirement for life insurance. Does the 240-year-old insurable interest doctrine adequately meet the needs of a modern society in recognizing a secondary market for life in- surance? If so, what additional remedies, if any, are available to both the insured and the insurer to legally protect the contractual rights and reasonable expectations of the parties?

The Risks Of Shadow Insurance, Daniel Schwarcz

Georgia Law Review

Shadow banking - often defined as financial intermediation that provides maturity transformation outside of the formal confines of a bank'-played a central role in causing the 2008 financial crisis. For this reason, a 2013 report of the New York Department of Financial Services generated substantial controversy when it labeled some life insurers' practices of reinsuring insurance policies with affiliated captive insurers as "shadow insurance." Yet the moniker of shadow insurance was not without at least some justification. Like shadow banking, life insurers' reinsurance of policies with affiliated captives is a form of regulatory arbitrage that moves traditional insurance risks from …

Should Patient Responsibility For Costs Change The Doctor-Patient Relationship?, Christopher Robertson

Faculty Scholarship

Copays, deductibles, coinsurance, and reference prices all now expose patients to increasingly larger shares of the costs of health care. Extant research on cost sharing has primarily focused on its impact on patients, their health care spending, and their health outcomes. Scholars have paid much less attention to the question of how patient exposure to health care costs may impact physicians and their relationships with their patients. This Essay is given on the occasion of a symposium motivated by two recent books by David Schenck, Larry Churchill, and Joseph Fanning that highlight the relational aspects of health care ethics. Accordingly, …

Goveille V. Liberty Mutual: An Opportunity To Correct The Problems Of Erisa Preemption, Edward A. Zelinsky

Articles

No abstract provided.

A Problem Not Yet Manifest: Gaps In Insurance Coverage Of Medical Interventions After Genetic Testing, Sarah Malanga, Ryan Sprissler, Christopher Robertson, Keith Joiner

Faculty Scholarship

In the past decade, the field of genomics has rapidly changed and expanded.1 With these advancements also come new applications of genomics and genetics to clinical medicine. The information gathered from genetic testing and genome sequencing can reveal a great deal about not only an individual's current health, but his/her future health as well.2 This rapid expansion of scientific and medical capacity is accompanied by rapid changes for law and policy making thoughtful regulation essential. The human genome includes many variations, most of which have no known significance. However, some variants can be the cause of important medical conditions, and …

Scaling And Splitting, New Approaches To Health Insurance, Christopher Robertson, Keith A. Joiner

Faculty Scholarship

In the United States, cost-sharing in health insurance coverage has become the primary mechanism for reducing insurance expenditures and, by extension, maintaining affordable coverage. Cost-sharing involves patients making various out-of-pocket (OOP) payments for their own health care aside from whatever the insurer pays. As a patient’s spending on health care grows month by month in any given year of coverage, she moves through three different “zones” of insurance, from no insurance, to partial insurance, and finally to full insurance.

Overvaluing Employer-Sponsored Health Insurance, Lauren R. Roth

Scholarly Works

Although positive and negative assessments of tying health insurance to employment abound, most scholars and policymakers have acknowledged that our long history in this area predicts our future. What they have largely ignored, however, is the extent to which individual attachment to employment-based insurance is at the root of our inability to make broader health reforms. The attachment (1) harms exchange-based insurance and (2) denies employers the ability to use Health Reimbursement Arrangements (“HRAs”) to subsidize the purchase of insurance by their employees on the exchanges.

This Article advocates reducing or eliminating workers’ overvaluation of their health insurance and increasing …

Restatement Of The Law Of Liability Insurance And The Duty To Settle, Leo P. Martinez

Faculty Scholarship

No abstract provided.