Insurance Law Commons^™

Health Care Sharing Ministries: Scam Or Solution?, Benjamin Boyd

Journal of Law and Health

Health Care Share Ministries (HCSMs) provide “a health care cost sharing arrangement among persons of similar and sincerely held beliefs.” HCSMs are not-for-profit religious organizations that act as clearinghouses for “those who have medical expenses and those who desire to share the burden of those medical expenses. This Article begins with a survey of the general regulatory landscape for HCSMs. Following that, four key questions about HCSMs structure the rest of this Article. The first question asks, what are HCSMs? To answer that question, this Article examines the basic aspects of the Medi-Share program and the Christian Brotherhood Newsletter. Second, …

County Care: A Step Forward For Adequate Health Insurance For Undocumented Immigrants?, Alisha Howell

Public Interest Law Reporter

No abstract provided.

An Insurance Structure To Encourage Investment In Preventative Health Care, Nicholas Georgakopoulos

University of Michigan Journal of Law Reform

The incentives for investments in Americans' health are poorly aligned. Health insurers are not sufficiently motivated to invest for the long term. The structure of health insurance does not compensate insurers for investments in lasting health, such as measures preventing chronic disease. If an American changes insurers, the new insurer reaps the benefits of the good health the prior insurer's investment produced. This Essay explores insurers' incentives to invest in health, illustrates how those incentives fail, explores possible improvements, and shows that subsequent insurers should have an obligation to compensate the prior insurer for the averted expenses of expected diseases …

Human Rights, Civil Rights: Prescribing Disability Discrimination Prevention In Packaging Essential Health Benefits, Anita Silvers, Leslie P. Francis

Utah Law Faculty Scholarship

The promise of health care as a right has all too often proved hollow for people with disabilities. In this article, we argue that the understanding of health care as a human right, as found in the CRPD, fails to provide the theoretical machinery for responding to the pressing challenges of health care costs. These challenges are real and potentially devastating. We develop instead an account of health care as a civil right. What this right requires is dependent on the context and resources of the time, so long as all have meaningful access to the benefits provided. The ACA …

Refashioning The Right Of Publicity: Protecting The Right To Lfse Your Name After Selling A Personal Name Trademark, Francesca M. Montalvo

Cardozo Arts & Entertainment Law Journal

No abstract provided.

Sex Matters: Considering Gender In Consumer Contracting, Amy J. Schmitz

Cardozo Journal of Equal Rights & Social Justice

We hear about the so-called "War on Women" and persisting salary gaps between men and women in the popular media, but contracts scholars and policymakers rarely discuss gender. Instead, dominant voices in the contracts field often reflect classical and economics-driven theories built on assumptions of gender neutral and economically rational actors. Furthermore, many mistakenly assume that market competition and antidiscrimination legislation address any improper biases in contracting. This Article therefore aims to shed light on gender's importance by distilling data from my own e-survey of Colorado consumers along with others' research regarding gender differences in contract outcomes, interests and behaviors. …

Stemming The Federal Tort Fountain: Why Federal Courts Should Maintain Implied Certification Limitations On Qui Tam Suits Against Nonclaimant Defendants, Dennis O. Vann Jr.

Georgia Law Review

Qui tam suits in the health-care industry increasingly
target pharmaceutical and medical-device manufacturers
rather than the medical providers who directly make
claims to federal health-insurance programs. These suits
commonly argue that the manufacturer induced the
provider to falsely certify compliance with federal and
state antifraud laws, such as the Anti-Kickback Statute.
This Note shows that suits based on such "implied
certification"of adherence to laws should not be permitted
under the Federal False Claims Act unless the
non submitting defendant is first convicted of providing a
kickback. First, this Note analyzes recent amendments to
the Anti-Kickback Statute in the Affordable Care …

Distinguishing Probability Weighting From Risk Misperceptions In Field Data, Levon Barseghyan, Francesca Molinari, Ted O'Donoghue, Joshua C. Teitelbaum

Georgetown Law Faculty Publications and Other Works

The paper outlines a strategy for distinguishing rank-dependent probability weighting from systematic risk misperceptions in field data. Our strategy relies on singling out a field environment with two key properties: (i) the objects of choice are money lotteries with more than two outcomes and (ii) the ranking of outcomes differs across lotteries. We first present an abstract model of risky choice that elucidates the identification problem and our strategy. The model has numerous applications, including insurance choices and gambling. We then consider the application of insurance deductible choices and illustrate our strategy using simulated data.

No Small Feat: Who Won The Health Care Case (And Why Did So Many Law Professors Miss The Boat)?, Randy E. Barnett

Georgetown Law Faculty Publications and Other Works

In this essay, prepared as the basis for the 2013 Dunwody Distinguished Lecture in Law at the Fredric G. Levin College of Law, University of Florida, I describe five aspects of the Supreme Court’s decision in NFIB v. Sebelius that are sometimes overlooked or misunderstood. (1) The Court held that imposing economic mandates on the people was unconstitutional under the Commerce and Necessary and Proper Clauses; (2) Whether viewed from a formalist or realist perspective, Chief Justice Roberts’ reasoning was the holding in the case; (3) The Court did not uphold the constitutionality of the individual insurance mandate under the …

The Gravitational Force Of Originalism, Randy E. Barnett

Georgetown Law Faculty Publications and Other Works

In part I of this essay, prepared for the Fordham conference on “The New Originalism and Constitutional Law,” I describe four aspects of the New Originalism: (1) The New Originalism is about identifying the original public meaning of the Constitution rather than the original framers intent; (2) The interpretive activity of identifying the original public meaning of the text is a purely descriptive empirical inquiry; (3) But there is also a normative tenet of the New Originalism that contends that the original public meaning of the text should be followed; (4) Distinguishing between the activities of interpretation and construction identifies …

California Dreaming: The California Secure Choice Retirement Savings Trust Act, Edward A. Zelinsky

Articles

Half of American workers are not covered by employer-sponsored retirement arrangements. The recently passed California Secure Choice Retirement Savings Trust Act seeks to solve this problem by mandating retirement savings arrangements for California employers, coupled with a public investment vehicle for investing these private retirement savings. The Act is important because of California’s size and status as a trendsetter for other states.

This Article is the first to examine the important legal questions the Act raises under the Internal Revenue Code and ERISA. Contrary to the drafters’ intent, the savings accounts authorized under the Act do not qualify as individual …

Segmented Settlements Are Not The Answer: A Response To Professor Squire’S Article, How Collective Settlements Camouflage The Costs Of Shareholder Lawsuits, Christopher C. French

Faculty Scholarship

In his recent article, Professor Richard Squire offers a provocative theory in which he claims the underlying claimants in shareholder litigation against corporate policyholders are overcompensated due to what he describes as “cramdown” settlements, under which insurers are forced to settle due to the “duty to contribute” that arises under multi-layered directors and officers (“D&O”) insurance programs. He also offers a novel idea regarding how this problem could be fixed by what he refers to as “segmented” settlements in which each insurer and the policyholder would be allowed to settle separately and consider only its own interests in doing so. …

A Supreme Court Ruling That's About Way More Than Preemption, Nancy Polikoff

Scholarly Articles in Law Reviews & Journals

No abstract provided.

Reconciling The Irreconcilable Conflict In Insurance Severability Of Interests Clause Interpretation, Johnny Parker

Articles, Chapters in Books and Other Contributions to Scholarly Works

No abstract provided.

Let Fifty Flowers Bloom: Health Care Federalism After National Federation Of Independent Business V. Sebelius, Ann Marie Marciarille

Faculty Works

Conventional wisdom is that the American public does not want to think too long or too hard about Medicaid. Medicaid’s reputation has long been big, complicated, and widely misunderstood. The 2012 presidential election campaign has been much about Medicaid, but Medicaid is a subject we love to talk around. Yet, our next president will be compelled to think and speak explicitly and fluently about Medicaid because Medicaid is the budget-buster of government funded health insurance. Its budget busting propensities are most pronounced at the intersection of Medicaid and the government-funded health insurance program we do love to discuss: Medicare.

This …

Insurance, Bradley S. Wolff, Stephen Schatz, Stephen L. Cotter

Mercer Law Review

In property insurance cases, there were two Georgia Supreme Court decisions with the potential for significant impact. The court held that insurance companies are liable for diminution in value of real property under commercial and homeowners insurance policies, extending the reasoning in State Farm Mutual Automobile Insurance Co. v. Mabry beyond motor vehicles for the first time. Answering a certified question, the supreme court also held a one-year suit limitation in a homeowners insurance policy is enforceable for losses not caused by fire, despite an insurance commissioner-issued regulation that would prohibit any limitation shorter than, two years.

Despite an insurer's …

What’S To Know? Puzzles In The Literature On The Value Of Statistical Life, W. Kip Viscusi

Vanderbilt Law School Faculty Publications

Notwithstanding the general acceptance of the value of statistical life (VSL) estimates for policy assessment purposes, several important unresolved issues remain. First, the results from revealed preference studies are systematically higher than those from stated preference studies, potentially limiting the usefulness of stated preference studies in generalizing the VSL estimates to different populations and kinds of risks. Second, extrapolating the results of meta-analyses to project the VSL for different population groups requires that such generalization be reflective of the underlying economic content of what average VSL estimates reflect. Third, government agencies within and across countries place differing emphasis on types …

Standing To Sue A Carrier's Killers , Davis J. Howard

Pepperdine Law Review

No abstract provided.

Do Damages Caps Reduce Medical Malpractice Insurance Premiums?: A Systematic Review Of Estimates And The Methods Used To Produce Them, Kathryn Zeiler, Lorian E. Hardcastle

Georgetown Law Faculty Publications and Other Works

Despite common claims made in policy debates, the theoretical connection between tort reform and medical malpractice insurance premiums is ambiguous. Simple models suggest reforms such as statutory damages caps reduce premiums. More elaborate models that account for changes in physician behavior suggest caps might increase or have no impact on premiums. A number of empirical studies have been conducted to estimate the impacts of caps on premiums, and several qualitative literature reviews have attempted to draw general conclusions from the literature. No review, however, has offered a comprehensive and systematic analysis of the full set of empirical studies. This chapter …

The Power To Block The Affordable Care Act: What Are The Limits?, John D. Kraemer, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Though Supreme Court upheld most parts of the Affordable Care Act (ACA), Congress’ goals in enacting it could still be frustrated by non-implementation. During his campaign for president, Governor Romney promised “to issue Obamacare waivers to all fifty states.” While such blanket waivers would likely violate the Constitution’s Take Care Clause, the ACA does permit other waivers. To be lawful, however, they must meet certain requirements designed to enhance access and lower cost. A president who opposes the ACA might be able to limit its implementation by refusing to issue premium subsidies in federally operated insurance exchanges, and this might …

The Tsunami Of March 2011 And The Subsequent Nuclear Incident At Fukushima: Who Compensates The Victims, Michael Faure, Jing Liu

William & Mary Environmental Law and Policy Review

No abstract provided.

Health Care Providers Meet Erisa: Are Provider Claims For Misrepresentation Of Coverage Preempted, Jeffrey A. Brauch

Pepperdine Law Review

No abstract provided.

Reimbursing Hazardous Waste Cleanup Costs Under Cercla: A Move Toward Re-Establishing A Faithful Application Of State Insurance Law, Gary M. Miller

Pepperdine Law Review

No abstract provided.

Exposure, Manifestation Of Loss, Injury-In-Fact, Continuous Trigger: The Insurance Coverage Quagmire , Nicolas R. Andrea

Pepperdine Law Review

No abstract provided.

The Nature Of Risk Preferences: Evidence From Insurance Choices, Levon Barseghyan, Francesca Molinari, Joshua C. Teitelbaum, Ted O'Donoghue

Georgetown Law Faculty Publications and Other Works

The authors use data on insurance deductible choices to estimate a structural model of risky choice that incorporates "standard" risk aversion (diminishing marginal utility for wealth) and probability distortions. They find that probability distortions--characterized by substantial overweighting of small probabilities and only mild insensitivity to probability changes--play an important role in explaining the aversion to risk manifested in deductible choices. This finding is robust to allowing for observed and unobserved heterogeneity in preferences. They demonstrate that neither Kőszegi-Rabin loss aversion alone nor Gul disappointment aversion alone can explain our estimated probability distortions, signifying a key role for probability weighting.

Issues And Problems In "Other Insurance," Multiple Insurance, And Self-Insurance, Douglas R. Richmond

Pepperdine Law Review

No abstract provided.

Recent Developments In California Insurance Law: Enforceability Of Stipulated Judgments Against Insurance Carriers, Steven L. Paine, Wynn Heather Sourial

Pepperdine Law Review

No abstract provided.

Outsourcing Regulation: How Insurance Reduces Moral Hazard, Omri Ben-Shahar, Kyle D. Logue

Michigan Law Review

This Article explores the potential value of insurance as a substitute for government regulation of safety. Successful regulation of behavior requires information in setting standards, licensing conduct, verifying outcomes, and assessing remedies. In various areas, the private insurance sector has technological advantages in collecting and administering the information relevant to setting standards and could outperform the government in creating incentives for optimal behavior. We explore several areas that are regulated more by private insurance than by government. In those areas, the role of the law diminishes to the administration of simple rules of absolute liability or no liability, and affected …

Angels Of Mercy Or Greedy Capitalists? Buying Life Insurance Policies From The Terminally Ill, Denise M. Schultz

Pepperdine Law Review

No abstract provided.

Selling Structured Settlements: The Uncertain Effect Of Anti-Assignment Clauses , Gregory Scott Crespi

Pepperdine Law Review

No abstract provided.