Insurance Law Commons^™

Racial Discrimination In Life Insurance, William G. Gale, Kyle D. Logue, Nora Cahill, Rachel Gu, Swati Joshi

Law & Economics Working Papers

We examine the historical and statistical relationship between race and life insurance. Life insurance can play a central role in households’ financial security. Race has played an important and changing role in the provision of life insurance in the U.S. from slave insurance before the Civil War, to “Scientific Racism” continuing into the 20th century, to policies that do not explicitly mention race in recent decades. In empirical work using new data, we confirm earlier work showing that Black individuals have higher life insurance coverage rates than white individuals, controlling for observable characteristics. We find no difference in the likelihood …

Time To Follow Florida: Why Gina's Definition Of "Genetic Information" Must Change In The Context Of Life Insurance, Kathryn Czekalski

Duquesne Law Review

Many Americans apply for a life insurance policy to protect their spouses and families in the event of an untimely death.¹ What if insurance companies required genetic tests as part of the application process? What if those results were used to exclude applicants or calculate premiums? Can an individual who has taken a commercial genetic test, such as the popular 23andMe, ² be forced to disclose the results to obtain an insurance policy? Surprisingly, genetic discrimination regarding life insurance decisions is currently legal in forty-nine of the fifty states.³ This Article argues that additional federal legislation to prohibit …

Is Fire Insurable?, Kenneth S. Klein

Faculty Scholarship

The focus of this chapter is on the extant data on the prevalence, causes, and depth of inadequate, unavailable, and/or unaffordable dwelling insurance for fire, and what might be done about it. Whether it is ‘bushfire’ in Australia or ‘wildfire’ in the United States, the frequency, intensity, and cost of fire is increasing, with no reason to expect the upward trend to dissipate any time soon. Most homeowners want to insure their homes for fire and think they both have done so and done so adequately. More often than not, they are wrong. And many are finding that insurance now …

The Color Of Property And Auto Insurance: Time For Change, Jennifer B. Wriggins

Faculty Publications

Insurance company executives issued statements condemning racism and urging change throughout society and in the insurance industry after the huge Black Lives Matter demonstrations in summer 2020. The time therefore is ripe for examining insurance as it relates to race and racism, including history and current regulation. Two of the most important types of personal insurance are property and automobile. Part I begins with history, focusing on property insurance, auto insurance, race, and racism in urban areas around the mid-twentieth century. Private insurers deemed large areas of cities where African Americans lived to be “blighted” and refused to insure all …

Medicare Disadvantaged: A Raft Of Lawsuits Exposes Fraud In Medicare Part C, John J. Locurto

Faculty Articles

Healthcare fraud is a massive and stubborn problem that can be confirmed by examining the annual Health Care Fraud and Abuse Control Program Report that the United States Departments of Justice and Health and Human Services prepare.

One Age Does Not Fit All: Late Career Practitioner Policies And Managed Care, Adella Katz, John J. Locurto

Faculty Articles

A late career practitioner policy (LCPP) is an age-based approach to screening physicians for physical, cognitive, and other limitations that could impact patient care. What makes LCPPs controversial is that they subject physicians to heightened or more frequent screenings based on arbitrary age thresholds, without specific evidence that their skills have diminished, their acuity has declined, or their performance has deteriorated. Supporters justify LCPPs based on data showing that capabilities decline with age. Aging is natural, they contend, and physicians are not immune to its effects. Critics call LCPPs discriminatory, the embodiment of capricious action that stigmatizes older practitioners by …

Third-Party Moral Hazard And The Problem Of Insurance Externalities, Peter Siegelman, Gideon Parchomovsky

Faculty Articles and Papers

Insurance can lead to loss or claim creation not only by insureds but also by uninsured third parties. These externalities-which we call third-party moral hazard-arise because insurance creates opportunities both to extract rents and to recover otherwise unrecoverable losses. Using examples from health, automobile, kidnap, and liability insurance, we demonstrate that the phenomenon is widespread and important and that the downsides of insurance are greater than previously believed. We explain the economic, social, and psychological reasons for this phenomenon and propose policy responses. Contract-based methods that are traditionally used to control first-party moral hazard can be welfare reducing in the …

The Limits Of Regulation By Insurance, Kenneth S. Abraham, Daniel Benjamin Schwarcz

Indiana Law Journal

Insurance is an enormously powerful and beneficial method of spreading risk and compensating for loss. But even insurance has its limits. A new and misleading aspiration for insurance—that it also can and often does substitute for or significantly complement health and safety regulation—is increasingly in vogue. This vision starts from the uncontroversial recognition that insurers typically adopt measures designed to counteract “moral hazard,” the tendency of insurance to blunt policyholders’ incentives to take care. But proponents of this vision go on to contend that the risk-reducing potential of insurance is significantly more extensive than is traditionally imagined, because insurers are …

Insurance Law, J. Price Collins, Aaron G. Stendell

SMU Annual Texas Survey

No abstract provided.

Patient Decision Aids Improve Patient Safety And Reduce Medical Liability Risk, Thaddeus Pope

Faculty Scholarship

Tort-based doctrines of informed consent have utterly failed to assure that patients understand the risks, benefits, and alternatives to the healthcare they receive. Fifty years of experience with the doctrine of informed consent have shown it to be an abject catastrophe. Most patients lack an even minimal understanding of their treatment options. But there is hope. Substantial evidence shows that patient decision aids (PDAs) and shared decision making can bridge the gap between the theory and practice of informed consent. These evidence-based educational tools empower patients to make decisions with significantly more knowledge and less decisional conflict than clinician-patient discussions …

Federal Courts’ Recalcitrance In Refusing To Certify State Law Covid-19 Business Interruption Insurance Issues, Christopher French

Faculty Scholarship

Over 2,000 COVID-19 business interruption insurance cases have been filed in state and federal courts the past two years with most of the cases filed in or removed to federal courts. The cases are governed by state law. Rather than certify the novel state law issues presented in the cases to the respective state supreme courts that ultimately will determine the law applicable in the cases, each of the eight federal circuit courts to issue decisions on the merits in such cases to date has done so by making an Erie guess regarding how the controlling state supreme courts would …

Debunking The Standardized Nature Of Insurance Policies, Elizabeth Sousa

Fordham Journal of Corporate & Financial Law

This article discredits the conventional view of insurance policies as standardized contracts that do not vary across insurance companies and policyholders. Contrary to this view, there are wide variations in policy language in both the admitted and non-admitted insurance markets. These deviations reduce the perceived benefit of insurance policies as standardized contracts intended to promote predictability and lower transaction costs for policyholders by focusing only on the most salient terms. Nowhere is this deviation more apparent than with Commercial General Liability (CGL) policies defendants are turning to in the current opioid litigation.

The opioid epidemic has been plaguing the United …

The Enforceability Of Step-Down Provisions In Automobile Insurance Policies, Constance A. Anastopoulo, Thomas P. Gressette Jr.

Mitchell Hamline Law Review

No abstract provided.

The Promise And Peril Of Paternalistic Approaches To Flood Risk, Alexander B. Lemann

University of Colorado Law Review

Our country's ever-growing exposure to flood risk has been the target of policy reform for decades. To many experts, it is clear that we must stop subsidizing flood-prone development and begin the process of moving people away from flood-prone areas. And yet, despite the seemingly obvious benefits of abandoning areas that will be permanently underwater in a generation, flood-prone living has been a difficult habit to kick.

Examining the problem against the background of the philosophical literature on paternalism helps show why. Paternalism- government intervention in people's choices for the good of those same people-has long been controversial. The insistence …

Insuring Fortuity—And Intent: A Comment On Professor French's Insuring Intentional Torts, Erik S. Knutsen, Jeffrey W. Stempel

Scholarly Works

No abstract provided.

The 2022 New Jersey Insurance Fair Conduct Act And The Incomplete Evolution Of Policyholder Protection, Jeffrey W. Stempel

Scholarly Works

No abstract provided.

The Litigation Landscape Of Fraternity And Sorority Hazing: Defenses, Evidence, And Damages, Gregory S. Parks, Elizabeth Grindell

Washington and Lee Law Review

In recent years, increasing public and media attention has focused on hazing, especially in collegiate fraternities and sororities. Whether it is because of the deaths, major injuries, or litigation, both criminal and civil, collegiate fraternities and sororities have received increased scrutiny. In this Article, we explore a range of tactical considerations that lawyers must consider—from defenses to evidentiary concerns. We also explore how damages are contemplated in the context of hazing litigation.

2021 Rhode Island Public Laws, Madison C. Picard

Roger Williams University Law Review

No abstract provided.

Don't Bet The Farm In Litigation Before Considering Mediation: The Case For Agriculture Mediation Program Implementation, John Schmitz

Cardozo Journal of Conflict Resolution

The American farmer wears several hats throughout each day. Each is a farmer, mechanic, businessperson, chemist, accountant, and economist. An ill-timed dispute resulting in litigation can cause farmers to miss planting or harvesting, lose property, or be denied credit. Agriculture mediation provides a unique opportunity for disputes-both big and small, and centered around agriculture-to be resolved in a timely manner.

What War Did To The Academy, What The Academy Did To War: A 20-Year Retrospective On The Effects Of The Post-9/11 Wars, Deborah Pearlstein

Articles

The history of the legal academy’s impact on the way states fight wars is hardly one of unmixed glory. It was a law professor moonlighting for President Lincoln who authored “Instructions for the Government of Armies of the United States in the Field” during the Civil War, a code still recognized worldwide today for having laid critical groundwork for the modern law of war. It was likewise a law professor whose work came to serve as both theoretical and practical justification for the sweeping powers of the Nazi state. So it should perhaps be unsurprising that, two decades of engagement …

Insuring Intentional Torts, Christopher French

Faculty Scholarship

This Article analyzes the competing public policies and arguments in favor of and against allowing insurance to cover intentional torts. In doing so, it discusses numerous lines of liability insurance that expressly cover various types of intentional torts. It then explores whether the theoretical foundation underlying the public policy against allowing liability insurance to cover intentional torts—that intentional misconduct is effectively deterred and punished by disallowing coverage—is supported by empirical evidence.

Why Insurance Needs A Restatement: The Case Of Settlement Decision Law, Chaim Saiman

Faculty Publications

Even before its publication, the Restatement of the Law, Liability Insurance had been subjected to withering wholesale criticism that it creates aspirational and pro-policyholder insurance law. This view continues to be forcefully promoted by insurers and their advocates in the legal literature and by governors and state legislatures in the political areas.

This Article finds these wholesale criticisms unwarranted. Liability insurance law is not a field where law is simply found and restated. In fact, settlement law offers the most vivid examples of why the Restatement of the Law, Liability Insurance is possible, useful, and justified. It is possible because …

A Deeper Dive Into Nautilus: Differentiating Insurer Efforts To Recover Defense Costs And Assessing Recoupment In The Wake Of The Ali Restatement, Jeffrey W. Stempel

Scholarly Works

Insurers and Policyholder have for decades contested whether the typical general liability policy requires policyholders to reimburse insurers for defense costs where a claim is ultimately held not to be one for which a defense is required. Although a slight majority of decisions favors insurers, the recent trend has favored policyholders, as reflected in §21 of the American Law Institute Restatement of the Law, Liability Insurance (“RLLI”), one of several contested portions of the RLLI. In Nautilus Insurance v. Access Medical, the Nevada Supreme Court provided the most extensive post-RLLI analysis of the dispute, ruling in favor of the …

Rejecting Word Worship: An Integrative Approach To Judicial Construction Of Insurance Policies, Jeffrey W. Stempel, Erik S. Knutsen

University of Cincinnati Law Review

Insurance coverage litigation is a quest for discerning meaning: Does the insurance policy cover the loss at issue? Construing the insurance policy, courts attempt to give legal effect to what the document purports to command. But what were the intentions and expectations of insurer and insured? Do those intentions even matter? Or is only the written text of the policy relevant to the coverage result? Courts addressing these questions typically frame the interpretative choice as one of strict textualism versus contextual functionalism.

In many, perhaps even most situations, text and context align to create an “easy” case. If a factory …

Health Insurance And Bankruptcy Risk: Examining The Impact Of The Affordable Care Act, Philip M. Pendergast, Michael D. Sousa, Tim Wadsworth

Brooklyn Law Review

The passage of the Patient Protection and Affordable Care Act (“ACA”) in 2010 represented a watershed moment for healthcare in the United States. As is well-noted, the federal courts are still wrangling over the constitutionality of the law, and there is significant uncertainty regarding the extent to which the ACA will survive these legal battles. Unquestionably, the ACA has expanded access to health insurance for many millions of Americans. Prior to the advent of the ACA, Medicaid income eligibility for adults without dependents was approximately 61 percent of the Federal Poverty Line. Empirical studies since the advent of the ACA …

What The Pandemic Taught Us: The Health Care System We Have Is Not The System We Hoped We Had, William M. Sage

Faculty Scholarship

The United States spends nearly twice as much per capita on medical care as any other country. The United States has the world’s most advanced biomedical technologies, sophisticated hospitals, and skilled health professionals. The United States has a national public health body, the Centers for Disease Control and Prevention (CDC), that is generally considered the world’s leader in infectious disease detection and response. Nonetheless, the United States suffered among the world’s worst COVID-19 disease burdens and outcomes, inflicting largely avoidable harm on patients, health professionals, and the broader community.

Why this happened is clearly important. But that it happened is …

Insurance, Thomas D. Martin, Bradley S. Wolff, Maren R. Cave

Mercer Law Review

During this Survey period, the courts in Georgia remained active despite the pandemic. In the property arena, the Survey disclosed only a few decisions from the Georgia Court of Appeals but several from the district courts in Georgia as parties grappled with coverage disputes relating to policy time limits, bad faith, and the effects of COVID-19 on business losses. In the automobile arena, the Georgia Court of Appeals addressed sovereign immunity, and the Georgia Supreme Court refined the “cause test” for evaluating a series of collisions. In the uninsured motorist (UM) arena, the court of appeals weighed in on various …

The Patient Assistance Problem, Daniel O’Brien Lichtenauer

Journal of Law and Policy

Implemented in January 2006 as a voluntary enrollment supplement to standard Medicare plans, Medicare Part D coverage subsidizes the cost of prescription drugs for participants. However, significant gaps in coverage exist for those suffering from rare diseases that require costly drugs. Pharmaceutical companies seek to remove the powerful market force of patient price sensitivity by directly sponsoring or substantially funding “patient assistance programs” that help cover out-of-pocket costs. While pharmaceutical donors insist that their goal is strictly altruistic, the reality is that many of these programs offer a financial windfall for drug makers because they help funnel patients towards new …

Development Of A Topics Course For Construction Law, Julia C. Hoever

Construction Management

The Cal Poly Construction Management program is designed to prepare students heading into the construction industry for daily management tasks. With construction comes many legal aspects integrated into a project’s operations. Though the curriculum includes a contract law course, a gap exists with a minimal number of classes that address the array of legal matters the construction industry must be versed in. Working with faculty member, Thomas Kommer, J.D., there is a need for a course that expands on these varying legal topics. In order to determine the specific topics that would impactfully benefit and educate Cal Poly Construction Management …

Proof Of Objective Falsehood: Liability Under The False Claims Act For Hospice Providers, Sebastian West

University of Cincinnati Law Review

No abstract provided.