Insurance Law Commons^™

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 …

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.

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 …