Insurance Law Commons^™

Construction Defects: Are They “Occurrences”?, Chris French

Faculty Scholarship

An issue in the area of insurance law that has been litigated frequently in recent years is whether construction defects are “occurrences” under Commercial General Liability (“CGL”) insurance policies. The courts have been divided in deciding the issue and in their approaches to analyzing the issue. This article addresses how the issue should be analyzed and concludes that construction defects are “occurrences”. The relevant rules of insurance policy interpretation dictate that construction defects are “occurrences”. Policy language should be interpreted in such a way as to fulfill the reasonable expectations of the policyholder when the policy is construed as a …

The Unaffordable Health Care Act - A Reponse To Professors Bagley And Horwitz, Douglas A. Kahn, Jeffrey H. Kahn

Articles

The Patient Protection and Affordable Care Act of 2010 has stirred considerable controversy. In the public debate over the program, many of its proponents have defended it by focusing on what is sometimes called the “free-rider” problem. In a prior article, we contended that the free-rider problem has been greatly exaggerated and was not a significant factor in the congressional decision to adopt the Act. We maintained that the free-rider issue is a red herring advanced to trigger an emotional attraction to the Act and distract attention from the actual issues that favor and disfavor its adoption. In a recently …

From Coverture To Contract: Engendering Insurance On Lives, Mary L. Heen

Law Faculty Publications

In the 1840s, state legislatures began modifying the law of marital status to ease the economic distress of widows and children at the family breadwinner's death. Insurance-related exceptions to the common law doctrine of "marital unity" under coverture permitted married women to enter into insurance contracts and protected life insurance proceeds from their husbands' creditors. These early insurance-related statutory exceptions to coverture introduced an important theoretical question that persisted for the rest of the nineteenth century-and into the next-as broader legal and social reforms took hold. How could equality of contract for married women be reconciled with the traditional dependencies …

The Inauthentic Claim, Anthony J. Sebok

Articles

This Article takes a critical look at the persistence of legal doctrines that prohibit or limit property rights in litigation. The Article focuses on prohibitions on assignment and maintenance. Assignment of personal injury tort claims is prohibited throughout the United States, while the assignment of other claims, such as fraud and professional malpractice, is prohibited in a large number of states. Maintenance, in which a stranger provides something of value to a litigant in order to support or promote the litigation, is prohibited in varying degrees in the United States.

These doctrines might seem quite independent of each other at …

Betting On Tort Suits After The Event: From Champerty To Insurance, Anthony J. Sebok

Articles

The article challenges the notion that champerty, a form of third-party litigation funding, is a form of gambling. It argues that champerty serves a functional purpose similar to insurance by transferring risk, thereby providing a legitimate form of "after the event" insurance for plaintiffs. The author, Anthony Sebok, contends that while champerty involves contingent outcomes, it should be recognized for its role in risk management rather than being dismissed as speculative gambling.

Who Pays? Who Benefits? Unfairness In American Health Care, Clark C. Havighurst, Barak D. Richman

Faculty Scholarship

American-style health insurance greatly amplifies price-gouging opportunities for health care providers, who inflate prices both to enrich themselves and to subsidize and expand the nation’s health care enterprise. To the extent that lower- and middle-income Americans with private health coverage pay premiums that go to support and expand the system, they are subject to an unfair (regressive) “head tax” levied by unaccountable entities for ostensibly public but also private purposes. Lower-income premium payers also often pay for costly health coverage designed to suit the economic interests and values of professional and other elites rather than their own. They also appear …

Four Constitutional Limits That The Minimum Coverage Provision Respects, Neil S. Siegel

Faculty Scholarship

Opponents of the minimum coverage provision in the Affordable Care Act charge that if Congress can require most people to obtain health insurance or pay a certain amount of money, then Congress can impose whatever mandates it wishes—or, at least, whatever purchase mandates it wishes. This Essay refutes that claim by identifying four limits on the Commerce Clause that the minimum coverage provision honors. Congress may not use its commerce power: (1) to regulate noneconomic subject matter; (2) to impose a regulation that violates constitutional rights, including the right to bodily integrity; (3) to regulate at all, including by imposing …

A Cautious Path Forward On Accountable Care Organizations, Barak D. Richman, Kevin A. Schulman

Faculty Scholarship

The wave of new Accountable Care Organizations (ACOs), spurred by financial incentives in the Affordable Care Act, could become the latest chapter in the steady accumulation of market power by hospitals, health care systems, and physician groups. The main purpose behind forming many ACOs may not be to achieve cost savings but instead to strengthen negotiating power over purchasers in the private sector. This would be an unfortunate sequel to the waves of mergers in the 1990s when health care entities sought to counter market pressure from managed care organizations. The possibility that ACOs might further concentrate health care markets …

Cultivating Justice For The Working Poor: Clinical Representation Of Unemployment Claimants, Colleen F. Shanahan

Faculty Scholarship

The combination of current economic conditions and recent changes in the United States' welfare system makes representation of unemployment insurance claimants by clinic students a timely learning opportunity. While unemployment insurance claimants often share similarities with student attorneys, they are unable to access justice as easily as student attorneys, and as a result, face the risk of severe poverty. Clinical representation of unemployment claimants is a rich opportunity for students to experience making a difference for a client, and to understand the issues of poverty and justice that these clients experience along the way. These cases reveal that larger lessons …

Family Security Insurance: A New Foundation For Economic Security, Workplace Flexibility 2010, Georgetown University Law Center, Berkeley Center On Health, Economic & Family Security, Uc Berkeley School Of Law

Published Reports

A report released by Georgetown Law's Workplace Flexibility 2010 and the Berkeley Center on Health, Economic & Family Security (Berkeley CHEFS) outlining a blueprint for establishing and financing a new national insurance program to provide wage replacement for time off for health and caregiving needs. The report describes the need among working Americans for time off from work to address personal illness, to care for a new child, or to care for a loved one with a serious illness. It argues that the need for time off is no longer an issue for individual families or select industries, but a …

American Law: Integrating Ultra-Traditional Muslims Through Accommodations, Mohamed A. Elsanousi

Maurer Theses and Dissertations

Appropriate legal accommodations for religious minorities can support their integration into American society. Historically, the teachings and practices of many religious communities that have otherwise conflicted with state or federal law have been successfully preserved through legal accommodations. A brief comparison with the experiences of such groups as the Hasidic Jewish community will provide a context for religiously based legal accommodations for various religious communities within the United States.

This dissertation examines the particular situation of a Tablighi Jamaat community, a Muslim missionary movement, as a means to explore how legal accommodations facilitate the successful, stable integration of such groups. …

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

Mercer Law Review

This survey year, from June 1, 2009 to May 31, 2010, brought significant developments to a broad array of insurance fields. Both the Georgia Supreme Court and the United States Court of Appeals for the Eleventh Circuit held that a cancellation notice for nonpayment of a premium can also contain an offer to reinstate upon payment in the "grace" period. The supreme court has strictly enforced basic concepts of "offer and acceptance" in the context of time-limit policy demands containing less than complete release and indemnity terms, thereby appearing to put insurers in "catch 22" situations with their insureds. A …

Erisa & Uncertainty, Brendan S. Maher, Peter K. Stris

Faculty Scholarship

In the United States, retirement income and health insurance are largely provided through private promises made incident to employment. These “benefit promises” are governed by a statute called ERISA, which many healthcare and pension scholars argue is the cause of fundamental problems with our nation’s health and retirement policy. Inevitably, however, they advance narrowly tailored proposals to amend the statute. This occurs because of the widely-held view that reform should leave undisturbed the underlying core of the statute. This Article develops a theory of ERISA designed to illustrate the unavoidable need for structural reform.

Reauthorizing Schip: Only A Starting Point, Pamela Newell

North Carolina Central Law Review

No abstract provided.

Misclassifying The Insurance Policy: The Unforced Errors Of Unilateral Contract Characterization, Hazel Beh, Jeffrey W. Stempel

Cardozo Law Review

No abstract provided.

The Deepwater Horizon Oil Spill: Potential Insurance Coverage Implications, Lynn K. Neuner, W. Nicholson Price

Articles

More than 300 lawsuits have already been filed in Louisiana, Florida, Texas, Mississippi, and Alabama against BP and other corporations involved in the Deepwater Horizon oil spill, including Transocean, Halliburton, and Cameron, with thousands more anticipated. This article briefly addresses the contours of the coverage lawsuit already filed against BP and other coverage disputes we may see in the future.

Rethinking Trust Law Reform: How Prudent Is Modern Prudent Investor Doctrine?, Stewart E. Sterk

Articles

During the 1990s, modern portfolio theory provided the theoretical foundation for significant reforms in trust investment doctrine-reforms that freed trustees from a legal regime in which they faced potential liability for making "speculative" investments. The reforms enabled trustees to pursue investment policies that protected beneficiaries against inflation risk. But the reforms worked too well; they encouraged trustees to invest a higher percentage of trust assets in equities just in time for a decade that has seen two precipitous stock market declines. Although no sensible investment strategy would have avoided losses during these periods of market turmoil, the doctrinal reforms endorsed …

Equally Insured? Lasting Insurance Industry Reform Came Only With A Rethinking Of Race, Mary L. Heen

Law Faculty Publications

Earlier this decade, some of America’s best-known life insurance companies quietly settled multimillion-dollar civil rights lawsuits challenging race-based life insurance rates and benefits. As a result, those companies closed a chapter of American economic history that began after the Civil War with the door-to-door marketing of small individual life insurance policies to poor workers, including former slaves, and their families. The closing of this chapter in history also marked the end of a form of Jim Crow race discrimination largely invisible to the American public.

The “Licentiousness” In Religious Organizations And Why It Is Not Protected Under Religious Liberty Constitutional Provisions, Marci A. Hamilton

Articles

No abstract provided.

Crisis On Campus: Student Access To Health Care, Bryan A. Liang

University of Michigan Journal of Law Reform

College-aged adults are an overrepresented group in the uninsured population of the United States, and traditionally underserved minorities are disproportionately affected. Students with private health insurance are often functionally uninsured as well, since most schools refuse to accept this traditionally elite calling card on campus. Consequently, the large uninsured and functionally uninsured populations often rely on school-sponsored health insurance plans for access to care. These plans have uneven coverage, limited benefits, exclusions and high co-pays and deductibles, and provide little health care security for their beneficiaries. Further, schools and insurance companies have profited substantially from these student plans, raising the …