Insurance Law Commons^™

Delay, Deny, Tax, Samuel D. Brunson

Faculty Publications & Other Works

Health insurance companies are having a moment in the United States. Their moment involves widespread public objections to their seemingly random and increasing willingness to deny coverage and reimbursement to insureds. These denials are in large part not part of a program to improve health coverage but, rather, to reduce insurance companies’ expenses and, in turn, increase their profits.

There is broad consensus that something has to change. The public demands it. Bipartisan groups of senators and representatives have investigated it. Even the health care industry acknowledges that something needs to change. To actually make the health care system better …

Designing A Victims’ Compensation System Amidst California’S Insurance Crisis: The Aftermath Of The 2025 Los Angeles Wildfires, Federica Simonelli

Cardozo Journal of Conflict Resolution

This Commentary will explore critical aspects necessary for creating victims’ compensation mechanisms capable of handling claims stemming from the 2025 Los Angeles wildfires from a theoretical perspective. Drawing from the successful examples of the 2020 PG&E Fire Victim Trust, the 2023 Maui Wildfires compensation schemes, and other forms of dispute resolution (such as mediation), this Commentary will demonstrate that the challenging fallouts of environmental disasters pose increased challenges and necessitate unique dispute system design to better respond to the need for fair and equitable solutions. These systems increasingly rely on settlement funds tailored to claimants’ specific needs and have proven …

The United States Healthcare System: From Medicare To Post-Pandemic Health Policy, William M. Sage

Faculty Scholarship

My purpose in this essay is to comment on national health policy in the United States over the past sixty years.  My conclusions are less optimistic than what I had hoped when I began my teaching and research career in the 1990s to be able to say in 2025.  In particular, the successful expansion of publicly supported health coverage via the passage of the Affordable Care Act (“ACA” or “Obamacare”) in 2010 seems to have triggered -- though I hesitate to say that it caused – a backsliding from broader commitments to clinical performance, population health, and social solidarity that …

The Rise Of China: Economic Expansion, Military Modification And The Belt And Road Initiative, Felix Padilla

Dissertations and Theses

In order to analyze China’s rise in power, we have to examine how China has achieved this growth. We need to observe their domestic reforms, international initiatives like the Belt and Road Initiative (BRI), and strategic military advancements. This thesis focuses on China’s economic integration, market reforms and military modernization. The thesis uncovers the effects of this rise on global governance and power balances, especially in trade, security, and geopolitics. I analyze China's vision of a multipolar world and how it contrasts with the current global order and how this fuels rivalry with the U.S. and other powers. China's rise …

Human Masters/Robot Servants: Highly Automated Vehicle Design, Intoxicated Drivers & Vicarious Liability, William H. Widen, Marilyn C. Wolf

Articles

A traditional engineering role is to design a safe product. Safety engineering is an exercise in harm avoidance ex ante. In contrast, liability attribution is an exercise to compensate for loss post hoc — traditionally viewed as a legal matter. We observe that, when a natural person incurs liability for a loss that exceeds insurance coverage, economic ruin can follow. Neither engineering nor law focus on the loss suffered by defendants considering law as a "safety risk." The highly automated vehicle (HAV) design space, however, provides an opportunity to prevent this kind of economic harm from occurring ex ante just …

Consumer Claims For Insurance Company Drone Surveillance, Chad J. Pomeroy

Faculty Articles

Many people do not own their homes outright-they finance the purchase of their home by taking out a mortgage against it. This typically means that the homeowner is contractually obligated to do a number of things-like pay real property taxes, keep the property in good condition, and keep it insured, even as prices skyrocket. But even worse, the pool of providers is materially shrinking with some insurers now either not writing or limiting new policies or tightening underwriting standards in some markets. Insurance companies pull out of markets because they cannot make enough money in those markets to be profitable. …

The Illusory Coverage Doctrine Is Not A Doctrine At All (But It Should Be), Shannon W. Conway

Catholic University Law Review

The Illusory Coverage Doctrine, if it ever becomes a true legal doctrine, has the potential to be an incredibly useful tool in insurance law. But courts around the country take very different approaches to the doctrine, ranging from one end of the spectrum—a hard-nosed “pro-insurer” stance where coverage is not illusory so long as a policy provides any coverage—to the other—a muscular “pro-policyholder” public policy approach that requires coverage even if some other exclusion might have prevented coverage under the applicable policy. And along the spectrum are various other iterations, contributing to the complete lack of certainty or consistency about …

Baybutt Construction Corp. V. Commercial Union Insurance Co.: A Question Of Ambiguity In Comprehensive General Liability Insurance Policies, Peter Alexander Meyer

Maine Law Review

A critical issue pervading the realm of commercial insurance contract law concerns the clarity of provisions contained in policy agreements. Insurance policies containing unclear or complicated language may give rise to situations in which the actual intentions of the contracting parties are not reflected in the technical terms of the policy. The parties' conflicting expectations often lead to costly litigation. In such cases, the Maine Supreme Judicial Court, sitting as the Law Court, has made it clear that it will ordinarily rule against the party who wrote the policy (the insurer) and in favor of the party whose expectations were …

Stacked Recovery Under Maine's Uninsured Motorists Statute: Connolly V. Royal Globe Insurance Company, Edward R. Benjamin Jr.

Maine Law Review

Foremost among the problems of automobile travel facing state legislatures may be that of ensuring adequate compensation for injuries and deaths suffered in traffic accidents. Frequently an injured party wins an award of damages against a negligent motorist, only to find the negligent party unable to meet the financial burden which the judgment imposes. The injured party, though innocent of any wrongdoing, may receive little or no compensation for injuries suffered. State legislatures have attempted to prevent such situations by enacting mandatory liability insurance laws, creating victim compensation funds, or requiring uninsured motorist coverage. Inherent weaknesses exist, however, in both …

American Home Assurance Co. V. Ingeneri: Misrepresentations In Insurance Applications, Richard P. Bennett

Maine Law Review

In American Home Assurance Co. v. Ingeneri, the Maine Supreme Judicial Court, sitting as the Law Court, addressed the issue of when an incorrect response to a question on an insurance application constitutes a sufficient misrepresentation to render the policy voidable under Maine law. Reversing the trial court, the Law Court held that to render the policy voidable, the applicable statutory provision required the insurer to prove that the insured's misrepresentation was fraudulent, material to the insured risk, and actually relied upon by the insurer. The Law Court determined that the word "or" in the misrepresentation statute should be read …

Improved Regulation Of Maine Physicians: One Solution To The Medical Malpractice Crisis, Joanne Buttolph Steneck

Maine Law Review

Maine began regulating allopathic and osteopathic physicians around the turn of the century with the passage of two statutes, in 1895 and 1919, commonly referred to as the Medical Practice Acts. As originally enacted, these statutes provided for the establishment of boards, composed of physicians, and empowered the boards to examine and license all persons seeking to practice as physicians and surgeons within the state. The boards were also responsible for investigating complaints of noncompliance with, or violations of, the Acts' provisions, and for revoking licenses for such violations. The boards were left to undertake these licensing and review functions …

Ending The Never-Ending Medical Malpractice Crisis, Allen Redlich

Maine Law Review

Another nationwide outbreak of what is commonly called the medical malpractice "crisis" is spreading. Once again, as during prior episodes, the public hears of dramatic increases in the cost of malpractice insurance, of growing numbers of multimillion dollar awards, and of increases in the number of suits filed. Already several states have passed statutes in attempts to resolve the crisis. This crisis atmosphere resembles the crisis of the mid-seventies when every state enacted so-called "remedial" statutes, which failed to solve the crisis. A physician would define a "crisis" as a turning point in the course of a disease; nonmedical definitions …

Affirmative Judicial Case Management: A Viable Solution To The Toxic Product Litigation Crisis, Patrick Francis Harrigan

Maine Law Review

With increasing frequency, federal courts throughout the nation have confronted a multiplicity of "toxic tort" claims, claims for relief arising from chronic and latent illnesses or diseases allegedly caused by toxic substances. Toxic substances are substances whose manufacture, processing, distribution, use, or disposal presents or will present an unreasonable risk of injury to a person's health or to the environment. Because many of these unreasonable health risks are caused by consumer and industrial products, many toxic tort claims are actually "toxic product" claims. Examples of toxic product claims include those arising from the use, exposure to, or consumption of chemicals …

Insurance, Maren R. Cave, Jessica Phillips, Rebecca Strickland

Mercer Law Review

During this Survey period, the most important development was the Georgia General Assembly’s enactment of critical changes to the statute related to pre-suit demands in automobile cases. These changes to O.C.G.A. § 9-11-67.1 may very well mark the ultimate end of litigation in Georgia’s appellate courts related to what constitutes a binding settlement in automobile cases involving time limited demands. The Survey period also saw a number of decisions in the “first party” area where Georgia courts strictly upheld the insurance contract provisions related to suit limitations and reformation of those policies, and another decision related to “recoupment” of defense …

Feasibility Study And Implementation Of Solar-Wind Energy Integration For Green Hydrogen Production At Dar Es Salaam Port, Nassibu Nassoro Kiobya

World Maritime University Dissertations

No abstract provided.

Florida's Homeowners Insurance Problems, Peter Molk

Connecticut Insurance Law Journal

Floridians have seen dramatically rising homeowners insurance premium increases over the past several years, with year-over-year increases of forty percent or more over multiple years. The problem grew so severe that the State legislature convened a special session in 2022 to address the problem, ultimately passing several efforts designed to moderate rates. This Article reviews the evidence of Florida's experience to interrogate why the State has suffered disparately high homeowners insurance premium increases. In light of this interrogation, I critically assess the prospects for the recent legislative efforts and other suggestions to address the underlying problems. Reform efforts predominantly address …

Rethinking Prop 103'S Approach To Insurance Regulation, Lars Powell, R. J Lehmann, Ian Adams

Connecticut Insurance Law Journal

No abstract provided.

Managing Medicaid Managed Care, Lance Plunkett Jd, Llm

The New York State Dental Journal

There is a system in place to ensure Medicaid managed care organizations operate properly. How effective these controls are is a different issue.

N Y State Dent J August-September 2024

The New York State Dental Journal

In the August-September 2024 issue, the reader will find the following feature articles:

• Success of Implant Placement in Patients with Human Immunodeficiency Virus
• Effects of Mandatory COVID-19 Testing Policy on No-Show Rates for Aerosol-Generating Procedures
• Heterotopic Bone Formation after TMJ Surgery
• Rural Oral Health Access Disparities in New York State

This issue includes regular columns with regional news impacting the New York membership including editorial and perspectives columns, legal, association activities, component news, continuing education opportunities, and classifieds.

A Sorry Situation, Chester J. Gary Dds, Jd

The New York State Dental Journal

Doing the right thing and apologizing to a patient for an adverse treatment outcome can, but shouldn't, increase a dentist's liability.