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Author: Bradley W. Matthiesen
Publisher: Juris Publishing, Inc.
ISBN: 1578233380
Category : Law
Languages : en
Pages : 34
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Book Description
Fundamentals of Insurance Coverage in All 50 States is a unique compendium and overview of all aspects of insurance coverage law in every state, with a special emphasis on some of the unique aspects of insurance coverage involving environmental claims. The treatise utilizes and cites state and federal statutes, insurance regulations, and case law from every state, as a framework for a unique and unprecedented treatment of this complicated subject. The book is designed specifically for insurance claims handlers and supervisors who have responsibility for or occasion to deal with coverage issues relating to third-party defense litigation, first-party claims litigation, and reservation of rights scenarios. In addition to being an excellent and easy to understand primer on coverage issues and the basic insurance contract, this book is suitable for both the inexperienced claims professional and the seasoned veteran. It is also the perfect "starting point" for any research or litigation briefing by trial lawyers, defense counsel, or in-house insurance counsel. It is a must for anyone with multi-state responsibilities. Fundamentals of Insurance Coverage in All 50 States compile all of the relevant law, regulations and case decisions from all 50 states into one easy to understand and easy to use reference book, the first place a lawyer or claims handler should turn when coverage matters rear their ugly heads. The book intentionally omits references to federal law, which plays a very limited role in insurance regulation, except insofar as it may be necessary to clarify issues of state law. The book is a comprehensive treatment of all coverage issues that the average insurance lawyer, claims handler or supervisor might be expected to run across in any given situation. This one of a kind treatise covers the following issues in all 50 jurisdictions: • Understanding Contracts of Insurance • Law Governing Insurance Policies • Tackling Ambiguity and Interpretation of Policies • General Contract Rules for Interpretation • Rights and Obligations of Contracting Parties • Limitations of the "Construed against Drafter" Rule • The Extent of Risks and Coverages • Good Faith and Fair Dealing; Bad Faith • Basic Policy Defenses • Cooperation of the Insured • Failure to Pay Premiums • Environmental Issues and Related Insurance Law
Author: Bradley W. Matthiesen
Publisher: Juris Publishing, Inc.
ISBN: 1578233380
Category : Law
Languages : en
Pages : 34
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Book Description
Fundamentals of Insurance Coverage in All 50 States is a unique compendium and overview of all aspects of insurance coverage law in every state, with a special emphasis on some of the unique aspects of insurance coverage involving environmental claims. The treatise utilizes and cites state and federal statutes, insurance regulations, and case law from every state, as a framework for a unique and unprecedented treatment of this complicated subject. The book is designed specifically for insurance claims handlers and supervisors who have responsibility for or occasion to deal with coverage issues relating to third-party defense litigation, first-party claims litigation, and reservation of rights scenarios. In addition to being an excellent and easy to understand primer on coverage issues and the basic insurance contract, this book is suitable for both the inexperienced claims professional and the seasoned veteran. It is also the perfect "starting point" for any research or litigation briefing by trial lawyers, defense counsel, or in-house insurance counsel. It is a must for anyone with multi-state responsibilities. Fundamentals of Insurance Coverage in All 50 States compile all of the relevant law, regulations and case decisions from all 50 states into one easy to understand and easy to use reference book, the first place a lawyer or claims handler should turn when coverage matters rear their ugly heads. The book intentionally omits references to federal law, which plays a very limited role in insurance regulation, except insofar as it may be necessary to clarify issues of state law. The book is a comprehensive treatment of all coverage issues that the average insurance lawyer, claims handler or supervisor might be expected to run across in any given situation. This one of a kind treatise covers the following issues in all 50 jurisdictions: • Understanding Contracts of Insurance • Law Governing Insurance Policies • Tackling Ambiguity and Interpretation of Policies • General Contract Rules for Interpretation • Rights and Obligations of Contracting Parties • Limitations of the "Construed against Drafter" Rule • The Extent of Risks and Coverages • Good Faith and Fair Dealing; Bad Faith • Basic Policy Defenses • Cooperation of the Insured • Failure to Pay Premiums • Environmental Issues and Related Insurance Law
Author: Gary L. Wickert
Publisher: Juris Publishing, Inc.
ISBN: 1578233755
Category : Actions and defenses
Languages : en
Pages : 2081
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Book Description
Automobile Insurance Subrogation: In All 50 States is the most thorough, comprehensive, and ambitious anthology of subrogation-related legal information and insurance resources ever put to paper. It is the last and most anticipated of the subrogation trilogy, and a book which will serve as the “bible” for any insurance company writing personal lines or commercial auto policies. It is destined to become the standard work and reference for attorneys, insurance companies, and subrogation industry professionals. Every year there are more than 7 million auto accidents in the United States with a financial toll of more than $300 billion. Nearly 3 million people are injured and 42,636 people are killed. In the overwhelming majority of these accidents there is at least one party at fault. For virtually every one of these accidents, a policy of automobile insurance provides some sort of claim payments or benefits. In the vast majority of those claims, one or more insurance policies and/or applicable state law grants the insurer a right of subrogation against a negligent third party whose carelessness caused the accident. This book is the bible on subrogating those claims. This book covers the nuts and bolts of auto subrogation in all 50 states, covering every topic imaginable -- including PIP, Med Pay, UM/UIM, property claims, deductible reimbursement, no-fault subrogation and more. It surveys the laws of every state and provides descriptions of every type of auto coverage imaginable, as well as the statutory, case law, and regulatory authority governing every aspect of auto subrogation. If you have subrogation responsibility involving auto claims, you need this book. It universally covers issues which are indelibly interwoven into the business of auto insurance, including a complete treatment of the laws of all 50 states and the District of Columbia relating to: • Basic and Statutory Subrogation Rights • Mandatory vs. Optional Insurance Coverage • No-Fault Laws, PIP, Mini-Torts, and Loss Transfer Laws • Tort Limitations • Medical Payments Coverage and Subrogation • Uninsured/Underinsured Motorist Coverage and Subrogation • Collision/Property Subrogation • Release of Tortfeasor by Insured • Accord and Satisfaction: Accepting Partial Payments from Tortfeasor • Made Whole Doctrine • Common Fund Doctrine • Economic Loss Doctrine • Deductible Recovery and Reimbursement • Collateral Source Rule • Contributory Negligence/Comparative Fault • Seat Belt Laws and Defenses • Rental Cars, Loaner Vehicles, and Test Drivers • Bailment/Parking Lot Liability • Negligent Entrustment • Facing Multiple Claims In Excess of Liability Policy Limits • Conflict of Laws/Interstate Subrogation • Recovery of Attorney’s Fees and Costs • Statutes of Limitations It is a complete treatment -- A to Z -- of virtually every issue which the insurance claims or subrogation professional will face in the area of automobile insurance. It is like no legal treatise ever written and promises to be the most used reference in any insurance company.
Author: Gary L. Wickert
Publisher: Juris Publishing, Inc.
ISBN: 1578233631
Category : Law
Languages : en
Pages : 1616
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Book Description
Workers' compensation subrogation continues to change and adapt, as trial lawyers prod its weak points and capitalize on confusing areas of the law. There have been numerous changes in workers' compensation statutes and case law in many states since the last edition. This edition includes an exhausting survey and detailed explanation of the crazy status of employer contribution in Illinois, which includes a step-by-step exposition of how contractual indemnity and the "Kotecki cap" play a role in expanded employer liability in Illinois workers' compensation subrogation cases. It covers the many nuances of Naig and Reverse-Naig settlements under Minnesota law, including an analysis of who has what burdens of proof and the effect such a settlement has on the remaining third-party case tried to a jury. In light of the landmark Missouri Court of Appeals decision in Robinson v. Hooker, the liability of co-employees in Missouri and surrounding states have been covered in greater detail. The concept of co-employee liability for acts which are intentional or committed outside of the course and scope of employment has been added in several states. New case law and explanations were added to the Texas chapter with regard to subrogating against UM/UIM policies, including arguments with regard to the efficacy of UM/UIM exclusionary policy language and the ability to subrogate against a UM/UIM policy actually issued by the same carrier insuring for workers' compensation coverage. West Virginia completely revised their subrogation statute and created a new statute relating to the "statutory employer" status of primary contractors and subcontractors on construction sites, limiting when and how primary contractors can become legitimate third parties for purposes of subrogation. Chapter 7, "Contractual Limitations to Subrogation" has been completely overhauled to include new statutes and case law for every state to assist practitioners in determining the law applicable when there is an alleged applicable waiver of subrogation which might otherwise destroy subrogation. A new Chapter 12 has been added, which focuses on jurisdiction of workers' compensation third-party actions taking a broad look at 28 U.S.C. § 1441, which prohibits removal of cases "arising under" state workers' compensation laws. A carrier now has the ability to prevent cases from being removed from favorable venues in state court to less favorable federal court venues - an attractive option for plaintiffs' attorneys with whom subrogated carriers can negotiate with for stipulations and concessions on their subrogation interests in exchange for maintaining a case in state court. This edition also expands on which states do and do not hold workers' compensation to be primary. Combined with more than 100 new case decisions, this Fifth Edition is the most complete and up-to-date edition yet. Workers' Compensation Subrogation is the most complete and thorough treatise covering workers' compensation subrogation ever published. There are very few areas in which the laws of each state vary more and are applied as differently, then in the area of workers' compensation subrogation. This book is intended to introduce the workers' compensation claims handler, in-house counsel, and subrogation professionals to some of the more esoteric and complex subrogation issues encountered in today's workers' compensation insurance subrogation marketplace. It covers the following issues in all 50 states: • Allocating Third Party Recoveries • Attorney's Fees • Borrowed Servant Doctrine • Conversion of Workers' Compensation Liens • Costs and Expenses • Dual Capacity Doctrine • Equitable Subrogation/Contribution • Exclusivity Rule Barring Action Against Employer • How To Calculate Your Credit/Advance and How It Is Applied In Each State • Intentional Acts • Joint Ventures • Made Whole Doctrine As Applied To Workers' Compensation Subrogation • Necessity of Intervention • Lien Reduction Statutes • Staff Leasing Services and Temporary Employment Agencies • Statutory Subrogation Rights • Subrogating Against UM/UIM Benefits • Subrogating In Medical Malpractice Cases • Subrogating In Legal Malpractice Cases • Waivers of Subrogation • Who Qualifies As A Third Party • Other Workers' Compensation Subrogation-Related Issues In addition to being an excellent primer on workers' compensation subrogation, suitable for both the new subrogation professional and the seasoned veteran, the book also contains a detailed synopsis of the workers' compensation subrogation laws in each of the 50 states. It is a must for anyone with multi-state subrogation responsibilities. Complete with diagrams, references and thousands of footnotes, this is the most ambitious workers' compensation subrogation project ever undertaken. The following issues and topics are covered in detail for each of the 50 states: Statutory Subrogation Rights • Identifies the statutory authority for workers' compensation subrogation in that state. • Discusses the purpose/legislative intent of the statute. • Is an election necessary by the worker? • Who can bring a third party action (plaintiff, carrier, employer, or all of the above)? • When and must a third party action be brought? • What are the rights of a carrier to intervene in an existing third party action filed by a worker? • Will a worker's compensation carrier's subrogation interest be barred if not brought timely? Third Parties • Who can be sued as third parties in a third party action? • Can a co-employee be sued and under what circumstances? • Can an uninsured/underinsured carrier be a "third party" under the laws of that state? • Is there a dual capacity or borrowed servant doctrine which somehow affects the ability of a worker's compensation carrier to effectively subrogate? • What is the state's workers' compensation bar? • Are there any specific restrictions regarding subrogation against a subcontractor or an employee of a subcontractor in a construction situation? • Under what circumstances can the employer be sued? • Can a carrier subrogate to the benefits of a recovery in a legal or medical malpractice action? Allocation of Third Party Recovery • How and when does the carrier recover its subrogated interest? • Does the carrier recover past benefits only or also the present value of future benefits which it owes under the Workers' Compensation Act of that state? • Is there a formula used to determine how a third party recovery is allocated? • What happens to the total recovery and how is it applied? • Can a carrier recover benefits paid by a third party or recovered in a third party action which relate to loss of consortium, or non-economic damages such as pain and suffering, mental anguish, or punitive damages? • Does the employer's negligence reduce the recovery by the worker or carrier? Attorneys' Fees/Costs • Can the plaintiff's attorney recover attorneys' fees and/or costs out of the carrier's subrogated recovery and under what circumstances? • How are attorneys' fees and costs handled if the carrier is also represented by subrogation counsel, intervenes into the third party action and actively represents its interest? • What if the carrier isn't represented? • Can a plaintiff's attorney recover attorneys' fees based on the value of past benefits only or will he be able to recover attorneys' fees based on the future benefits/credit recovered by the carrier? • Must a carrier bear its proportionate share of expenses as many states require, and what does that really mean? Credit/Advance • Can a carrier take a vacation from paying workers' compensation benefits once a worker makes a third party recovery? • How is the credit calculated under state law? • Does the carrier have to do anything special to obtain the credit, such as filing with the Workers' Compensation Commission? • Does the carrier get a credit toward future compensation benefits it owes or does it actually get to collect the present value of the future benefits it owes and still be obligated to pay the scheduled benefits in the future? Statutes of Limitation • What are the applicable statutes of limitation or statutes of repose that may be applicable to third party subrogation actions? Related Subrogation Issues • Are there any other issues or statutes which affect a worker's compensation carrier's right of subrogation, such as the made whole doctrine, common fund doctrine, or anti-subrogation statutes? • Are there any lien reduction statutes, such as those existing in Indiana, which affect a worker's compensation carrier's right of recovery? • Does the state have any no-fault laws which complicate workers' compensation subrogation involving an automobile accident, such as exist in Michigan and Colorado? • What are the carrier's options if the worker and his attorney simply refuse to repay a worker's compensation carrier's lien after settling a third party action? • If the worker fails to repay the carrier, is there a cause of action for conversion of a carrier's subrogation interest or may the carrier still proceed against the third party tortfeasor to recover its subrogation interest?
Author: Gary L. Wickert
Publisher: Juris Publishing, Inc.
ISBN: 1578233291
Category : Law
Languages : en
Pages : 1300
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Book Description
ERISA and Health Insurance Subrogation In All 50 States is the most complete and thorough treatise covering the complex subject of ERISA and health insurance subrogation ever published. NEW TO THE FIFTH EDITION! • Updated To Include All The Newest Case Law! • Updated To Include Medicaid Subrogation and Preemption of FEHBA ! • New Plan Language Recommendations! • Complete Health Insurance Subrogation Laws In All 50 States • Covers The Application of ERISA In Every Federal Circuit The Fifth Edition of ERISA and Health Insurance Subrogation In All 50 States has been completely revised, edited, and reorganized. This was partly to reflect the new direction recent case decisions have taken regarding health insurance subrogation as well as the crystallization of formerly uncertain and nebulous areas of the law which have now received some clarity. An entirely new chapter entitled, “What Constitutes Other Appropriate Equitable Relief?” has been added and replaces the old Chapter 9, which merely dealt with Knudson and Sereboff. The new edition introduces new state court decisions addressing the issue of causation and whether and when a subrogated Plan seeking reimbursement must prove that the medical benefits it seeks to recover were causally related to the original negligence of the tortfeasor. An entirely new section was added concerning the subrogation and reimbursement rights of Medicare Advantage Plans, a statutorily-authorized Plan which provides the same benefits an individual is entitled to recover under Medicare. This includes recent case law which detrimentally affects the rights of such Plans to subrogate. Also added to the new edition is additional law and explanation regarding Medicaid subrogation, including the differentiation between “cost avoidance” and “pay and chase” when it comes to procedures for paying Medicaid claims. Significant improvements have been made to suggested Plan language which maximizes a Plan’s subrogation and reimbursement rights. The suggested language stems from recent decisions and developments in ERISA and health insurance subrogation from around the country since the last edition. The new edition has been completely reworked both in substance and organization. Recent case law has necessitated consolidation of several portions of the book and elimination or editing of others. A new section entitled “Liability of Plaintiff’s Counsel” has been added, which provides a clearer exposition on the laws applicable and remedies available when plaintiff’s attorneys and Plan beneficiaries settle their third-party cases and fail to reimburse the Plan. Also new to the book are recently-passed anti-subrogation measures such as Louisiana’s Senate Bill 169, § 1881, which states that no health insurer shall seek reimbursement from automobile Med Pay coverage without first obtaining the written consent of the insured. The new edition also goes into much greater detail on the procedures for and law underlying the practice of removal of cases from state court to federal court, and the possibility of remand back to state court. This includes the Federal Courts Jurisdiction and Venue Clarification Act of 2011, effective Jan. 6, 2012, which amended federal removal, venue, and citizenship determination statutes in very significant ways. The new edition also delves into, for the first time, the role which the federal Anti-Injunction Act plays when beneficiaries sue in state court to enforce the terms of an ERISA Plan, while the Plan files suit in federal court seeking an injunction against the state court action. New case law and discussion on preemption of FEHBA subrogation and reimbursement claims have been added to Chapter 10 in the wake of new decisions regarding same.
Author: Randy J. Maniloff
Publisher: OUP USA
ISBN: 9780199846559
Category : Law
Languages : en
Pages : 0
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Book Description
Insurance coverage disputes raise issues in which laws and outcomes regularly vary from state to state. Whether a claim is covered can depend a great deal on whether the case arises on one side of the street or another. It is imperative that insurance claims professionals, lawyers, brokers, risk managers, risk consultants, regulators and judges have adequate access to comparative state-law research. This book is designed to give the stakeholders in the claims process ready access to the law of all 50 states on the most important liability insurance issues to quickly learn and assess state law relevant to coverage disputes. The Second Edition includes nearly 800 new cases covering all 50 states and the District of Columbia, and adds a new chapter addressing Coverage for Pre-Tender Defense Costs.
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 128415209X
Category : Medical
Languages : en
Pages : 355
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Book Description
Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
Author: Gary L. Wickert
Publisher:
ISBN: 9781578234981
Category : Insurance law
Languages : en
Pages :
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Book Description
Author: Jeffrey W. Stempel
Publisher:
ISBN: 9781422476864
Category : Insurance law
Languages : en
Pages : 0
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Book Description
Over the past two decades, there have been a number of important developments in the areas of liability, property, and life and health insurance that have significantly changed insurance law. Accordingly, the Fourth Edition of Principles of Insurance Law has been substantially rewritten, reformatted, and refocused in order to offer the insurance law student and practitioner a broad perspective of both traditional insurance law concepts and cutting-edge legal issues affecting contemporary insurance law theory and practice. This edition not only expands the scope of topical coverage, but also segments the law of insurance in a manner more amenable to study, as well as facilitating the recombination and reordering of the chapters as desired by individual instructors. The Fourth Edition of Principles of Insurance Law includes new and expanded treatment of important insurance law developments, including: The critical role of insurance binders as temporary forms of insurance as illustrated in the World Trade Center property insurance disputes resulting from the terrorist attacks of September 11, 2001; The continuing debate between "legal formalists" and "legal functionalists" for "the heart and soul" of insurance contract law; What constitutes a policyholder's "reasonable expectation" regarding coverage; The current property and liability insurance "crisis"; Risk management and self-insurance issues; Emerging, and frequently conflicting, case law concerning the intersection of insurance law and federal anti-discrimination regulation; Ongoing interpretive battles over the preemptive scope of ERISA; The United States Supreme Court ruling that a California statute attempting to leverage European insurers into honoring commitments to Holocaust era policies is preempted by the Executive's power over foreign affairs; The State Farm v. Campbell decision, which struck down a $145 million punitive damages award in an insurance bad faith claim as well as setting more restrictive parameters for the recovery of punitive damages; New issues over the dividing line between "tangible" property typically covered under a property insurance policy and "intangible" property, which is typically excluded -- an issue of increasing importance in the digital and cyber age; Refinement of liability insurance law regarding trigger of coverage, duty to defend, reimbursement of defense costs, and apportionment of insurer and policyholder responsibility for liability payments; The difficult-to-harmonize decisions concerning when a loss arises out of the "use" of an automobile; Insurer bad faith and the availability, if any, of actions against a policyholder for "reverse bad faith"; and The degree to which excess insurance and reinsurance may be subject to modified approaches to insurance policy construction. The Teacher's Manual highlights the differences between the Third Edition and the Fourth Edition. In addition, it includes case-brief summaries of the major cases excerpted in the book; authors' analyses of the notes, questions, and problems that follow the principal cases; and offers alternative syllabuses for planning purposes. This book also is available in a three-hole punched, alternative loose-leaf version printed on 8.5 x 11 inch paper with wider margins and with the same pagination as the hardbound book.
Author: James P. Lewis
Publisher: Amacom
ISBN: 9780814471326
Category : Business & Economics
Languages : en
Pages : 166
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Book Description
Updated concepts and tools to set up project plans, schedule work, monitor progress-and consistently achieve desired project results.In today's time-based and cost-conscious global business environment, tight project deadlines and stringent expectations are the norm. This classic book provides businesspeople with an excellent introduction to project management, supplying sound, basic information (along with updated tools and techniques) to understand and master the complexities and nuances of project management. Clear and down-to-earth, this step-by-step guide explains how to effectively spearhead every stage of a project-from developing the goals and objectives to managing the project team-and make project management work in any company. This updated second edition includes: * New material on the Project Management Body of Knowledge (PMBOK) * Do's and don'ts of implementing scheduling software* Coverage of the PMP certification offered by the Project Management Institute* Updated information on developing problem statements and mission statements* Techniques for implementing today's project management technologies in any organization-in any industry.
Author: Laura K. Guidry-Grimes
Publisher: Routledge
ISBN: 0429017545
Category : Philosophy
Languages : en
Pages : 307
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Book Description
The Basics of Bioethics, Fourth Edition offers an easy-to-follow introduction to this dynamic field, intended for healthcare professionals, teachers, students, and anyone interested in bioethics. Accessible and enjoyable for readers of all backgrounds, the book contains numerous cases—including ones that recently have dominated international headlines—to help anchor the broader discussion. The text is suitable for use in short courses in schools of medicine, nursing, and other health professions; continuing professional education; various undergraduate departments; and adult education. Chapters are organized around common moral themes in order to help readers understand the values and other connections that tie together different positions in bioethics. This fourth edition adds a new chapter on alternative frameworks in bioethics, including narrative ethics and casuistry, feminist approaches, care ethics, and virtue ethics. Due to significant advances in genetics and reproductive possibilities, this new edition devotes a full chapter to each. The combined teaching, research, and clinical experience of the two authors helps make this edition current with the evolving field of bioethics, while still embedding the major issues in a systematic framework that allows readers easily to navigate the larger field. Key Changes to the Fourth Edition: • An added chapter on new and emerging approaches in bioethics, including those based on virtue ethics, casuistry and narrative ethics, feminist ethics, and care ethics • Updates throughout the book based on developments in ethical theory and new medical research • Revisions and updates to the Learning Objectives, Key Terms, Bibliographies, and URLs • The addition of multiple recent case studies, including: Jahi McMath an undocumented patient who needs a rule bent a pediatrician who turns away unvaccinated patients a minor eligible for pediatric bariatric surgery a daughter suing a hospital for non-disclosure of her father’s Huntington’s diagnosis CRISPR-edited newborn babies
