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PROPERTY CASUALTY INSURANCE REGULATION IN THE UNITED KINGDOM
Richard Spiller, Esq.
REGULATION OF MULTI-STATE GROUP HEALTH INSURANCE
David L. Martin, Esq. The company proposing to insure a group1 with members in 10, 15 or even more states is truly in the middle of a regulatory quagmire. Although exceptions or exemptions exist, determining which jurisdictions have exemptions and how they apply could easily take weeks or months and require the expenditure of substantial amounts of money. Retaining lawyers or identifying the appropriate staff member at the regulatory bodies alone could amount to a major undertaking. Generally the need for information is on a far shorter time schedule. A potential group looking for insurance coverage may not be able to wait the weeks or months needed to insure regulatory compliance. Furthermore, the economic considerations of the insurer may militate against spending the time or money necessary to submit a proposal that may be rejected by the group or may be underbid by an insurer willing to take the risks of regulatory non-compliance.
RESCISSION OF HEALTH INSURANCE POLICIES AFTER HIPAA
Timothy S. Knowlton, Esq. The Health Insurance Portability and Accountability Act ("HIPAA") was intended to expand the availability of group and individual health coverage. HIPAA requires group and individual health insurers to provide coverage to individuals who, prior to its enactment, would not have met underwriting requirements because of their medical histories. In light of HIPAA, the only meaningful protection health insurers have against these substandard risks is the ability to charge higher than standard premiums, assuming that the applicable state insurance law permits such premium increases. This protective mechanism is, of course, highly dependent upon the health insurer obtaining accurate medical histories at the time group and individual risks are underwritten.
INVESTMENTS IN SUBSIDIARIES: SOME SPECIAL PROBLEMS
Robins H. Ledyard, Esq. General. This article examines some edge-of-the-envelope questions dealing with the effects that investments in subsidiaries may have on an insurance company's policyholders' surplus account. It emphasizes statutory accounting and regulatory perceptions in a highly technical area, with focus on some areas where the price imposed on an insurance company for taking the wrong course of action could be absolutely calamitous.
THE CURIOUS CASE OF RASKOB VS. SANCHEZ
Gary Kilpatric, Esq. On November 23, 1998 the New Mexico Supreme Court issued a slender two page opinion in a simple automobile negligence case which may wreak about as much havoc among auto insurers in New Mexico as the Queen of Hearts did in Alice's Adventures in Wonderland or its effects may disappear like the Cheshire cat as described by Lewis Carroll in that same classic tale, leaving only a trace of a smile.
THE GOLDEN RULE OF SOVEREIGN IMMUNITY: THE KING CAN DO NO WRONG
Frank R. Liggett, III, Esq. Generally, insurance regulators are immune from tort liability arising from fundamental government policy and decision-making. Insurance regulators are afforded this immunity through the same federal and state statutes that protect all government officials for their legislative, judicial and administrative acts. Under these statutes, an insurance regulator or any other public officer is protected from liability as long as he "... lawfully exercises the judgment and discretion with which he is invested by virtue of his office ... keeps within his scope of his official authority, and acts without malice or corruption." This language means that a public officer will not be held officially liable for executing the duties of his office or personally liable for the tortious consequences of his actions, providing they are not unlawful or performed out of spite. Naturally, the question arises as to what extent a regulator may take action before his behavior is beyond his "scope of authority," "corrupt" or "malicious"?
ADVERSE UNDERWRITING DECISION DILEMMA IN VIRGINIA
Ben R. Lacy, IV, Esq The Virginia Insurance Information and Privacy Protection Act (the "Virginia Act") was passed by the Virginia General Assembly during the 1981 Session and took effect on January 1,1982. It generally duplicated the Adverse Underwriting Decision Law found in the old Unfair Trade Practice Act but is now a separate chapter and section in 17 states and is modeled on the NAIC Insurance Information Privacy Protection Model Act (the "Model Act"), as revised in December, 1980. |
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