I study the demand for health insurance during the COVID-19 pandemic using Special Enrollment Period (SEP) individual-level enrollment data from the Washington State Affordable Care Act Marketplace. I document that most individuals enrolling in plans during the pandemic are those who lost minimum essential coverage, followed by uninsured individuals making use of Washington’s limited-time SEP for uninsured individuals. I estimate a demand model and find that low-income individuals and young individuals are more premium sensitive. I find that 20.4 percent of the individuals in my analysis sample did not pay their initial premium. Individuals losing minimum essential coverage are less likely to pay their initial premium than individuals using the SEP for other qualifying events. Lower income individuals are less likely to pay the initial premium than higher income individuals. My results suggest three reasons for considering more generous premium subsidies during the remainder of the pandemic: (1) individuals losing minimum essential coverage are already using the exchange to replace lost coverage, (2) consumers are premium sensitive, and (3) there are meaningful differences across demographic groups in the probability of paying the first premium, which is necessary for coverage to take effect.
{"title":"Demand for Health Insurance in the Time of COVID-19: Evidence from the Special Enrollment Period in the Washington State ACA Marketplace","authors":"Gerardo Ruiz Sánchez","doi":"10.2139/ssrn.3683430","DOIUrl":"https://doi.org/10.2139/ssrn.3683430","url":null,"abstract":"I study the demand for health insurance during the COVID-19 pandemic using Special Enrollment Period (SEP) individual-level enrollment data from the Washington State Affordable Care Act Marketplace. I document that most individuals enrolling in plans during the pandemic are those who lost minimum essential coverage, followed by uninsured individuals making use of Washington’s limited-time SEP for uninsured individuals. I estimate a demand model and find that low-income individuals and young individuals are more premium sensitive. I find that 20.4 percent of the individuals in my analysis sample did not pay their initial premium. Individuals losing minimum essential coverage are less likely to pay their initial premium than individuals using the SEP for other qualifying events. Lower income individuals are less likely to pay the initial premium than higher income individuals. My results suggest three reasons for considering more generous premium subsidies during the remainder of the pandemic: (1) individuals losing minimum essential coverage are already using the exchange to replace lost coverage, (2) consumers are premium sensitive, and (3) there are meaningful differences across demographic groups in the probability of paying the first premium, which is necessary for coverage to take effect.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86979057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A key argument for providing unauthorized immigrants with driver licenses is that such policies will improve automobile insurance. The paper uses data on auto insurance take-up, claims, and premiums to test this argument in the context of California's Assembly Bill (AB) 60, which was implemented in January 2015. Exploiting cross-county variation in the estimated share of AB60 licenses, we find that even though more than one million licenses have been issued under the policy to date, it had no measurable effects on the rate of uninsured vehicles, uninsured motorists claims, or automobile insurance premiums. Our findings are supported by a power analysis and multiple robustness checks. We suggest that unauthorized immigrants may have already had access to cars and even auto insurance before AB60. In a highly car-dependent society, they had no choice but to drive even when it was illegal before 2015. As such, the effects of AB60 on the insurance market were negligible.
{"title":"Licensing the Insured: Providing Driver Licenses to Unauthorized Immigrants Has Not Impacted Auto Insurance in California","authors":"Hans Lueders, M. Mumper","doi":"10.2139/ssrn.3541901","DOIUrl":"https://doi.org/10.2139/ssrn.3541901","url":null,"abstract":"A key argument for providing unauthorized immigrants with driver licenses is that such policies will improve automobile insurance. The paper uses data on auto insurance take-up, claims, and premiums to test this argument in the context of California's Assembly Bill (AB) 60, which was implemented in January 2015. Exploiting cross-county variation in the estimated share of AB60 licenses, we find that even though more than one million licenses have been issued under the policy to date, it had no measurable effects on the rate of uninsured vehicles, uninsured motorists claims, or automobile insurance premiums. Our findings are supported by a power analysis and multiple robustness checks. We suggest that unauthorized immigrants may have already had access to cars and even auto insurance before AB60. In a highly car-dependent society, they had no choice but to drive even when it was illegal before 2015. As such, the effects of AB60 on the insurance market were negligible.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87583006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper summarizes the U.S. program for terrorism insurance, outlines its advantages and disadvantages, and describes the current proposals for extension of the program. The program, generally referred to as a “Federal Backstop,” functions in some ways that are similar to reinsurance, but it does not require participants to pay premiums ex ante. Instead uses an ex post recoupment mechanism to recover some or all of the Federal payments made under the program. This approach has the advantage of reducing the cost and increasing the availability of terrorism insurance. Some have criticized the program for its interference in market mechanisms, but the program facilitated the development of the market underneath the backstop. The program does not cover NBCR risk, and some types of insurance are excluded. In addition, the program does not preempt state price regulation or the mandated use of the standard fire insurance policy, which provides coverage for ensuing fires after terrorism events. These weaknesses are not addressed by current proposed legislation to extend the program for seven years without any changes. The strong, bipartisan support for the proposed legislation suggests that it is likely to pass.
{"title":"Terrorism Risk Insurance Act: Time to Renew . . . or Rethink?","authors":"J. Thomas","doi":"10.2139/ssrn.3525461","DOIUrl":"https://doi.org/10.2139/ssrn.3525461","url":null,"abstract":"This paper summarizes the U.S. program for terrorism insurance, outlines its advantages and disadvantages, and describes the current proposals for extension of the program. The program, generally referred to as a “Federal Backstop,” functions in some ways that are similar to reinsurance, but it does not require participants to pay premiums ex ante. Instead uses an ex post recoupment mechanism to recover some or all of the Federal payments made under the program. This approach has the advantage of reducing the cost and increasing the availability of terrorism insurance. Some have criticized the program for its interference in market mechanisms, but the program facilitated the development of the market underneath the backstop. The program does not cover NBCR risk, and some types of insurance are excluded. In addition, the program does not preempt state price regulation or the mandated use of the standard fire insurance policy, which provides coverage for ensuing fires after terrorism events. These weaknesses are not addressed by current proposed legislation to extend the program for seven years without any changes. The strong, bipartisan support for the proposed legislation suggests that it is likely to pass.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81212484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Travel insurance policies require insureds to take adequate precautions to protect their personal property including their luggage. They exclude cover for the loss or theft of personal property which has been left ‘unattended in a public place’. The relevant authorities on this exclusion including the often-cited decision by Lord Denning in the Starfire Case in the UK in 1962 would appear to give the final word to the insurer. However, caselaw is mixed and shows that a determined insured would have a good chance of success on appeal.
The fact that insurers regularly reject claims which are successful on appeal is another example of the conduct of the finance sector falling below community standards and expectations as demonstrated in the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry (Australia, 2018-2019). Wrongly rejecting claims can expose the insurer to several potential legal liabilities at common law and under statute.
This article recommends deleting the intricacies of the standard exclusion for property being left ‘unattended in a public place’ in favour of the standard policy condition that the insured must take adequate precautions to protect their personal property. It also recommends amendments to the Corporations Act 2001 (Cth) to empower the Australian Securities and Investments Commission (ASIC) to regulate the claims procedures of insurers.
{"title":"Loss of ‘Unattended Property in a Public Place’ – Testing the Good Faith of the Travel Insurer","authors":"P. Latimer","doi":"10.2139/ssrn.3501987","DOIUrl":"https://doi.org/10.2139/ssrn.3501987","url":null,"abstract":"Travel insurance policies require insureds to take adequate precautions to protect their personal property including their luggage. They exclude cover for the loss or theft of personal property which has been left ‘unattended in a public place’. The relevant authorities on this exclusion including the often-cited decision by Lord Denning in the Starfire Case in the UK in 1962 would appear to give the final word to the insurer. However, caselaw is mixed and shows that a determined insured would have a good chance of success on appeal. <br><br>The fact that insurers regularly reject claims which are successful on appeal is another example of the conduct of the finance sector falling below community standards and expectations as demonstrated in the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry (Australia, 2018-2019). Wrongly rejecting claims can expose the insurer to several potential legal liabilities at common law and under statute. <br><br>This article recommends deleting the intricacies of the standard exclusion for property being left ‘unattended in a public place’ in favour of the standard policy condition that the insured must take adequate precautions to protect their personal property. It also recommends amendments to the Corporations Act 2001 (Cth) to empower the Australian Securities and Investments Commission (ASIC) to regulate the claims procedures of insurers.<br>","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90069635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This investigative study examines the business of insurance from a loss exposure and coverage development perspective and compares its findings with current market practices dealing with cyber risk(s). It discusses the importance of government regulation of data and privacy protection for the public, in general, and insurance buyers, in particular. Evidence shows incomplete communication among information technology professionals, risk managers and insurance underwriters. Their efforts are inadequately coordinated, and each industry seems to have its own set of risk management guidelines. Evidence shows that insurance policies – including risk classification and policy wording – are not standardized, likely resulting in coverage gaps and a litigious claims environment. More importantly, the insurance market treats all insurable loss exposures and the parties exposed to them in cyberspace using a single policy approach – an approach for a world of risk in which human activities, artificial intelligence and machine-learning become complicated and are increasingly interconnected. This multiplicity-in-cause, multiplicity-in-outcome nature of the risks in the cyber world, of which coverages every individual and business will need, requires the insurance industry to evaluate whether this single policy approach is appropriate, and separately to agree on meaningful standardization of coverages. Finally, this study proposes that, as the cyber world adds more risks on top of cybersecurity-related loss exposures, the business of insurance is in transition to operations in the physical-cyber market.
{"title":"The Insurance Business in Transition to the Physical-Cyber Market: Communication, Coordination and Harmonization of Cyber Risk Coverages","authors":"W. Kwon","doi":"10.2139/ssrn.3201875","DOIUrl":"https://doi.org/10.2139/ssrn.3201875","url":null,"abstract":"This investigative study examines the business of insurance from a loss exposure and coverage development perspective and compares its findings with current market practices dealing with cyber risk(s). It discusses the importance of government regulation of data and privacy protection for the public, in general, and insurance buyers, in particular. Evidence shows incomplete communication among information technology professionals, risk managers and insurance underwriters. Their efforts are inadequately coordinated, and each industry seems to have its own set of risk management guidelines. Evidence shows that insurance policies – including risk classification and policy wording – are not standardized, likely resulting in coverage gaps and a litigious claims environment. More importantly, the insurance market treats all insurable loss exposures and the parties exposed to them in cyberspace using a single policy approach – an approach for a world of risk in which human activities, artificial intelligence and machine-learning become complicated and are increasingly interconnected. This multiplicity-in-cause, multiplicity-in-outcome nature of the risks in the cyber world, of which coverages every individual and business will need, requires the insurance industry to evaluate whether this single policy approach is appropriate, and separately to agree on meaningful standardization of coverages. Finally, this study proposes that, as the cyber world adds more risks on top of cybersecurity-related loss exposures, the business of insurance is in transition to operations in the physical-cyber market.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91394596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Is it fair and just to charge men and women identical life insurance premiums despite their different actuarial risk? What about charging the old and the young different premiums? As entities whose core business is to classify people based on their actuarial risk, should private insurance companies not be allowed to discriminate between various groups? To answer these and various other questions, I start this chapter by revealing the complete confusion that exists in the legal terrain with respect to antidiscrimination norms in insurance. I then show how philosophers writing about discrimination mostly have been writing at a level of abstraction so high that it comfortably ignores relevant nuances, thus making the entire literature largely useless for any insurance-related policy-making purposes. I conclude by proposing a theoretical framework that can help policy makers apply a fair and just anti-discrimination policy.
{"title":"Discrimination and Insurance","authors":"R. Avraham","doi":"10.2139/ssrn.3089946","DOIUrl":"https://doi.org/10.2139/ssrn.3089946","url":null,"abstract":"Is it fair and just to charge men and women identical life insurance premiums despite their different actuarial risk? What about charging the old and the young different premiums? As entities whose core business is to classify people based on their actuarial risk, should private insurance companies not be allowed to discriminate between various groups? To answer these and various other questions, I start this chapter by revealing the complete confusion that exists in the legal terrain with respect to antidiscrimination norms in insurance. I then show how philosophers writing about discrimination mostly have been writing at a level of abstraction so high that it comfortably ignores relevant nuances, thus making the entire literature largely useless for any insurance-related policy-making purposes. I conclude by proposing a theoretical framework that can help policy makers apply a fair and just anti-discrimination policy.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90965214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In International Energy Group v Zurich Insurance, the Supreme Court considered the implications of the special rule in Fairchild v Glenhaven Funeral Services Ltd for insurers’ for employers’ liability. The question for the Court was whether, in the light of its earlier decision in Durham v BAI (Run off) Ltd, insurers could be held liable for employees’ mesothelioma claims, even if the employer was not insured throughout the period of employment. The seven Justices unanimously held that insurers’ liability was proportionate to the period of insurance. In reaching that result, the majority recognised that the insurers were entitled to ‘equitable recoupment’ from insured‐employers in respect of periods during which they were uninsured. This note critiques the recoupment right with an unjust enrichment lens.
在国际能源集团诉苏黎世保险案中，最高法院考虑了仙童诉格伦黑文殡葬服务有限公司一案中特别规则对保险公司的影响’为雇主# 8217;责任。法院面临的问题是，根据其早先在Durham v BAI (Run off) Ltd的判决，保险公司是否可以对雇员承担责任。间皮瘤索赔，即使雇主在整个雇佣期间没有投保。七名大法官一致认为，保险公司’责任与保险期间成比例。在达成这一结果的过程中，大多数人认识到保险公司有权获得公平赔偿。向投保雇主提供他们未投保期间的信息。这篇文章用不公正的浓缩镜头批评了赔偿权。
{"title":"Unjust Enrichment in the ‘Fairchild Enclave’ International Energy Group Ltd v Zurich Insurance Plc","authors":"K. Krishnaprasad","doi":"10.1111/1468-2230.12306","DOIUrl":"https://doi.org/10.1111/1468-2230.12306","url":null,"abstract":"In International Energy Group v Zurich Insurance, the Supreme Court considered the implications of the special rule in Fairchild v Glenhaven Funeral Services Ltd for insurers’ for employers’ liability. The question for the Court was whether, in the light of its earlier decision in Durham v BAI (Run off) Ltd, insurers could be held liable for employees’ mesothelioma claims, even if the employer was not insured throughout the period of employment. The seven Justices unanimously held that insurers’ liability was proportionate to the period of insurance. In reaching that result, the majority recognised that the insurers were entitled to ‘equitable recoupment’ from insured‐employers in respect of periods during which they were uninsured. This note critiques the recoupment right with an unjust enrichment lens.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83931318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Section 1411 imposes a 3.8% surtax on investment income of high earners that mirrors Medicare taxes on earned income. The enactment of the net investment income tax highlights gaps in the employment tax rules for passthrough entities—particularly limited partnerships, S corporations, and limited liability companies. This Article considers how businesses can be structured to allow active high-income owner-employees of passthrough entities to avoid all three of the 3.8% Medicare taxes (SECA, FICA and section 1411). Part I considers the anachronistic limited partner exception to the SECA tax and the well-known S corporation loophole under the FICA tax, as well as the failure of section 1411 to reach active business income that avoids these employment taxes. Part II considers the recent Renkemeyer case, which has reignited the employment tax debate and threatens to upend structures used in investment and real estate funds to shelter management fees from all of the 3.8% taxes. Although repeal of section 1411 remains high on the Republican tax-cutting agenda, Part III suggests the need to reform (not repeal) section 1411 to backstop the employment tax rules for active passthrough businesses, regardless of organizational form. The proposed approach would curtail opportunities to avoid the 3.8% taxes, raise substantial revenue, and promote the goal of parity in the taxation of earned and unearned income. By contrast, tax legislation enacted in 2017 leaves intact planning to avoid employment taxes and section 1411, while dramatically lowering the income tax rate on business income. As a result, business taxation has grown increasingly incoherent, regressive, and unstable.
{"title":"Exploiting the Medicare Tax Loophole","authors":"K. Burke","doi":"10.2139/SSRN.3041694","DOIUrl":"https://doi.org/10.2139/SSRN.3041694","url":null,"abstract":"Section 1411 imposes a 3.8% surtax on investment income of high earners that mirrors Medicare taxes on earned income. The enactment of the net investment income tax highlights gaps in the employment tax rules for passthrough entities—particularly limited partnerships, S corporations, and limited liability companies. This Article considers how businesses can be structured to allow active high-income owner-employees of passthrough entities to avoid all three of the 3.8% Medicare taxes (SECA, FICA and section 1411). Part I considers the anachronistic limited partner exception to the SECA tax and the well-known S corporation loophole under the FICA tax, as well as the failure of section 1411 to reach active business income that avoids these employment taxes. Part II considers the recent Renkemeyer case, which has reignited the employment tax debate and threatens to upend structures used in investment and real estate funds to shelter management fees from all of the 3.8% taxes. Although repeal of section 1411 remains high on the Republican tax-cutting agenda, Part III suggests the need to reform (not repeal) section 1411 to backstop the employment tax rules for active passthrough businesses, regardless of organizational form. The proposed approach would curtail opportunities to avoid the 3.8% taxes, raise substantial revenue, and promote the goal of parity in the taxation of earned and unearned income. By contrast, tax legislation enacted in 2017 leaves intact planning to avoid employment taxes and section 1411, while dramatically lowering the income tax rate on business income. As a result, business taxation has grown increasingly incoherent, regressive, and unstable.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85602994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the last 11 years, the Law Commission and the Scottish Law Commission have worked on a joint project to modernise the law of insurance contracts. Due to the size of the project, the Law Commissions proceeded in phases and separated out specific issues for legislative reform. Their proposals have already resulted in the Consumer Insurance (Disclosure and Representations) Act 2012 and the Insurance Act 2015 which brought about significant changes for consumer and non-consumer insureds and insurers alike. This paper examines two further areas of reform: the introduction of an implied term about payment of insurance claims by insurers within a reasonable time and a statutory restatement of the doctrine of insurable interest. It considers the old and new substantive law and provides an insight into the reform process.
{"title":"Insurance Law Reform by Degrees: Late Payment and Insurable Interest","authors":"Franziska Arnold-Dwyer","doi":"10.1111/1468-2230.12267","DOIUrl":"https://doi.org/10.1111/1468-2230.12267","url":null,"abstract":"Over the last 11 years, the Law Commission and the Scottish Law Commission have worked on a joint project to modernise the law of insurance contracts. Due to the size of the project, the Law Commissions proceeded in phases and separated out specific issues for legislative reform. Their proposals have already resulted in the Consumer Insurance (Disclosure and Representations) Act 2012 and the Insurance Act 2015 which brought about significant changes for consumer and non-consumer insureds and insurers alike. This paper examines two further areas of reform: the introduction of an implied term about payment of insurance claims by insurers within a reasonable time and a statutory restatement of the doctrine of insurable interest. It considers the old and new substantive law and provides an insight into the reform process.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82711800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Two UK Supreme Court decisions have considered insurance fraud. The first, Versloot Dredging BV v HDI-Gerling Industries Versicherung (The DC Merwestone), concerned the use of a fraudulent device being harnessed to support a legitimate claim which, in the view of the majority, was an area of insurance law in need of re-evaluation. The second, Haywood v Zurich Insurance Co, concerned the use of fraud to increase the settlement paid by the insurer and whether an insurer, which suspects fraud but has nevertheless chosen to settle a claim, is entitled to set aside the settlement under the tort of deceit where it subsequently discovers proof that it was in fact fraudulent. This case note examines not only the legal implications of the decisions and their likely impact on industry practice, it also focuses on the broader issue of the proper province of the civil law and whether general deterrence can be justified as a proper objective where the criminal law is deficient in punishing fraud because of its higher standard of proof.
英国最高法院的两项判决涉及保险欺诈。第一起案件是Versloot Dredging BV诉HDI-Gerling Industries Versicherung (The DC Merwestone)，涉及使用欺诈性设备来支持合法索赔，在大多数人看来，这是一个需要重新评估的保险法领域。第二起案件是Haywood v Zurich Insurance Co .，涉及保险人利用欺诈手段增加支付的和解金额，以及如果保险人怀疑存在欺诈行为，但仍选择和解索赔，在随后发现证据证明其实际上是欺诈行为的情况下，是否有权根据欺诈侵权行为撤销和解金额。本案例说明不仅审查了这些决定的法律含义及其对行业实践的可能影响，还侧重于民法适当范围的更广泛问题，以及在刑法因其更高的举证标准而在惩罚欺诈方面存在缺陷的情况下，一般威慑是否可以被证明是一个适当的目标。
{"title":"Insurance Fraud and the Role of the Civil Law","authors":"P. Rawlings, Jon P. Lowry","doi":"10.1111/1468-2230.12269","DOIUrl":"https://doi.org/10.1111/1468-2230.12269","url":null,"abstract":"Two UK Supreme Court decisions have considered insurance fraud. The first, Versloot Dredging BV v HDI-Gerling Industries Versicherung (The DC Merwestone), concerned the use of a fraudulent device being harnessed to support a legitimate claim which, in the view of the majority, was an area of insurance law in need of re-evaluation. The second, Haywood v Zurich Insurance Co, concerned the use of fraud to increase the settlement paid by the insurer and whether an insurer, which suspects fraud but has nevertheless chosen to settle a claim, is entitled to set aside the settlement under the tort of deceit where it subsequently discovers proof that it was in fact fraudulent. This case note examines not only the legal implications of the decisions and their likely impact on industry practice, it also focuses on the broader issue of the proper province of the civil law and whether general deterrence can be justified as a proper objective where the criminal law is deficient in punishing fraud because of its higher standard of proof.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90484482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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