Insurance Law is, as the name implies, the body of law pertaining to insurance. This includes insurance policies, insurance claims, insurance regulations and rates, and recently enacted laws, like the Affordable Care Act. Basically, insurance law can be broken into three categories: the business of insurance, the content of insurance policies, and the handling of claims.
Business of Insurance
These laws affect the requirements for companies wishing to operate the insurance industry. These laws can vary widely from state to state, but can affect things like ensuring the insurance company will have sufficient liquidity to cover claims in the event of catastrophic events or natural disasters. These laws also govern licensing insurance companies, regulating who insurance companies can turn away from coverage, the types of insurance a company must offer in a jurisdiction if it wishes to offer other policies, and many others.
Content of Insurance Policies
Laws related to the content of insurance policies are designed to prevent predatory practices that would essentially let insurers offer worthless or diminished value policies. They also prevent insurers from misleading clauses and titles on policies that would allow an unsophisticated buyer to believe that they are buying one type of insurance but receive another. These laws also govern other provisions, like reasonable cancellation, disclosures to third parties, and delineations of insured and uninsured events.
Handling of Claims
These laws affect how insurance companies must respond when a claim is made. They prevent insurance companies from denying claims unreasonably. They also prevent insurance companies, in certain instances, from canceling policies simply for making claims. They also affect how insureds can make claims and what happens if someone attempts to make a fraudulent claim.
Affordable Care Act / "Obamacare"
The Patient Protection and Affordable Health Care Act, also known simply as the Affordable Care Act or “Obamacare,” is a sweeping set of federal laws designed to increase the quality and affordability of health insurance, lower the rate of uninsured Americans by increasing public and private insurance coverage, and reduce the costs of healthcare for both individual citizens and the government. To do this, it uses a number of mechanisms, like mandates, subsidies, and insurance exchanges, to promote coverage and affordability. The Affordable Care Act also requires insurance companies to cover all applicants, including those with preexisting medical conditions and without regard to gender, provided they meet new minimum standards for coverage.
Although the Affordable Care Act has been a hot button issue for political controversy, the United States Supreme Court upheld the constitutionality of the Affordable Care Act in the case of National Federation of Independent Business v. Sebelius. However, the Court also held in that case that states cannot be forced to participate in the Affordable Care Act's Medicaid expansion under penalty of losing their current Medicaid funding. Since that ruling, politicians have hotly contested the law's implementation, including a bid by Congressional conservatives to force a repeal of the law by exercising Congress's “purse power” and allowing a brief federal government shut down to occur in 2013 rather than pass a budget that included funding for the implementation of the Act.
If you have questions about insurance laws, you can review the materials found below for more information or use our Law Firms page to find an attorney in your area who can assist you.
Know Your Rights!
- If You Ever Work From Home, How Protected Are You If A Disaster Strikes?
Millions of Americans work from home, either all of the time or on occasion. But, if a fire, flood, or natural disaster were to hit your home, would your insurance cover the lost business revenues, office equipment, or property belonging to your company?
- Legally Speaking, What is an Act of God?
Contracts talk about them, statutes mention them, even TV sitcoms joke about them, but what are acts of God? Many people might think they have a good idea, but given that insurance is often designed to protect against most catastrophes except acts of God, how confident are you that you actually know what is covered?
- What is the Difference Between Short- and Long-Term Disability Coverage?
In simplest terms, short-term disability (also known as “STD”) covers a percentage of an insured person's lost salary should injury or illness prevent them from working for more than a few days. Long-term disability (also known as “LTD”), on the other hand, is designed to protect an insured from catastrophic illness or injury that permanently end the insured's ability to earn a paycheck.
- What To Do After a Tornado or Other Natural Disaster
When any sort of natural disaster hits, it can be terrifying. Once it has passed, though, victims are often left wondering what they need to do to pick up the pieces. Is there anything they need to do in filing their insurance claims to make sure that they will get paid soon and as much as possible?
Articles About Insurance Law
- New Texas Legislation Provides Consumer Protections Concerning Freestanding ERsAs the Texas Tribune reports, a couple of pieces of legislation recently passed into law in Austin will provide considerable protection for Texas health care consumers with regard to freestanding emergency rooms. Freestanding emergency rooms are facilities, often located in strip shopping malls, which are not attached to any hospital.
- Types of Insurance Products that Can Protect Your BusinessThere are many types of insurance needed to protect the company that has been built, but many individuals are unaware they are even needed. To ensure the business is safeguarded from various incidents, problems and complications, it is important to purchase insurance and similar items that could assist in preventing possible issues from arising.
- Hacking and Duping: Legal Risks in Do-It-Yourself Crafting and AlterationsSomeone recently asked about the legal implications of altering something yourself, such as piece of furniture, of selling the altered furniture in person, of selling the altered furniture via the Internet, of making a copy of the furniture, of instructing others on how to perform these alterations. In the current vernacular, some people call these efforts, a hack or a “mod” (as in modifying) or a “dup” (as in duplication).
- What Are First Party Benefits and How Do I Get Them after a Motor Vehicle Accident?So, you’ve been in a motor vehicle accident and been injured. Now what? What do you do about your medical bills? What about your lost wages? What about the damage to your vehicle? These are important questions that demand answers.
- Preparing Yourself for an Examination Under OathIn Wisconsin, when you file a fire loss claim, water damage claim, or other property damage claim against your insurance company, your insurance policy most likely allows your insurer to take your examination under oath. What is an examination under oath, and why would you have to attend one if you were filing an insurance claim?
- Insurance Settlements and Service ProvidersSome people are provided additional amounts of compensation after an insurance company gives out a settlement. When this is larger than the repairs from a service provider or company, it is important to know what occurs next.
- When Is the Filed Rate Doctrine a Defense to an Antitrust Lawsuit?The doctrine of federal antitrust law includes several immunities and exemptions—entire areas that are off limits to certain antitrust actions. This can be confusing, especially because these “exceptions” arise, grow, and shrink over time, at the seeming whim of federal courts.
- Pursuing a Bad Faith Insurance ClaimWhen an insurance company has denied coverage, is unwilling to provide a settlement and similar matters, an insurance company may be involved in bad faith claims. This means the carrier is attempting to get out of providing entitled monetary compensation for a policy that has coverage of the damage caused by the incident.
- Intersection between Arson and Insurance FraudArson usually involves at least one other crime when committed such as insurance fraud. This happens when the person that sets the fire also has an insurance policy on the building and causes the immolation for the settlement the carrier would provide.
- When Insurance May Not Cover Issues in Real EstateWhen someone purchases a property, it is advised to also buy associated insurance for a myriad of protections. A policy could protect from fires, floods, theft and similar concerns. However, it is crucial to understand what types of safety are not provided in these types of coverage as well.
- All Insurance and Reinsurance Law Articles
Articles written by attorneys and experts worldwide discussing legal aspects related to Insurance and Reinsurance including: bad faith insurance, insurance defense, insurance fraud and medical insurance.
Department of Insurance by State
Insurance and Reinsurance Law - US
- ABA - Tort Trial and Insurance Practice Section
Issues addressed within the committee include regulation of both life and health and property and casualty insurance entities at the state level, subject to Congressional oversight, for purposes of promoting the soundness and solvency of insurers. Protecting consumers, promoting the availability and affordability of essential insurance and assuring fair insurance trade practices are also examined.
- Federal Deposit Insurance Corporation - Legislation
There is hereby established a Federal Deposit Insurance Corporation (hereinafter referred to as the Corporation) which shall insure, as hereinafter provided, the deposits of all banks and savings associations which are entitled to the benefits of insurance under this chapter, and which shall have the powers hereinafter granted.
- Federal Insurance Contributions Act (FICA)
FICA stipulates that there is a maximum that can be allocated to Social Security, while there is no maximum on what can go toward Medicare. Once the maximum to Social Security is achieved, the contributor's FICA payment will not increase the Social Security portion but will continue to increase the contribution to Medicare. The amount of the FICA payment depends on the income of the contributor; the higher the income, the higher the FICA payment.
- Financial Reinsurance - Wikipedia
Financial Reinsurance (or fin re), is a form of reinsurance which is focused more on capital management than on risk transfer. In the non-life segment of the insurance industry this class of transactions is often referred to as finite reinsurance. One of the particular difficulties of running an insurance company is that its financial results - and hence its profitability - tend to be uneven from one year to the next. Since insurance companies generally want to produce consistent results, they may be attracted to ways of hoarding this year's profit to pay for next year's possible losses (within the constraints of the applicable standards for financial reporting). Financial reinsurance is one means by which insurance companies can "smooth" their results.
- Insurance Law - Overview
A contract in which one party agrees to indemnify another against a predefined category of risks in exchange for a premium. Depending on the contract, the insurer may promise to financially protect the insured from the loss, damage, or liability stemming from some event. An insurance contract will almost always limit the amount of monetary protection possible.
- Insurance Library Association of Boston
Founded in 1887, the Insurance Library Association of Boston is the leading resource for and provider of literature, information services, and quality professional education for the insurance industry and related interests.
- Old-Age and Survivors Insurance Benefit Payments
In the United States, Social Security refers to the federal Old-Age, Survivors, and Disability Insurance (OASDI) program. The original Social Security Act (1935) and the current version of the Act, as amended encompass several social welfare and social insurance programs. The larger and better known programs are: * Federal Old-Age, Survivors, and Disability Insurance * Unemployment benefits * Temporary Assistance for Needy Families * Health Insurance for Aged and Disabled (Medicare) * Grants to States for Medical Assistance Programs (Medicaid) * State Children's Health Insurance Program (SCHIP).
- Reinsurance - Wikipedia
Reinsurance is a means by which an insurance company can protect itself with other insurance companies against the risk of losses. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.).
Insurance and Reinsurance Law - International
- EU Insurance Legislation
A single insurance market, promoting economic efficiency and market integration, requires a common framework, to allow insurers to operate throughout the EU and to establish and provide services freely.
- International Association of Insurance Law (AIDA)
AIDA was formed in 1960 for the purpose of promoting and developing, at an international level, collaboration between its members with a view to increasing the study and knowledge of international and national insurance law and related matters.
Organizations Insurance Law
- AIDA Reinsurance and Insurance Arbitration Society, ARIAS - US
The AIDA Reinsurance and Insurance Arbitration Society, ARIAS·U.S., is a not-for-profit corporation that promotes improvement of the insurance and reinsurance arbitration process for the international and domestic markets.
- American Insurance Association (AIA)
The American Insurance Association (AIA) is the leading property-casualty insurance trade organization, representing 350 insurers that write more than $123 billion in premiums each year. AIA member companies offer all types of property - casualty insurance, including personal and commercial auto insurance, commercial property and liability coverage for small businesses, workers' compensation, homeowners' insurance, medical malpractice coverage, and product liability insurance.
- Forum of Insurance Lawyers - FOIL
The Forum of Insurance Lawyers (FOIL) is an organization for lawyers who act predominantly or exclusively for insurance companies. It also lobbies actively on insurance litigation issues. Much of the content of its web site is restricted to members only, but some news and information is freely available.
- Insurance Information Institute (I.I.I.)
The mission of the Insurance Information Institute (I.I.I.) is to improve public understanding of insurance -- what it does and how it works.
- Interstate Insurance Product Regulation Commission (IIPRC)
The Interstate Insurance Compact (“Compact”) is an important modernization initiative that benefits state insurance regulators, consumers and the insurance industry. The Compact enhances the efficiency and effectiveness of the way insurance products are filed, reviewed and approved allowing consumers to have faster access to competitive insurance products in an ever-changing global marketplace. The Compact promotes uniformity through application of national product standards embedded with strong consumer protections.
- National Association of Insurance Commissioners (NAIC)
The mission of the NAIC is to assist state insurance regulators, individually and collectively, in serving the public interest and achieving the following fundamental insurance regulatory goals in a responsive, efficient and cost effective manner, consistent with the wishes of its members.
- National Association of Professional Insurance Agents (PIA)
The National Association of Professional Insurance Agents (PIA) represents independent Professional Insurance Agents in all 50 states, Puerto Rico and the District of Columbia. Our members are local Main Street Agents who serve their communities throughout America.
- National Insurance Producer Registry (NIPR)
Incorporated in October 1996, the National Insurance Producer Registry (NIPR) is a non-profit affiliate of the National Association of Insurance Commissioners (NAIC). NIPR developed and implemented the Producer Database (PDB) and the NIPR Gateway. NIPR is governed by a 13 member board of directors, with 6 members representing the NAIC, 6 industry trade association representatives, including 3 producer trades and the CEO of the NAIC as an ex-offcio voting board member.
- Property Casualty Insurers Association of America
PCI is constantly working to develop innovative programs to organize our members and strengthen the influence of property casualty insurers nationwide. PCI political programs focus on participating in the political process through campaigns and elections, and by contacting legislators on important public policy measures. Companies learn many ways to maximize the pro-business vote and gain access to advocacy resources that makes the process of educating, organizing and motivating voters seamless.
- Reinsurance Association of America (RAA)
The Reinsurance Association of America (RAA) is a national trade association, headquartered in Washington, D.C., that is committed to an activist agenda to represent the interests of the property and casualty reinsurance industry in Congress, state legislatures, and international forums. As a benefit to its membership, the RAA also offers unparalleled resources for its membership: continuing reinsurance education programs, unique industry underwriting statistics, and premier reinsurance legal references.
Publications For Insurance Law
- Deposit Insurance Assessment Appeals - Guidelines and Decisions
On April 13, 2010, the Federal Deposit Insurance Corporation Board of Directors adopted Guidelines for Appeals of Deposit Insurance Assessment Determinations. The Guidelines govern the Assessment Appeals Committee (AAC) process. The Guidelines reconstitute the AAC and set out procedures for appeals to the AAC.
- Publications of Chartered Property Casualty Underwriters (CPCU)
CPCU Society know that your professional success depends on keeping up to date with the latest news and trends in the industry. That's why they give you quick, easy access to one of the most comprehensive publication libraries around, ranging from resources on academic developments in the insurance industry to the latest news from the interest groups.