What is Insurance?
Insurance is, “a contract whereby, for a stipulated consideration, one party undertakes to compensate the other for loss on a specified subject by specified perils. The party agreeing to make the compensation is usually called the “insurer” or “underwriter;” the other, the “insured” or “assured;” the agreed consideration, the “premium;” the written contract, a “policy;” the events insured against, “risks” or “perils;” and the subject, right, or interest to be protected, the “insurable interest.” (Black’s Law Dictionary 946. 4th Ed. Rev. 1968)
An insurance policy is a contract in which an individual or entity (the policyholder) pays an insurance company (the insurer) in regular payments in exchange for financial protection over specific risks or losses. For example, medical insurance helps to cover medical costs, such as hospital visits, hospital stays, and medications. Similarly, auto insurance helps to cover damages incurred from car accidents. Insurance payments are known as premiums. Insurance contracts typically limit the amount of costs that an insurance provider may be required to pay.
The McCarran-Ferguson Act (15 U.S.C. § 1011) grants many aspects of insurance regulation to individual state governments. However, federal laws like federal taxes do apply to insurance, and must be acknowledged. Insurance is important to the legal system, as it helps protect individuals, those who cause harm to individuals through negligence, and any third party that is faced with the burden of compensating for an injury.
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Never Means Never Under New Policy Under Medicare
Editor: In this world of skyrocketing health-care costs and financial crises, some good news has finally come to the average American consumer and taxpayer.
Last week, Medicare changed its rules to withhold payment for certain “never events” — medical mistakes that should never occur, such as administering the wrong blood type or leaving an instrument inside a surgical patient. Medicare also says it won’t pay for serious bed sores, injuries from falls and urinary tract infections caused by catheters, among other things. Four state Medicaid programs, including Pennsylvania, as well as several of the nation’s largest health insurers, are following suit.
It’s about time. Unlike any other service we consume, we have been living — and dying — with a U.S. health-care system that rewards mistakes and profits by making patients sicker. Hospitals that fail to prevent deadly post-operative infections, turning three-day stays into three-month stays, […]
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The Limbo Stage: 21 Days to Accept or Deny
Once you have given notice of your injury to your employer, their insurance carrier has 21 days under the Workers’ Compensation Act to either accept or deny your claim for benefits. During this period of time, you are basically in limbo.
To accept the claim, the insurance carrier needs to file either one of two notices with the Bureau in Harrisburg. The first notice is a notice of temporary compensation payable. As the name implies, this notice temporarily accepts the claim for a period of 90 days to give the insurance carrier additional time to investigate your claim before making its final determination.
Prior to the end of the 90-day period, if the insurance carrier wishes to deny your benefits, they are required to file notice stopping temporary compensation. If the insurance carrier does not file the notice stopping the temporary benefits in the allotted time, […]
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Marion Munley in Philly for Seminar
Attorney Marion Munley is a featured speaker at the Lorman Education Services seminar, Trucking Litigation: Handling Various Issues Unique to Trucking in Pennsylvania today in Philadelphia.
Marion was chosen to lead the forum because of her expertise in trucking and commercial vehicle litigation. The purpose of the seminar is to educate attorneys, trucking industry officials, safety professionals and insurance representatives on the complex and changing issues surrounding catastrophic trucking cases.
Marion Munley is a partner here at Munley Law Personal Injury Attorneys. She is a graduate of Temple University School of Law, and is admitted to practice in the state and federal courts of Pennsylvania and New York. Munley is a Civil Trial Specialist, certified by the National Board of Trial Advocates, and is a named Diplomate of the National Board of Trial Advocacy. […]
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Marion Munley at Gerry Spence Trail Lawyers College
Marion Munley will be spending the rest of the week in the great state of Wyoming. She, along with the rest of the teaching staff at Gerry Spence Trail Lawyers College, will be meeting with the one and only, Gerry Spence and his team, to learn his freshest techniques, in order to educate and inspire incoming classes of trial attorneys.
Marion is an alumnus of TLC. After graduation, she was invited onto the teaching staff and has taught nearly a dozen seminars at Spence’s Wyoming ranch and across the country. TLC is truly something else; it molds everyday trail lawyers into warriors of justice and enables its students to more successfully try cases on behalf of ordinary people- not insurance companies, banks, or big business.
The Gerry Spence Trial Lawyers College was founded as a not-for-profit institution dedicated to the preservation of justice and the protection of the jury-trial system through the education of legal professionals. […]
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HIPAA- A Barrier Between You & Your Medical Records?
Back in 1996, when the Health Insurance and Portability and Accountability Act (HIPAA) was signed into law, the intention of the law (especially Title IV) was to protect a patient’s right to privacy, reduce fraudulent activity, streamline data systems and improve the health insurance system overall.
For years prior to the law’s passage, there was no federal standard for obtaining your medical records. Without the patient’s knowledge, records were being given to insurance companies, sent to landfills or just flat-out lost. Alerted by highly publicized lapses in medical record confidentiality (a garbage truck crash that sent medical records flying all over the highways, a doctor selling a computer without deleting patient information from the hard drive, and the list went on and on), lawmakers decided a better system was needed. So the whole theory behind HIPAA regs are that your medical records are just that, […]
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