An alternative to health insurance marketplaces available through healthcare.gov are “short term” health insurance plans purchased through insurance brokers. These short term plans have surprisingly low premiums and even slimmer coverage. The problems with these short term plans have caused four states – California, Massachusetts, New Jersey, and New York – to ban them. Insurance brokers are incentivized with higher commissions to sell short term plans compared to Affordable Care Act (“ACA”) plans.  See more…
Health insurance plans provide coverage only for health-related serves that they define or determine to be “medically necessary.” Medical necessity refers to a decision by your health plan that your treatment, test, or procedure is necessary for your health or to treat a diagnosed medical problem. Most health plans will not pay for healthcare services that they deem to be not medically necessary. The most common example is a cosmetic procedure, such as the injection…
Punitive Damages Limited by Reprehensibility of the Defendant’s Conduct See the full video at https://rumble.com/ve5ycd-a-video-explaining-the-application-of-campbell-v.-state-farm-to-punitive-da.html?mref=6zof&mrefc=2 and at https://youtu.be/gLXRBMMm1i4 In State Farm Mut. Auto. Ins. Co. v. Campbell (2003) 538 U.S. 408, the United States Supreme Court held that “‘the most important indicium of the reasonableness of a punitive damages award is the degree of reprehensibility of the defendant’s conduct.’” (Id. at p. 419.) Moreover, in Campbell, the high court noted that its “‘holdings that a…
Buyers Remorse Insufficient to Change a Settlement Agreement Claxton Street Apartments, LLC, appealed the order disbursing $81,727.19 in escrowed insurance proceeds to defendant, the City of Detroit, pursuant to a settlement agreement between plaintiff, the City, and defendant, Western World Insurance Company in Claxton Street Apartments, LLC v. Western World Insurance Company and City Of Detroit, No. 350507, State Of Michigan Court Of Appeals (February 18, 2021). Claxton was upset with the terms of a…