Health Insurance

Northern District of California finds that California's ban on discretionary clauses applied to health plan

A U.S. District court recently held that California’s prohibition on discretionary authority clauses in certain insurance policies applies to health insurance policies in a decision that has not yet been addressed by either the California Supreme Court or Ninth Circuit Court of Appeals. This ruling has the potential to make it easier for plaintiffs to recover for claims denials in court.

What Is An “Insurable Interest”

The existence of an insurable interest is essential to any insurance contract. As a general matter, an insurance policy is void unless the insured has an “insurable interest” in the subject of insurance.

What Is The Difference Between An Insuring Clause and Exclusions?

Property insurance can take two different forms: open peril or named peril. Open peril policies cover all losses that are not expressly excluded.

How Do Policy Limits and Deductibles Affect My Claim?

A typical property insurance policy limits the value of the particular property insured through deductibles and policy limits for claimed losses.

How Do Policy Exclusions Work?

Insurance policies follow the adage that “what is giveth is taketh away.”  The vast majority contain broad grants of coverage in the opening pages, only to be followed by numerous exclusions several pages later. 

What Is The Difference Between “First Party” And “Third Party” Coverage?

There are two broad categories of insurance: first-party and third-party. This article explains an easy way to understand the distinction is as follows.