|
|
|
Iowa insurers get more time on new health law
Legal Business |
2011/07/24 08:27
|
Iowa insurance companies have been given more time to comply with a new federal rule designed to curb insurers' profits.
The regulation that went into effect this year calls for insurance companies to spend at least 80 percent of premiums on medical care and quality assurance. For employer plans covering more than 50 people, the requirement is 85 cents. Insurers that fall short of the mark are required to issue their customers a rebate.
The U.S. Department of Health and Human Services told the state on Friday that Iowa insurers will be given have to reach the 80 percent mark by 2013, but will be required to meet interim goals until then, the Des Moines Register reported.
The Iowa Insurance Division had requested extra time to comply with the law, citing fears that insurers would leave the state in droves. Six pulled out of Iowa after the law was passed.
Steve Larsen, director of HHS' Center for Consumer Information and Oversight, said in a letter to the state that implementing the law in Iowa in 2011 could cause turmoil in the insurance market. So, he laid out a timetable for compliance that calls for Iowa insurers to spend 67 percent of premiums on medical care this year, 75 percent in 2012 and 80 percent in 2013.
Iowa insurance commissioner Susan Voss said she wasn't displeased by the decision. The state had sought even more time for companies to comply, but, "I don't think we'll see companies exit as a result of this," Voss said.
Of those particularly hard-hit by the law are insurers who sell individual policies because those premiums are more volatile. Employers or large groups can negotiate for better premiums, and the risk in those plans are spread among the group.
There are 56 insurance companies in Iowa that offer individual policies. Seven of those account for 95 percent of the market, with Wellmark holding onto almost 84 percent. Wellmark spent 92 percent of premiums on care but none of the state's other top insurers met the 80 percent standard in 2010.
Federal regulators said that had the law gone into effect this year, Iowa consumers would have received $6.5 million in rebates over three years.
|
|
|
|
|
|
|
Indiana Court of Appeals Disagrees Over Effect of Admissions
Law Blogs |
2011/07/21 09:03
|
Today, the Indiana Court of Appeals issued a memorandum decision, uncitable as authority under App. R. 65(D), in which the Court disagreed over the extent to which admissions could be used against a party in a motion for summary judgment in Clark v. Clark, Cause No. 01A02-1007-CT-759. While the decision itself cannot be used as precedent, the disagreement is informative.
In this case, a father and son traveled in a car together to the home of another person. When they arrived, the son got out of the car to help the father parallel park. The son positioned himself in front of his father's vehicle, between it and another vehicle parked in the alley. When the father's vehicle was in the appropriate position, the son signaled for the father to stop by putting his hand up. The father hit the gas pedal instead of the brake, and the son was pinned between his father's vehicle and the parked vehicle. The son sustained serious injuries to his leg. He brought suit against his father for his injuries and the father asserted the Indiana Guest Statute as an affirmative defense.
The Indiana Guest Statute provides that people with certain types of relationships, such as father-son, cannot sue each other for injuries arising out of the operation of a motor vehicle if the person is "in or upon" the vehicle at the time of the injuries. During the course of the litigation, the son sent requests for admissions to the father. Two of those requests and responses are reproduced below.
19. On September 5, 2007, at the time of the collision, Robert L. Clark, Jr. was not in the Chevrolet.
RESPONSE: At the moment of impact the plaintiff was not in the Chevrolet, whether he was a pedestrian is genuine issue for trial and therefore denied.
20. On September 5, 2007, at the time of the collision, Robert L. Clark, Jr. was not upon the Chevrolet.
RESPONSE: At the moment of impact the plaintiff was not upon the Chevrolet, whether he was a pedestrian is genuine issue for trial and therefore denied.
Based on those responses, the son moved for summary judgment. The father filed a cross-motion and the trial court granted the father's motion.
On appeal, the father argued that the admissions were not dispositive of whether the son was in or upon the vehicle at the time of his injuries because that is a legal conclusion that the Court would have to make after applying the law to the facts. The Court disagreed, holding that admissions can be directed to legal conclusions, not merely facts.
The dissent found the admissions ambiguous, because of the qualification about whether the son was a pedestrian and because there were questions concerning whether "in" and "upon" have the same generic meaning as they do as a legal term of art.
The lesson here is that requests for admissions can be powerful litigation tools and we lawyers must be careful when responding to them. You may find out that you have admitted something inadvertently.
Lesson:
1.Even a qualified response to a request for admission can count as an admission.
Brad A. Catlin
Price Waicukauski & Riley, LLC
http://www.indianalawupdate.com/entry/Indiana-Court-of-Appeals-Disagrees-Over-Effect-of-Admissions
|
|
|
|
|
|
|
Fresno DA charges woman after deadly bus crash
Topics in Legal News |
2011/07/20 09:25
|
A woman accused of providing alcohol to a teenage driver who caused a deadly Greyhound bus crash has been charged with a misdemeanor, officials said Tuesday.
Michelle Kay Cole, 22, was charged with purchasing an alcoholic beverage for a person under 21 resulting in death, Fresno County District Attorney Elizabeth Egan said at a news conference.
Cole was cited Monday but not arrested, Egan said. She could face up to six months in jail and a $1,000 fine if convicted.
A California Highway Patrol report placed sole blame for the crash on 18-year-old Sylvia Garay. Investigators said she was drunk when her SUV hit a concrete barrier and overturned on Highway 99 on July 22, 2010.
The oncoming bus, carrying 31 passengers on a route from Los Angeles to Sacramento, struck the SUV, skidded into a concrete center divider, then tumbled down a 15-foot embankment and plowed into a eucalyptus tree shortly after 2 a.m. a few miles from downtown Fresno.
Garay, her two passengers and three people on the bus were killed. Authorities say Garay had a blood alcohol level of .11 when she died. The legal limit is .08.
The CHP report said the bus driver had no way to avoid the SUV, which was left without lights when it overturned.
|
|
|
|
|
|
|
Ex-CEO convicted in scam at auto-chemical company
Court Watch |
2011/07/20 09:25
|
A former corporate executive officer of a New York-based automotive-chemical company was convicted Tuesday in a multimillion-dollar investor fraud scheme that enabled him to buy expensive jewelry and take private jets.
A jury in Manhattan state Supreme Court found Cleveland lawyer James Margulies guilty of charges including grand larceny and scheme to defraud. He faces up to 25 years on the top two counts, which could run consecutively. Bail was set at $1.5 million.
Ira London, an attorney for Margulies, said he planned to file "a very vigorous appeal."
"The jury has spoken. I believe they have convicted an innocent man," he said.
While serving as the company's finance chief — and briefly as CEO — of Industrial Enterprises of America, Inc., from 2004 to 2008, Margulies illegally issued millions of shares of stock to friends and relatives, inflating the share price by making the company look more profitable than it was, prosecutors said.
A teachers' pension fund in Ohio and a church were among the victims of the scheme, prosecutors said.
Margulies personally reaped more than $7 million, spending it on lavish luxuries such as a $350,000 diamond ring for his wife from jeweler Harry Winston, prosecutors said.
He also paid more than a million dollars on the mortgage of his first home, bought a second home and spent $500,000 on a vacation club membership, prosecutors said.
Margulies was charged in the scheme in 2010 along with John D. Mazzuto, who pleaded guilty Jan. 14 to his role in issuing fraudulent shares of stock.
|
|
|
|
|
|
|
When is a Person an Employee of Another?
Law Blogs |
2011/07/20 09:25
|
On July 19, 2011, the Indiana Court of Appeals issued a decision which I found surprising in McCann v. City of Anderson, ___ N.E.2d ___ (Ind. Ct. App. 2011), Cause No. 48A02-1009-PL-1060. At issue was whether a trial court had properly granted summary judgment on the question of whether a warrant officer was an employee of the Anderson City Court. Despite the procedural posture of the case and factors that weighed in favor of finding an employer-employee relationship, the Court affirmed a decision granting summary judgment to the defendants.
In this case, McCann was a police officer, who eventually became warrant officer for the Anderson City Court in 1998. He held that post until 2005, when the judge asked that McCann be reassigned. As a result of this dismissal, McCann filed suit based on the Indiana Wage Statute, arguing that he had been an employee of the Court and was entitled to funds that had been allocated to the position of warrant officer by that court. The parties filed cross-motions for summary judgment and the trial court granted the defendants' motion.
On appeal, the Court quoted GKN Co. v. Magness, 744 N.E.2d 397, 402 (Ind. 2001), for the seven factors that a court should consider when determining whether an employer-employee relationship exists. The Court then analyzed each of these factors and determined that three weighed in favor of the existence an employer-employee relationship and four against, with the "most important" factor weighing against.
Thus, over all, four of the seven factors, including the most important, "Control over the Means Used," indicate McCann was not an employee of the City Court. Because the City Court was not McCann's employer, he cannot be due any "unpaid wages" from the City Court. Therefore, he cannot assert a claim against the City Court under the Indiana Wage Statute.
The aspect of this decision that is most surprising is that the Court reached this conclusion despite the procedural posture of the case. It could have easily held that, viewing the facts in the light most favorable to McCann, the seven factors weighed both for and against a finding of an employer-employee relationship between McCann and the City Court created a genuine issue of material fact. This indicates that the factor the Court identified as being "most important", whether the purported employer exercised control over the means used by the purported employee to perform work, is very important indeed.
Lesson:
1.It will be exceedingly difficult to prove the existence of an employer-employee relationship if the purported employer did not exercise control over the means that the purported employee used to perform his work.
Brad A. Catlin
Price Waicukauski & Riley, LLC
http://www.indianalawupdate.com/entry/When-is-a-Person-an-Employee-of-Another
|
|
|
|
|
|
Legal News RSS Feed
