bhoffman | August 25, 2010
Coordination of Benefits
The common-law collateral source rule is intended to ensure that a person who suffers a financial loss as a result of other person’s wrongdoing does not achieve reimbursement of more than 100 percent of the loss from all sources. In Ohio, the modern collateral source rule is governed by a statute that permits [...]
bhoffman | August 12, 2010
CCH® BENEFITS, www.hr.cch.com
California
The California Public Employee’s Retirement System (CalPERS) has approved an average increase of more than 9% in health premiums next year for state and local government workers. CalPERS blamed the rate increase on rising costs for hospital care, doctor visits, and prescriptions. The increase will mean higher premiums for public agencies and their [...]
Adam V. Russo | May 17, 2010
Case: Galion Community Hospital v. Hartford Life & Accident Ins. Co,, No. 1:08-cv-1635, in the United States District Court for the Northern District of Ohio, Eastern Division, May 7, 2010).
Mr. Croft’s Comment: This case involves two arguably conflicting provisions in an advance funding endorsement concerning the timing of submission of requests for advance funding:
To be [...]
Adam V. Russo | May 7, 2010
On May 4, 2010, the Ohio Supreme Court issued a decision in Jaques v. Manton, Slip Opinion No. 2010-Ohio-1838, and held that a defendant in a personal injury lawsuit is not barred by Ohio’s collateral source statute from introducing evidence of medical bill “write-offs” – the difference between the amount reflected on the medical bill [...]
Adam V. Russo | March 3, 2010
The Ohio Bar Association’s new Subrogation Committee held its first meeting today to try to formulate what the purpose of this committee is. The committee developed a working statement which states as follows: “Parties injured by a wrongdoer often are not receiving full or fair compensation in part because of subrogation laws of Ohio.” The [...]
Adam V. Russo | February 1, 2010
MyHealthGuide Source: Meredith Z. Maresca, BNA’s Pension & Benefits Daily, 1/27/2010, www.bna.com
In a decision addressing identification of the proper defendant in a benefit claim action brought pursuant to the ERISA’s civil enforcement provision, the U.S. District Court for the Southern District of Ohio held that the health plan’s TPA potentially could be liable for the [...]
Adam V. Russo | November 23, 2009
By TIM HULL
(CN) – An insurance company must award benefits to an Ohio man who lost his leg in a drunken motorcycle crash, the 6th Circuit ruled, because the incident falls within the broad definition of an “accident.”
Adam V. Russo | August 31, 2009
From The Bench – The Self-Insurer Volume 26* August 2009
By John H. Eggertsen, Esq. and Michael Friedman, Esq.
After the U.S. Supreme Court’s recent decision in Metropolitan Life Ins. Co. v. Glenn ___ U.S.___, 128 S. Ct. 2343 (2008), many circuit courts have been applying a magnifying glass to their prior standard of review decisions, and [...]
Adam V. Russo | May 27, 2009
by Andy Thompson, www.mariettatimes.com
The Ohio House of Representatives recently passed a budget bill that included yet another mandate for state-regulated health insurance plans – a mandate that falls squarely on the backs of the small business and individual policy holders that are already struggling with higher costs than other insured groups (self-insured companies, government plans [...]
Adam V. Russo | April 27, 2009
by Friedman, Domiano, & Smith, Co., L.P.A., please visit us at http://www.fdslaw.com
In a tort action in Ohio, a defendant is barred from introducing evidence of insurance payments to a plaintiff. This is known as the collateral source rule. The objective of the collateral source rule is to prevent liable defendants from benefitting from payments made [...]
Adam V. Russo | June 13, 2008
California
The California Assembly Health Committee recently passed a series of bills that will mandate expansion of specific benefits and health services for insurers. Benefits and services include mental health coverage (AB1877), screening and diagnostic test for gynecological cancer (AB1774), HIV testing (AB1894), maternity health care (AB1962), and breast cancer screening (AB 2234). Insurance plans [...]
