Regulatory News

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MISSISSIPPI
Gov. Haley Barbour vetoes $20 million subsidy to state wind pool that had been approved by legislature. Money would have been diverted from the Hurricane Disaster Reserve Fund and would not have been available, if moved, for use in federal disaster-related matches in the case of wind damage disasters, such as the April 2010 spate of tornadoes. Commissioner Mike Chaney says the veto won’t affect coastal wind pool rates; there is enough in reserve.
www.mid.state.ms.us/

MONTANA
U.S. Supreme Court refuses to hear a case that argued against Insurance Commissioner John Morrison’s prohibition of a clause in group health and disability policies that gives insurers discretion over which claims they will pay. He implemented the rule in 2003, and it was challenged in court in 2006. The court’s refusal allows the prohibition on discretionary clauses to stand, making capricious claims denials more difficult.
http://sao.mt.gov

NEW MEXICO
Deputy insurance chief, Thomas Rushton, resigns. No reason given. Craig Dunbar will now serve as interim super. Morris Chavez resigned the commissioner’s post in May reportedly over a negative response to a contentious health insurance rate case.
www.nmprc.state.nm.us/insurance/inshm.htm

NEW YORK
Two insurance agent/broker groups have filed a joint lawsuit to enjoin the state from implementing Insurance Regulation 194, which would require producers, as of Jan. 1, 2011, to disclose certain information on compensation to clients whether the client requests it or not. >> State approves state agents group’s 226-word boilerplate statement as sufficient for compliance with compensation disclosure regulations.
www.ins.state.ny.us

OHIO
Approves 3.9% private employer premium decrease beginning July 1. >> State Supreme Court rules that wages lost from an employee’s second job can be considered in determining temporary total disability compensation for an injury received at a first job under the latter employer’s workers comp policy.
www.insurance.ohio.gov

OKLAHOMA
Mark Croucher, an agency owner in Jenks, Okla., has declared his candidacy for insurance commissioner post. He specializes in health, life and senior-oriented products. >> Gov. Brad Henry signs law requiring Senate confirmation of his nominees to Workers Compensation Court and reducing the number of court judges from 10 to eight. Five judges must be assigned to Oklahoma City and three to Tulsa, and judges must have five years experience in the field.
www.oid.state.ok.us

TEXAS
State Supreme Court refuses to review a workers comp stop loss exception case from the Austin Court of Appeals. Vista Medical Center had argued that the stop loss exception on medical charges should apply to all admissions for which it charged more than $40,000. The insurer in the case, Texas Mutual, argued that the provider had to meet additional criteria, according to the law, including that the services provided were “unusually extensive.” The court ultimately sided with Texas Mutual by refusing to review the Austin court’s decision for the insurer and, in so doing, sets precedent for any remaining fee disputes under the stop loss exception to the old workers comp reimbursement rules. (Those rules were repealed in 2008 but still affect some outstanding disputes.) >> Insurance Department officially proposes rule to ban use of discretionary clauses in policies, which make it easy for insurers to deny benefits in disability, life, accident and health coverage.
www.tdi.state.tx.us

UTAH
Neal Gooch sworn in as new insurance commissioner, replacing Kent Michie, who retired in January.
www.insurance.utah.gov

VERMONT
Promotes Mike Bertrand to insurance commissioner, replacing Paulette Thabault, who has joined CVS Caremarks MinuteClinic division as chief nurse practitioner officer. >> Twenty-year veteran Peter Raymond leaves as director of captive insurance to become a contract examiner and consultant for the Florida Hurricane Catastrophe Fund. He is succeeded by Sandy Bigglestone, who has 13 years with the department.
www.bishca.state.vt.us