Insurance Business & Regulatory News - Spring 2012


In This Issue:

- NAIC Changes Target Insurance Holding Company System

- Delaware Series LLC Captive Insurance Programs

- State Spotlights

- Insurance Business and Regulatory Law

Excerpt from State Spotlights

Arizona Spotlight By Christina Geremia and John F. Barwell

Two Arizona trial courts recently held that a Medicare Advantage (MA) plan lien is unenforceable. These decisions mirror a long progeny of federal decisions reaching the same result.

In Pradia v. Recovery Management Systems (Maricopa County Cause No. CV2011-014963)(Jan. 25, 2012), the Arizona Superior Court considered whether federal Medicare law preempted Arizona law and provided a private right of action to enforce the MA plan lien. The court, relying on Ferlazzo v. 18th Ave. Hardware, Inc., 33 Misc. 3d 421, 423- 26, 929 N.Y.S.2d 690, 692-94 (Sup. Ct. 2011), held that the MA plan’s right of reimbursement “stemmed from a private contract made with the enrollee,” and not federal law. Further, because Arizona’s anti-subrogation doctrine, as articulated in Allstate Ins. Co. v. Druke, 118 Ariz. 301, 304, 576 P.2d 489, 492 (1978), prohibits the assignment of a personal injury claim, the MA lien was held to be unenforceable under state law...

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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