Vetoed The Insurance Law Foundation Act’' or “ILF Act

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Aladeen

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State Department
Redmont Bar Assoc.
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Aladeen22
Aladeen22
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A
BILL
To

Establish the foundation of Insurance Law

The people of Democracy Craft, through their elected representatives in the Congress and the force of law ordained to that Congress by the people through the constitution, do hereby enact the following provisions into law:


1 - Short Title and Enactment
(1) This Act may be cited as the ”The Insurance Law Foundation Act’' or “ILF Act”.
(2) This Act shall be enacted immediately upon its signage.
(3) The Act has been co-sponsored by: President Pro Tempore GoldBlooded


2 - Purpose
Insurance law shall provide the citizens of Redmont a safety net when facing fines, injunctions, damages, or other sort of legal damages where the government has a legal right to take money from an individual. By providing a safety net for all citizens, this law shall also protect business interests who want to engage in legal relations in regards to loans, contracts, or other forms of financial transfers from the risk of players being judgment proof.


3 - Responsibilities
(1) Sets out the foundation for the area of insurance law and legal guidance
(2) Gives simple definitions and terms for both private and public insurance.
(3) Sets the standard for legal practitioners/advocates to work from.
(4) Helps ensure that people are given some money when they would otherwise not have it.


4 - Insurance Recognition
(1) The Following Insurance Types shall be recognized by the legal system of Redmont:
(a) Liability Insurance
(b) Medical Insurance
(2) While other sorts of insurance can be established through contracts, the Federal Court of Redmont will determine whether or not the contract qualifies as insurance or a misrepresentation of insurance.




5 - Public Insurance By Statute
(1) The government shall have by law two public insurances run by the Executive Branch.
(a) Lawcare shall be Liability Insurance run by the DEC and overseen by Auditors and the DEC Secretary and managed by Section 6 of this law.
(b) Medicare shall be Medical Insurance run by DOH and overseen by Medical Specialist and the DOH Secretary and managed by the Medicare Guide of the forums and executive orders that relate to it.

6 - Lawcare Public Liability Insurance
(1) The DEC shall provide insurance for all citizens of Redmont who have accumulated 12 hours of playtime within Redmont. This insurance shall be named “Lawcare”.
(2) Lawcare shall by law provide for all eligible citizens liability protection in the event of monetary damages or injury determined as a result of a court case.
(3) Lawcare shall have limits on how much liability protection any one citizen can have.
(a) All citizens are eligible for up to $1000 dollars in liability protection.
(b) If the liability is greater than $10,000 dollars, then a citizen is eligible for an additional $250 dollars in liability protection.
(c) For every $10,000 dollars in liability after the first $10,000, a citizen is eligible for an additional $250 dollars in liability protection. Capping at $100,000 dollars for $3,500 dollars of liability protection.
(4) Liability protection shall be paid out from the DEC Government Budget.
(a) The DEC must keep $25,000 or 20% of the budget, whichever is lower, of its budget set aside for Lawcare.
(b) The DEC cannot use the money set aside for Lawcare for anything other than Lawcare.
(c) If Lawcare runs out of money for the month, the DEC Secretary or the President may request emergency appropriations from Congress for Lawcare.
(5) Lawcare claims are handled by an individual auditor, who is assigned by the DEC Secretary, Deputy DEC Secretary, or The DEC Temporary Secretary. If a case is not assigned by one of the aforementioned roles, then an auditor shall be assigned to a claim by rotation. Auditors are allowed to limit payouts on claims for any of the following reasons.
(a) If the Lawcare budget is equal to or less than half of the Public Liability Insurance appropriated amount for the month. An Auditor can choose to halve the payment given to a claim.
(b) An Auditor can choose to halve the payment of a claim if the claimant has a criminal record.
(c) If an Auditor believes that any sort of fraud on the part of the claimant may be involved in the claim or the court case, they can reject all payment of a claim until the fraud can be resolved in a court case.
(d) An Auditor can choose to reject a claim if a claimant or organization that the claimant is in has already claimed insurance once this current month.
(e) An auditor will reject your claim if it is used to pay off damages as a result of your criminal activity.
(6) Lawcare protection shall only kick in if the Claimant does not have any other private liability insurance.
(7) Appeals to Lawcare claim rejections are to be handled by the District Court utilizing the Public Defender system for lawyers to defend the program, overseen by the Attorney General’s Office who shall be in charge of the defense of the program.
(8) The program must be run via the ticket tool to generate private and secure communications for claimants. The discord it is located in does not matter, but must stay in the location in the place chosen for it.
(9) Any funds within Lawcare’s budget that goes unused returns to the DC Government account, including money awarded due to Lawcare Insurance Fraud.


7 - Private Liability Insurance Rules
(1) Private Liability Insurance is allowed for the purposes of providing greater protection than the public option Lawcare offers.
(2) Any corporation is allowed to open their own Liability Insurance department as a subsidiary of the company or any company can choose to directly become an insurance provider.
(3) Private Liability Insurance is allowed to set up their insurance program however they wish within reason and within legal boundaries.
(a) They are allowed to reject claims for people for the same reasons that the government chooses to in addition to any additional reasons that they may come up with. Though additional reasons for withholding claim payment is subject to court scrutiny.
(b) Private Liability Insurance can choose to make a tiered system where players are allowed to choose the type of coverage they want.
(c) Private Liability Insurance is allowed to sell their services as a product via contract. Both sides are expected to keep up their respective ends of the deal and breaks in contract shall be scrutinized by the court using the Contract Law Foundation Act.
(4) In order to become a Private Liability Insurance company or subsidiary, the company must register with the DEC with its insurance tiers, rules, and costs clearly laid out for both customers and the DEC to inspect. Additionally the company must have $75,000 dollars starting liquid capital.
(5) Private Liability Insurance must payout claims that are valid, appealed insurance rejections that are found to be valid for a legitimate purpose in a court of law can result in the insurance company or subsidiary being charged with Insurance Fraud.
(6) When reviewing over Private Liability Insurance, a Magistrate/Judge/Justice shall review over the contract made by the claimant and insurance company utilizing the Contract Law Foundation Act and any amendments made to it, the Insurance Law Foundation Act and any amendments made to it, and any other applicable law that a lawyer brings to an insurance case.


8 - Private Medical Insurance Rules
(1) Private Medical Insurance is allowed for the purposes of providing greater protection than the public option Medicare offers.
(2) Any corporation is allowed to open their own Medical Insurance department as a subsidiary of the company or any company can choose to directly become an insurance provider.
(3) In order to become a Private Medical Insurance company or subsidiary, the company must register with the DEC with its insurance tiers, rules, and costs clearly laid out for both customers and the DEC to inspect. Additionally the company must have $10,000 dollars starting liquid capital.
(4) Private Medical Insurance has to pay out in the event that Medicare does not cover the disease within the Hospital. Otherwise Medicare will cover the claim.
(5) Private Medical Insurance is allowed to set up their insurance program however they wish within reason and within legal boundaries.
(a) Private Medical Insurance can choose to make a tiered system where players are allowed to choose the type of coverage they want.
(b) Private Medical Insurance is allowed to sell their services as a product via contract. Both sides are expected to keep up their respective ends of the deal and breaks in contract shall be scrutinized by the court using the Contract Law Foundation Act.
(6) Private Medical Insurance is allowed to choose whether or not they want to cover pharmaceutical costs, though the highest tier of coverage should include some coverage of pharmaceutical costs.


9 - Insurance Fraud
(1) Corporate Insurance Fraud
(a) This law shall be a criminal law placed under title 11 Business Law.
(b) Shall be defined as a deliberate deception perpetrated by an insurance company or agent for the purpose of financial gain. Such as misrepresenting facts on insurance products, refusing to pay valid insurance claims, embezzlement or misuse of insurance funds/premiums.
(c) Any Insurance Company that is found guilty of this crime shall see a fine no less than $3,000 dollars and no greater than $100,000 dollars. Additionally a Judge may order that the DEC deregister the company.
(2) Personal Insurance Fraud
(a) This law shall be a civil law placed under title 10 Commerce.
(b) Shall be defined as a deliberate deception perpetrated against an insurance company or agent for the purpose of financial gain. Such as inflating insurance claims or organizing false or fake scenarios to create a claim
(c) If an insurance company believes that a plaintiff who is insured by them is organizing a false or fake scenario to siphon money from the court, they may write an amicus curiae brief to become a party pursuant to the case. They have the right to ask for an emergency injunction and dismissal of the previous case to start a Personal Insurance Fraud claim against the plaintiff, who shall become the defendant if accepted by the Magistrate/Judge/Justice.
(d) Any Person that is found guilty of this crime shall return any money that was fraudulently taken from an insurance company, is returned to the insurance company, and shall see a fine no less than $500 dollars and no greater than $10,000 dollars. Additionally a Judge may order that the DEC deregister the company.
(3) Lawcare Insurance Fraud
(a) This law shall be a criminal law placed under title 11 Business Law.
(b) Shall be defined as an attempt by any lending organization or person to purposely lend money to non-eligible players of Lawcare to specifically siphon funds from the government by lending to risky players.
(c) This crime must be reported to a prosecutor by an auditor who suspects that Government Insurance Fraud is happening due to claimants consistently lending to risky players who were non-eligible for Lawcare at the time of signing the loan.
(d) Any lending organization or person found guilty of this crime shall return all money as fraudulently taken from Lawcare and returned to it. A Judge may order a fine of up to $10,000 dollars made payable to Lawcare Liability Insurance as supplemental funding.

10 - Insurance Negotiating
(1) If a claimant does not like the offer that they are given by their insurance company, they may bring this grievance to court.
(a) The case must go into the appropriate courthouse for the maximum amount of the claim. Example, if you are offered $4,500 on your $50,000 dollar claim, you would take it to the federal court since the potential amount exceeds the District Court Limit.
(b) You can only argue for what you are covered for by your insurance. You may argue for an amount greater than what your insurance company is offering for the claim but not for an amount greater than your insurance limits.
(c) When reviewing over Insurance Negotiations, a Magistrate/Judge/Justice shall review over the contract made by the claimant and insurance company utilizing the Contract Law Foundation Act and any amendments made to it, the Insurance Law Foundation Act and any amendments made to it, and any other applicable law that a lawyer brings to an insurance case.
(d) Judges will take all things into consideration, such as emotional damages and pain and suffering, when determining whether or not an injunction should be granted in excess of what the insurance company initially offered.
(2) Insurance Companies are free to adjust their payouts as they see fit and offer based on negotiation. If they wish to offer more or less based on current negotiations they are allowed to do so. For Liability Insurance, Insurance companies do NOT have to pay the full amount of the initial judgement given by a Court, however, they MUST pay the full amount of the judgement given by a Court in an Insurance case.

11 - Statute of Limitations on Claims.
(1) Any claimant making a Liability Insurance claim both private and public has one week to do so, otherwise their claim will be rejected. Any claimant may take a liability insurance claim to court as long as they have not settled to court for the two months after they have filed their claim.
(2) Any claimant making a Medical Insurance claim both private and public has three days to do so, otherwise their claim will be rejected. Any claimant may take a medical insurance claim to court as long as they have not settled to court for the two months after they have filed their claim.
(3) This Statute of Limitations overrides the normal Statute of Limitations provided in the normal Statute Of Limitations Act and all of its amendments.

12 - Definitions:
(1) Liability - Judgment given against somebody for damages or injuries they have inflicted.
(2) Damages - Any fines given within a law
(3) Injuries - Any value stolen from another party, contracts not followed resulting in monetary loss, any monetary loss resulting from illegal activity caused by another party, or anything of tangible value lost due to another party negligent or maleficent behavior.
(4) Claimant - The person claiming their insurance.

13 - Ex Post Facto Exemption
(1) This law shall not be affected by Ex Post Facto at the time of it being signed into law.
(a) This clause is to prevent confusion in regards to how insurance should be implemented, this is the path going forward.
(b) Ex Post Facto only applies to criminal laws, and as this is a civil law, this bill shall not be affected by it.
 

Veto

After discussing with the Treasurer, we came to a consensus that several things about this bill were unworkable in its current state:

1. The legal requirement of "Auditors" managing the program when Auditors are no longer a job.
2. The requirement of claims being filed via ticket instead of on the forums when the forums would be administratively easier for the DEC.
3. Lack of general flexibility for the department.

As for my own reservations, I'm concerned about the bill's effort to increase regulations for a non-existing industry: medical insurance. If we want to develop a private insurance industry at all, adding restrictions for its formation won't help.

Further, I'm still not sold on the concept itself: why use government tax dollars to hold citizens less accountable for legal damages they incurred themselves? While I agree with the premise of the bill that the development of private legal insurance would be both interesting and viable as a new business model, I don't see how this is a responsibility of the government.

 
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