Subject Index Insurance

Illinois will transition from an Affordable Care Act health insurance exchange to a state-based health insurance exchange by 2026

November
2024
Illinois Law Update
, Page 18
Illinois will transition from the current Affordable Care Act health insurance exchange to a state-based exchange in two phases. In the first phase, Illinois will transition to a state-based health insurance exchange on a federal platform by 2025; during the second phase, Illinois will transition to a fully state-administrated exchange by 2026.

Insurance coverage for wig and scalp prosthesis

November
2024
Illinois Law Update
, Page 18
The Illinois General Assembly amended the Illinois Insurance Code. Any group or individual plan of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after Jan. 1, 2026, must now provide coverage for one wig or scalp prosthesis no less than once every 12 months.

Group or individual accident and health insurance policies must now include coverage for dependent parents

October
2024
Illinois Law Update
, Page 16
The Illinois General Assembly amended the Illinois Insurance Code. A group or individual accident and health insurance policy that provides dependent coverage and is issued, amended, delivered, or renewed after Jan. 1, 2026, must also provide dependent coverage for a qualifying dependent parent or stepparent of the policyholder.

Insurance companies are not required to provide underinsured motorist coverage if the policy only has minimum uninsured motorist limits

October
2024
Illinois Law Update
, Page 16
On June 21, 2024, the Fourth District of the Illinois Appellate Court held underinsured motorist coverage is not automatically required to be included in a bodily injury liability policy where the policy provides uninsured motorist coverage at the minimum limits required by law.

Summary judgment and dismissal of one of six counts affirmed in a case involving a carbon monoxide leak at a middle school

October
2024
Illinois Law Update
, Page 16
On June 18, 2024, the Fourth District of the Illinois Appellate Court held an insurance company did not have a duty to defend, reasoning the underlying negligence claim against the insured fell under the professional services exclusion.

All individual and group health-insurance plans must cover over-the-counter contraceptives

September
2024
Illinois Law Update
, Page 16
The Department of Insurance adopted a new part requiring health insurance coverage for over-the-counter contraceptive drugs, devices, and products, and which prohibits health insurers from requiring a prescription to cover them.

Insurance clauses prohibiting stacking of liability coverage are allowed

August
2024
Illinois Law Update
, Page 20
On May 23, 2024, the Illinois Supreme Court held that insurance clauses prohibiting the stacking of liability coverage are allowed.

Insurance policy’s exclusion for “knowing violation of rights of another” bars coverage when allegations of the underlying complaint allege malicious acts

July
2024
Illinois Law Update
, Page 20
On April 19, 2024, the First District of the Illinois Appellate Court held that an insurance policy’s exclusion for “knowing violation of rights of another” bars coverage when allegations of the complaint in the underlying matter allege malicious acts.

Uninsured motorist policies that limit coverage to vehicle occupants violate section 143a of the Illinois Insurance Code

March
2024
Illinois Law Update
, Page 18
On Nov. 30, 2023, the Illinois Supreme Court held that uninsured motorist policies that limit coverage to vehicle occupants violate section 143a of the Illinois Insurance Code and are unenforceable as a matter of public policy.

Anti-retaliation provision established for when a pharmacy or pharmacist discloses information in a proceeding or to a government or law enforcement agency

December
2023
Illinois Law Update
, Page 16
The Illinois General Assembly amended the Illinois Insurance Code. A pharmacy benefit manager may not engage in retaliatory acts against a pharmacy or pharmacist for disclosing information they reasonably believe contains evidence of a violation of a state or federal law, rule, or regulation.

Health insurance coverage for mental health expanded

December
2023
Illinois Law Update
, Page 16
The Illinois General Assembly amended the Illinois Insurance Code. Any group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after Jan. 1, 2025, must include coverage for one annual mental health prevention and wellness visit for children and adults.

Insurers owe no duty to defend insured when underlying action does not constitute an “occurrence” as defined by their policy

December
2023
Illinois Law Update
, Page 16
On Aug. 30, 2023, the First District of the Illinois Appellate Court held insurance companies are not required to defend an insured when the alleged conduct does not constitute an “occurrence” as defined by their policies.

Insurance company has no duty to defend or indemnify in its insured’s derivative suit when judgment already issued in prior case; res judicata and collateral estoppel apply

November
2023
Illinois Law Update
, Page 18
On Aug. 14, 2023, the Third District of the Illinois Appellate Court held that an insurance company had no duty to defend or indemnify its policyholder in a derivative suit where the insurance company was found to have no duty to defend in a previous case arising from the same transaction.

The Insurer-Insured Privilege

By Scott O. Reed
August
2023
Article
, Page 32
Unusual among American jurisdictions, Illinois courts recognize a privilege for statements an insured gives to its insurer, even without an attorney present. But this privilege is not absolute.

Certain accident and health insurance policies may no longer impose copays upon coverage for naloxone hydrochloride

July
2023
Illinois Law Update
, Page 16
The Illinois General Assembly amended the portion of the Illinois Insurance Code regarding coverage for naloxone hydrochloride (Narcan), a drug used to rapidly reverse opioid overdoses. Accident and health insurance policies for groups and individuals that provide coverage for naloxone hydrochloride and are delivered, amended, issued, or renewed after Jan. 1, 2024, will be prohibited from imposing copays.

New regulations for insurers providing primary residential flood insurance

April
2023
Illinois Law Update
, Page 16
The Illinois General Assembly enacted the Private Primary Residential Flood Act. The Act regulates private insurers offering primary residential flood insurance to consumers. All insurers must notify and obtain the approval of the Department of Insurance at least 30 days before writing a residential flood insurance policy within the state.

Failure to provide notice to insurer within 30 days of an automobile accident as required by policy is not a material breach justifying nonperformance by insurer

February
2023
Illinois Law Update
, Page 16
On Nov. 30, 2022, the First District of the Illinois Appellate Court held that failure to provide notice of a claim to an insurer within 30 days of an automobile accident per the policy was not a material breach justifying nonperformance by an insurer.

Statute governing effect of marriage dissolution judgments on life insurance policies not retroactive

February
2023
Illinois Law Update
, Page 16
On Nov. 16, 2022, the First District of the Illinois Appellate Court held a statute governing the effect of marriage dissolution judgments on life insurance policy beneficiaries should not be applied retroactively.

Insurers must pay replacement vehicle use or occupation tax, title fees, and transfer fees

December
2022
Illinois Law Update
, Page 12
This Act amends the Illinois Insurance Code. When an insurer determines an insured or third-party claimant’s private-passenger vehicle is a total loss and is covered under the terms of a personal automobile policy issued or renewed on or after July 1, 2022, the insurer must pay a replacement vehicle use or occupation tax, and title and transfer fees.

Insurance company’s lack of notice of underlying action relieves duty to indemnify or defend the resulting judgment

November
2022
Illinois Law Update
, Page 18
On Aug. 15, the First District of the Illinois Appellate Court held that an insurance company must receive actual notice of a suit against its insured to trigger a duty to indemnify or defend the insured.

Insurance Providers & BIPA Litigation

By Charles N. Insler
October
2022
Article
, Page 36
BIPA litigation has become a mainstay of Illinois courts. But do insurers have an obligation to defend their insureds in BIPA litigation?

Homeowner’s policy must provide coverage for fire started by policyholder at other property

September
2022
Illinois Law Update
, Page 16
On June 22, 2022, the First District of the Illinois Appellate Court held that a homeowner’s insurance policy provided coverage for a fire that started when the policyholder was performing plumbing work at the property he did not own.

Subscriber not subject to family member exclusion within auto liability insurance policy in auto accident that took place while driving father’s car

September
2022
Illinois Law Update
, Page 16
On June 27, 2022, the Third District of the Illinois Appellate Court held that a vehicle was not excluded from liability coverage because the family member exclusion did not apply, and the vehicle was not available for “regular” use.

COVID-19 not a “physical loss” that triggers insurance coverage

June
2022
Illinois Law Update
, Page 16
On Mar. 21, 2022, the First District of the Illinois Appellate Court held that disruptions to a restaurant’s business during the COVID-19 pandemic constituted an economical, but not physical, loss within the meaning of an insurance policy.

Insurance policies must be interpreted as a whole

December
2021
Illinois Law Update
, Page 14
On Sept. 14, 2021, the Fourth District of the Illinois Appellate Court reversed and remanded a trial court’s order requiring an insurance company to provide coverage.

Filing police report within 11 days of hit-and-run may be sufficient for insurance purposes

November
2020
Illinois Law Update
, Page 18
On July 23, 2020, the First District of the Illinois Appellate Court found that a plaintiff who waited 11 days to report a hit-and-run accident did so “as soon as practicable” under the circumstances.

Uninsured-motorist coverage allowed for passenger on public-policy grounds

November
2020
Illinois Law Update
, Page 18
On July 22, 2020, the Second District of the Illinois Appellate Court affirmed a circuit court’s ruling that, in the interest of public policy, an insured passenger in a car accident was entitled to uninsured-motorist coverage despite the terms of the insurance policy clearly stating the opposite.

Insurer may not depreciate labor costs for “actual cash value” 

October
2020
Illinois Law Update
, Page 16
On July 24, 2020, the Fifth District of the Illinois Appellate Court held that the cost of labor cannot be depreciated when an insurer is calculating the actual cash value of a loss.

Tender-Hearted Insurers

By Scott O. Reed
January
2020
Article
, Page 44
What are a liability insurer’s duties to an insured before a suit or tender of claim?

Vague term in auto policy construed against the insurer

January
2020
Illinois Law Update
, Page 16
On Sept. 30, 2019, the Fifth District Court of Appeals found the term “mechanical device” in an auto policy to be overly broad and vague. It held that the policy, which excluded coverage for incidents involving a “mechanical device,” was to be construed against the insurer.

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