Appeals court delivers another defeat to faith-based health systems' pension plans
This case involves medical institutions that have direct influences from their founder religions suing the federal government, accusing it of preventing the religious institutions involved from funding their retirement benefits, which are generally underfunded. The federal government, in this case the plaintiff, does not want to associate itself with religious institutions as this may open a Pandora box of accusations of religious interference in the affairs of the state. Therefore, this action only but protects it against the possibility of religious institutions entangling themselves with retirement securities of their affiliated hospitals. The defendant, on the other hand, believes that their clients, the medical staff that they employ, deserve better than the federal government is offering and are therefore, choosing to fill the gap on their own terms. The court rules in favor of the plaintiff, and this is basically to avoid government involvement with religion. As a personal opinion, in making this determination, the courts were right. This is because if the government were to get itself involved in religious matters, then there are great chances that the whole concept of state neutrality in religious matters would have been compromised, causing it to be caught up in a great misunderstanding with the diverse religious communities. The federal government is just trying to unify the people it represents (Choi, 2009) . As for the federal Employee Retirement Income Security Act (ERISA), universality is greater that segregated benefits, without a union. Therefore, the medical institutions in question will have to work with the inadequate funds that the government has to offer, and hope for and hope for more from the from the federal government. Their main source of hope will be based on the fact for the religious institutions to completely back off their attempts, the government must improve their funding’s.
SCOTUS: Insurers Cannot Require Refunds from Some Beneficiaries after Injury Settlements
Having a medical insurance to cover for treatments when one is injured is very important. For one to have such a plan, he or she must take an insurance cover with an insurance company. This case involves an insurance company attempting to make claims for refunds from a former patient. The insurance provider covers the patient and is, therefore, attempting to reclaim the funds released to cover the client’s alleged medical bill. The plaintiff insists that the insured should not pay their insurers after any settlements have been made, as that will be exploitation. Conversely, the defendant, in this case the insurance company, requires the insured to pay some kind of fee after their successful settlement of medical bills. The court ruled in favor of the plaintiff, According to the Employee Retirement Income Security Act (ERISA), insurers are barred from demanding payment after settling the medical expenses of the insured. Demanding payment from the beneficiaries of the insurance plan after the expenses have been paid is like double payment for the insurance plan. It is not realistic for the insurer to ask for payment after having awarded the insured his benefits. This means that the plaintiff is strained by paying double for the same service. Instead of demanding for the already spent money, the insurer should encourage the insured to take another insurance plan with the company. Paying for an insurance this way means that the cost of insurance would go up. Such incidences are some of the factors that would discourage individuals from taking a medical insurance plan. ERISA, therefore has the mandate to see to it that such issues are solved amicably and none of the parties are disadvantaged in any way.
Delegate your assignment to our experts and they will do the rest.
The defendant’s claim, in this case, could not be justified as in a real sense the insurer had only spent the money that the insured had been paying in terms of premiums for the insurance plan. The court’s verdict is justified. This is because the defendant, who is the insurer, only spent the money that the insured had been paying for the purpose of his or her medical cover (Einav, 2015) . As much as ERISA bars insurers from demanding payment after having settled medical bills, the defendant could demand payment if the expenses were more than the premiums that the insured would have paid. If this was the case, the insurer should allow the insured to continue with the insurance contract so that the excess money spent could be recovered in the future. Even if this was the case, it is still not appropriate for the insurer to demand payment following the settlement of medical expenses. Furthermore, insurers can never settle bills if an individual does not have insurance cover with them. The insurer demanding payment after having settled an insurance policy is not advisable as per the stipulations of ERISA, usually seeing as the institution should be able to recover its funds if the individual is allowed to continue with the insurance contract.
References
Choi, S. (2009). Diversity in the US federal government: Diversity management and employee turnover in federal agencies. Journal of Public Administration Research and Theory, 19(3) , 603-630.
Einav, L. &. (2015). Managed competition in health insurance. Journal of the European Economic Association, 13(6) , 998-1021.
