Healthcare reform, one of the hottest topics in Bermuda and this week in the US where the Supreme Court is hearing oral arguments in a case challenging the constitutionality of the Obama administration’s landmark Patient Protection and Affordable Care Act, dominated the agenda at a forum held by XL Insurance (Bermuda) Ltd.During the day-long event at XL, brokers, underwriters and other invited guests heard first hand from healthcare legal expert Victoria Vance who has more than 20 years of experience in counselling and representing healthcare providers, (re) insurers and underwriters in the evaluation, monitoring, management and resolution of claims, investigations and other risks.Speaking from her experiences, the former senior counsel and director of litigation for The Cleveland Clinic Foundation and current counsel at Tucker Ellis & West LLP in Cleveland, compared the US healthcare system to a jigsaw puzzle with some aspects easy to identify and understand while others remain unclear and full of challenges.Listing EMR (electronic medical records) and other technology, relationships between healthcare providers and pharmaceutical companies, patient safety measures, and a litany of Medicare issues among the various pieces of the healthcare puzzle, Ms Vance emphasised the need for healthcare providers, insurance companies and their clients to understand and communicate more closely given the dynamic and challenging healthcare environment.Noting as an example that three days (March 26, 27 and 28) were set aside for arguments over a law designed to extend insurance to approximately 32 million people and revamp an industry that accounts for 18 percent of the US economy, she said: “Oral arguments over three days in the Supreme Court is very unprecedented. The decision is expected in June if the Supreme Court holds to their practice of announcing their decisions at the end of the term. Occasionally, they have held a decision until the Fall but it is very rare. Everyone is expecting to hear in June. That decision will not only have a huge impact on the US presidential election but on the healthcare industry in general. ““It is an exciting and challenging time,” Ms Vance concluded. “There’s much to be aware of in the next several years.“Peter Clancy, of the law firm Johnson and Bell Ltd in Chicago, Illinois, gave a comprehensive and informative update of the changing healthcare landscape, focusing on the formation of accountable care organisations, and the requirement to implement and use electronic medical records. Mr Clancy reviewed recent large healthcare claims verdicts, discussed common themes, and provided an update on state tort reform. He also discussed the increasing prevalence of Healthcare Data Breaches and his predictions of what might be store in the future.The XLIB forum also examined various insurance healthcare forms available; included a presentation on healthcare claims and featured a broker round-table discussion.XLIB President Patrick Tannock said: “As a leader in the Bermuda Insurance market, XLIB has an established track record of assembling top intellectual capital to offer interactive, topical, dynamic seminars and educational events to help our brokers and our colleagues to stay ahead of emerging risk issues.“This is one of several forums that we have hosted and will continue to hold in order to ensure that XLIB is well positioned to provide real time solutions for our clients in an extremely dynamic landscape. Based on the feedback from our distribution partners, they have been well received.”XLIB chief casualty underwriter Beth Piggott added: “XLIB has been a committed insurer for the healthcare industry since our inception in 1986. As providers of coverage to both hospitals and long-term care providers in North America, we were driven to arrange this forum in recognition of the evolving healthcare landscape.‘The implications of healthcare reform will be far reaching and we have been closely watching this week’s Supreme Court debate and will continue to monitor healthcare reform.”