When the NAIC approved multiple underwriting in 1946, casualty insurance was defined as a blanket term for legal liability except marine, disability and medical care, and some damage to physical property.
Ultimately, the National Association of Insurance Commissioners regulated the situation, adopting a Nationwide Marine Definition in 1933 which laid out what types of property were eligible for "inland marine" insurance coverage.
In the United States, insurance is regulated by the states under the McCarran-Ferguson Act, with "periodic proposals for federal intervention", and a nonprofit coalition of state insurance agencies called the National Association of Insurance Commissioners works to harmonize the country's different laws and regulations.
At the IOM, she directed studies on health insurance and access to care and provided testimony on children’s coverage to the U.S. Senate Finance Committee and the National Association of Insurance Commissioners.
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