Coverage that focuses on both the legal risks facing insurance companies, as well as how companies are using insurance to hedge risk. We cover health insurance and cyber insurance frequently.
By Emily Cousins | October 2, 2023
"Medicare Advantage plans that submit false information to increase payments from CMS show blatant disregard for the integrity of these vital federal health care funds," Christian J. Schrank, deputy inspector general for investigations with the Office of Inspector General for the Department of Health and Human Services, said. "Such actions are an affront to the Medicare program and the millions of patients who rely on its services. Working with our law enforcement partners, our agency will continue to prioritize investigating alleged fraud that targets the Medicare Advantage program."
3 minute read
By William G. Passannante and Raymond A. Mascia Jr. | October 1, 2023
In the authors' experience, insurance companies interpret the bump-up exclusion far too broadly and beyond the insurance industry's purported intent behind the exclusion. D&O policyholders should be prepared to resist such coverage denials.
12 minute read
By Courtney C.T. Horrigan, John Ellison and Russell M. Squire | October 1, 2023
Hawaii, recently devastated by the Lahaina Fire, looks to be the first state to have its Supreme Court weigh in on the applicability of pollution exclusions to climate change lawsuits. This article examines what is at stake for policyholders and the road to recovery in this rapidly evolving area of insurance coverage law.
8 minute read
By Jillian Raines and Alex Harris | October 1, 2023
How should a federal court decide whether to enforce a choice-of-law provision? That's the question at the heart of 'Great Lakes Ins. v. Raiders Retreat Realty', a maritime coverage dispute that will be argued before the Supreme Court. However the court rules, the decision could have wide-ranging implications for insurance disputes—even those on land.
8 minute read
By Howard B. Epstein and Theodore A. Keyes | September 28, 2023
Recently, the Eastern District of New York granted summary judgment to an insurer, holding that the insurer had no duty to defend based on the terms of an exclusion in the policy. This decision highlights how, where the facts plainly fall within a clearly-drafted exclusion, courts will not hesitate to enforce the exclusion as written.
6 minute read
By Patricia A. Monahan | September 28, 2023
While it is well known that an insured has a clear and convincing standard of proving bad faith in order to recover such damages, it is lesser recognized that an insured does not have to prove outrageous conduct or evil motive to prove entitlement to punitive damages.
6 minute read
By Emily Cousins | September 27, 2023
"Absent any improvement whatsoever in [my client's health], they out of the blue do an about-face and declare [she] can work based primarily ... on a doctor three time zones away who wrote a five-page report," Ian O. Smith said. "For 22 years, I've been doing my best to counter that because ... under any standard, any reasonable person would view this as wrong."
4 minute read
By Allison Dunn | September 27, 2023
"I am pleased with the decision from the Court of Appeals and I am proud of my office's efforts to ensure that these workers are treated fairly and given the benefits they right deserve," Virginia Attorney General Jason Miyares said in a statement to Law.com.
5 minute read
By Jacquelyn Mohr Heitman | September 27, 2023
Many policyholders misunderstand their relationship with their insurers. Having purchased an insurance policy, they assume that their insurer will make a good-faith effort to honor its contractual obligations, which is not always the case, according to Jacquelyn Mohr Heitman of Pasich.
8 minute read
By Allison Dunn | September 25, 2023
"Here, we have concluded that Wesco's contacts with Massachusetts are unrelated to the claims in this case, and that whatever indirect contact (if any) Wesco had with Massachusetts related to Pray's claims is insufficient to satisfy due process," Massachusetts Appeals Associate Justice Peter Sacks wrote for the unanimous three-judge panel.
5 minute read
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