Civil Procedure Insurance Administrative Agency

Read Civil Procedure updates, alerts, news, and legal analysis from leading lawyers and law firms:
News & Analysis as of

A Question of Timing – Social Security Disability Determinations and the Administrative Record

Seyfarth Synopsis: Court excludes evidence of Social Security disability award issued after the final decision issued on plaintiff’s claim for plan disability benefits. The decision accentuates the importance of fighting to...more

Hospital and Fixed Indemnity Policies; Excepted Benefits; Supplemental Coverage under Recently Proposed Treasury Regulations; and...

We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more

Commonsense Misconduct Not so "Common": Illinois Supreme Court Significantly Narrows Use of Commonsense Rationale in Employee...

In the absence of a rule prohibiting specific conduct, employers can no longer rely merely on what one would deem "commonsense" to deny unemployment benefits. In Petrovic v. Department of Employment Security, the Illinois...more

Is Your Workers Compensation Program Unlawful?

A popular workers compensation insurance program offered by Berkshire Hathaway subsidiaries Applied Underwriters Captive Risk Assurance Company (Applied Underwriters) and California Insurance Company may be in trouble. On...more

New York State Clarifies Taxation of Unauthorized Insurance Companies

Three recent decisions (March 3, 2016) by a New York State Division of Tax Appeals administrative law judge help to clarify the taxation of unauthorized insurance companies subject to New York State taxation. New York...more

CIGA Avoids C&R Lien Obligation At Expense of Co-Defendant

On March 22, 2016, the Second District Court of Appeal, Division One, published its opinion in California Insurance Guarantee Assn. v. Workers’ Comp. Appeals Bd., No. B263869, Cal.App.4th, in which it determined that the WCAB...more

New York State Division of Tax Appeals Addresses Unauthorized Insurance Company Taxation

A New York State Division of Tax Appeals administrative law judge (ALJ) issued three determinations addressing the tax implications for unauthorized insurance companies, both life and non-life. Significant uncertainty has...more

Court Rules Hospitals Must Exhaust HHS Administrative Appeals Process for Medicare Advantage Out-of-Network Payment Dispute

According to a Georgia federal district court ruling issued on February 11, 2016, a group of hospitals must exhaust their out-of-network Medicare Advantage (MA) payment dispute through the Department of Health and Human...more

Texas Says EPA Administrative Actions under CERCLA Trigger Duty to Defend

As any company facing EPA administrative action under CERCLA knows, the financial risk and defense costs associated with those proceedings can be the same as the risk and costs of an EPA lawsuit under CERCLA. But insurers...more

Ninth Circuit Extends ERISA Deadline, Revives Untimely Appeal

Last week, the Ninth Circuit Court of Appeals issued its opinion in LeGras v. AETNA Life Insurance Company, No. 12-56541 (May 28, 2015), holding that the 180-day period to appeal a denial of a long-term disability claim was...more

ERISA (9th Cir.) A Day Late, But Not A Dollar Short — Counting The 180 Day Appeal Period Gets Easier For Claimants

You know that under ERISA regulations a claimant has at least 180 days to appeal a benefit denial. ERISA plans set out contractual timelines for appeals. But what happens when that 180 day period runs out on a weekend?...more

Federal Court Changes the Playing Field on ‘Agreed’ Civil Penalties in Regulatory Proceedings

The very recent decision of the Full Court of the Federal Court (handed down on 1 May 2015) in Director, Fair Work Building Industry Inspectorate v CFMEU [2015] FCAFC 59 has changed the law in relation to the Court’s approach...more

Florida Appeals Court Quashes Order Requiring Insurance Commissioner to Testify

On March 13, 2015, in Florida Office of Insurance Regulation v. Florida Department of Financial Services, Florida’s First District Court of Appeals quashed the trial court’s order compelling the deposition of the Florida...more

California Insurance Commissioner Lacks Authority to Regulate Formula for Estimating Replacement Cost Value

In Assn. of Cal. Insurance Companies v. Jones ( No. B248622, filed 4/8/15), a California appeals court held that California’s Insurance Commissioner Dave Jones lacked the authority to promulgate California Code of...more

Ninth Circuit Rules That Harmless Procedural Violation Does Not Alter Standard of Review

The Ninth Circuit held that a plan administrator’s failure to render a decision on a long-term disability benefits claim within the period mandated by the plan and ERISA did not alter the standard of review that the court...more

Do Lawyers Professional Liability Policies fall within the “no prejudice” amendments to New York’s Insurance Law for late notice?

The New York State Insurance Department has issued an ambiguous opinion taking the position that the amendment to Insurance Law §3420(a)(5), changing the “no prejudice” rule, applies to all liability policies, which arguably...more

Should the Insurance Commissioner Actually Read the Policy Forms Submitted for Approval?

Dave Jones identifies himself to voters as an activist Insurance Commissioner who champions the insurance consumers’ rights. This is the guy who took on the insurance industry practice of side arbitration agreements in...more

Insurer Sues Department of Insurance Over Multi-Million Dollar Penalty

In suing the California Insurance Commissioner on July 10, 2014, PacifiCare Life Insurance Company sought a writ of mandamus ordering the Commissioner to set aside his Decision and Order imposing a record $173 million penalty...more

If A Tree Falls In The City, Is It Serving A Public Purpose?

Today’s posting has nothing to do with corporate law and everything to do with trees. On November 30 and December 1, 2011, the City of Pasadena experienced an unusually violent windstorm. Wind speeds in excess of 100 miles...more

Florida Court of Appeal Holds Insured’s Death Alone Does Not Trigger Unclaimed Property Law Obligations

In an opinion filed August 5, Florida’s First District Court of Appeal held that Florida’s unclaimed property law does not make life insurance proceeds due and payable at the time of the insured’s death and does not impose an...more

A Tale of Two Circuits: D.C. Circuit, Fourth Circuit Split on ACA Subsidies

It was the best of times for ACA subsidies, it was the worst of times for ACA subsidies. On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth...more

Harsh Justice

Concerned that its own decision might have "the potential to conflict" with that of the Pennsylvania Insurance Department, a Pennsylvania federal court relied on the primary jurisdiction doctrine to dismiss a putative class...more

High Court allows application for permission to bring judicial review proceedings relating to the jurisdiction of the Financial...

In this case report, Sarah Hitchins, an associate in Allen & Overy LLP’s Banking, Finance and Regulatory Litigation Group, considers the High Court’s decision to allow an application for permission to bring judicial review...more

Proposed Expansion of OIG’s Exclusion Authority

In May, the Office of Inspector General of the Department of Health and Human Services (OIG) proposed a new rule (Rule) that would implement changes included in the ACA. The Rule would expand OIG’s authority to exclude...more

I Can’t Get No SATISFACTION-- In the Eleventh Circuit, Is Discretionary Language Still "Satisfactory to Us"?

Ever since the United States Supreme Court addressed the question of whether a wholesale adoption of the "arbitrary and capricious" standard of review would be appropriate for judicial review of denial of benefit...more

99 Results
View per page
Page: of 4

Follow Civil Procedure Updates on:

JD Supra Readers' Choice 2016 Awards

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.