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U.S. District Court Judge Bars Plaintiff’s Individual Disability Claims in Their Entirety by Application of the Doctrine of...

In the Eastern District of Pennsylvania, applying the doctrine of collateral estoppel, a judge adopted the Report and Recommendation of her magistrate judge and granted an individual disability insurer summary judgment on its...more

Arbitration Clause In Agreement Between Insured And Reinsurer Held Invalid Under Nebraska Law

A federal district court has held an arbitration clause in a Reinsurance Participation Agreement (RPA) between an insured and a reinsurer invalid and unenforceable under governing state law. The RPA complemented a standing...more

Fundamental Distinction Between “Medically Distinguishable” Injuries Under Section 301(1) and “Significant Manner Contribution”...

There is a confusion among the Workers’ Compensation Board of Magistrates and, in some cases, in the Michigan Compensation Appellate Commission (the Commission) between the proper prima facie injury analysis required of a...more

Saskatchewan Trial Court Awards Record Punitive Damages for Insurer Bad Faith

A Justice of the Saskatchewan Court of Queen’s Bench has assessed punitive damages totalling $4,500,000 against two insurers in a recent trial decision, Branco v. American Home Assurance et. al., 2013 SKQB 98. In rendering a...more

Court Rules That Ohio Bureau Of Workers' Compensation Overcharged Non-Group Rated Employers

After a long bench trial which began on August 20, 2012, Judge Richard McMonagle recently issued his decision in an important class-action lawsuit. The suit was brought on behalf of certain employers doing business in Ohio,...more

Pay me once, pay me twice, pay me thrice?

On November 15th the Supreme Court of Appeals of West Virginia issued the opinion of Jeffery Jenkins, et ux. v. City of Elkins, et al. (No. 11-1059). Factually, Mr. Jenkins was an employee of Bombardier Aerospace driving a...more

California Court of Appeal Extends Howell v. Hamilton Meats Rule to Limit Injured Person's Medical Expenses to Discounted Amounts...

Last year, the California Supreme Court held in Howell v. Hamilton Meats & Provisions, Inc. that an injured plaintiff whose medical expenses were paid through private health insurance could not recover as economic damages...more

Successfully Defending a Lawsuit

Anyone who has been a defendant in a lawsuit will tell you that the process is expensive, time consuming and stressful. I have spent the past twenty years defending businesses and individuals in courts throughout Virginia and...more

Texas Insurance Law Newsbrief

CARE CUSTODY & CONTROL EXCLUSION PRECLUDES COVERAGE Last Friday, in Ohio Casualty Insurance Company v. Lloyd Technologies Inc., No. A-09-CA-633-LY (W.D.Tex. September 30, 2011), a Federal District Court Judge in the Austin...more

Texas S.Ct.: Workers Comp Carriers Not Subject to Statutory Unfair Claims Settlement Practices Claims

In a ground-breaking decision, the Texas Supreme Court today decided that workers compensation insurers are not subject to "bad faith" claims for unfair claims settlement practices under the Texas Insurance Code. The...more

When to Use a Liability Medicare Set-aside Arrangement

The Centers for Medicare & Medicaid Services (CMS) has put the insurance industry on high alert. Threat of penalties for failure to report liability claims involving a Medicare beneficiary has raised concerns over properly...more

Schmelling v Whitty et al

Court of Appeals Interprets Notice of Non-Party Fault Offset to Apply Even if Party at Fault Cannot Be Liable in Suit

The Court of Appeals here confirms my thinking that even if a party would not be liable in suit, e.g., as a governmental entity for immunity or for some other reason (in this case the exclusive remedy provision of the...more

Company Doctor Uses X-Rays Instead of MRI and Misses Herniated Disc

Often, when a worker injures his back on the job, the human resources manager will take down a claim and refer the worker to an industrial clinic for evaluation and treatment. All too often, the industrial clinic or other...more

More Reasons Why Facebook can be Dangerous to Your Workers' Comp. Case

Last year I published an article on this blog entitled "How Facebook Can Undermine Your Workers' Compensation Case." I pointed out then that the default "privacy" settings on Facebook offered very little privacy at all – your...more

How "Absolute" is the "Absolute Pollution Exclusion"?

In a recently published decision, Ohio’s Third District Court of Appeals addressed the scope of the so-called “absolute pollution exclusion.” Bosserman Aviation Equipment, Inc. v. United States Liability Insurance Company...more

Medicare Secondary Payer Statutes, Part II: Liability Settlement Issues

As discussed in a previous alert, self-insured health care providers face the same compliance requirements and challenges as do those primary payers that qualify as Required Reporting Entities (“RRE”) under Section 111 of the...more

How to Utilize the California Workers' Compensation System

This article is for workers and employers alike. It is not meant to replace attorney advice for your specific case. No agreement for representation is expressed or implied herein. For information purposes only....more

Litigant Is Not Entitled To Attorney Fees Where Insurer Disputes Request For Medical Treatment

In Smith v. Workers’ Compensation Appeals Board, 2009 DJDAR 6715, May 11, 2009, the California Supreme Court decided a case concerning the contours of Labor Code §4607. That statute provides: “Where a party to a...more

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