Conflict of Laws Insurance

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New Jersey Federal Court Examines Claim Dispute Under Standard Flood Insurance Policy

The court in Damiano v. Harleysville Ins. Co., Case No. 13-cv-07293-FLW-LHG, 2014 U.S. Dist. LEXIS 97988 (D.N.J. July 17, 2014) recently addressed the scope of claims that can be asserted against property insurers issuing...more

Circuit Court Split on ACA Could Impact Employer Penalties

In conflicting opinions released on July 22nd, two federal circuits split on whether Affordable Care Act subsidies are available under a federally operated health insurance exchange. “Pay or play” penalties apply only if...more

Halbig v. Burwell: A Death Blow for the Affordable Care Act?

On July 22, 2014, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit ruled in Halbig v. Burwell that the Affordable Care Act (ACA) authorizes the issuance of tax credits to assist...more

Fifth Circuit Holds That a TPEE in a CGL Policy Can Exclude Pollution Claims Even in the Face of a UREC

What you need to know: The Fifth Circuit Court of Appeals, applying Texas law, held that a Total Pollution Exclusion Endorsement in a CGL Policy did not irreconcilably conflict with, and therefore was not superseded...more

FIO Focus, Issue No. 58: Senate Passes TRIA Reauthorization and NARAB II

Devoted to exploring the progress of the modernization of the insurance industry, FIO Focus provides information and insights about the organizations and issues that are driving change and influencing the future of the...more

D.C. Circuit Holds Government False Claims Case Not Precluded By National Mortgage Settlement

On June 10, the U.S. Court of Appeals for the District of Columbia affirmed the district court’s decision not to enjoin the federal government from pursuing alleged False Claims Act violations against a bank that argued such...more

Federal Court Erie Prediction Insufficient to Establish Conflict of Law

In its recent decision in Bridgeview Health Care Ctr. v. State Farm Fire & Cas. Co., 2014 Ill. LEXIS 596 (May, 22, 2014), the Supreme Court of Illinois had occasion to consider whether a federal court’s Erie prediction is...more

NY Bill Seeks to Strip Insurers of Discretion When Substance Abuse Services Should Be ERISA Preempted

The New York State Senate is considering passing Bill No. 4326 which seeks to address an epidemic of heroin and prescription drug abuse by requiring insurers to provide in-patient treatment to addicts. Publicity over the...more

The Check’s in the Mail - Who Is Responsible for Payment in a Delegated-Network System?

In today’s healthcare system, reimbursement issues involve not only prompt pay statutory provisions but also various risk-shifting arrangements included in a delegated-network system of managed care. When the insolvency of...more

Court Rejects Plaintiff’s Attempt to Prevent Plan from Recouping $250,000 Overpayment

A federal district court in the Northern District of California dismissed an equitable estoppel claim brought by a pension-plan participant seeking to prevent the plan from recouping an overpayment. See Groves v. Kaiser...more

Florida, Georgia And Texas Appraisal Update: Is Causation A Coverage Question For The Court Or A Damages Question For The Panel?

In most jurisdictions, underlying coverage issues must be resolved prior to invoking appraisal in a first-party property claim. The question of what constitutes a coverage issue (typically reserved for a court’s judicial...more

Missouri Supreme Court Holds Federal Act Does Not Preempt Missouri Law Barring Subrogation Of Personal Injury Claims

In essence overruling a previous opinion from the courts of appeal, the Missouri Supreme Court has held that the Federal Employee Health Benefits Act (“FEHBA”) does not preempt Missouri law prohibiting the subrogation of...more

Carrier's Website Does Not Limit Liability Under Carmack Amendment

A recent decision in District Court in New Jersey may interest insurers subrogating transportation claims. In particular, it sets forth the legal argument to challenge target-carriers’ arguments about purported limitations of...more

Florida Business Litigation Update: The Carmack Amendment Preempts Virtually Everything

The Carmack Amendment to the Interstate Commerce Act established a uniform national policy for interstate carriers’ liability for property loss. 49 U.S.C. § 14706. Under Carmack, while a carrier is generally liable for the...more

Washington's Unprecedented Bid to Supplant State Insurance Regulators

In mid-October, Prudential Financial Inc. dropped its fight against being designated as a systemically important financial institution (SIFI) by the Treasury Department's Financial Stability Oversight Council. When the...more

Courts Split On Whether Mandatory Contraceptive Coverage Violates Religious Freedoms Of For-Profit Corporations

Under the Patient Protection and Affordable Care Act’s preventive services mandate, non-grandfathered group health plans must provide 100% coverage of contraceptives for women, subject to exemptions and safe harbors for...more

Multiple Causes of Loss: An “Efficient” Standard for First-Party Coverage

What happens when a loss results from two or more perils, only one of which is covered under a first-party insurance policy? In American Home Assurance Company, Inc. v. Sebo, 38 Fla. L. Weekly D1982a (Fla. 2d DCA Sept. 18,...more

The Meaning Of Life Settlements: Are They Securities Or Not?

“Life settlements” are financial transactions in which the original owner of a life insurance policy sells it to a third party for an up front, lump sum payment. The amount paid for the policy is less than the death benefit...more

California Supreme Court Holds Insurers are Subject to Unfair Competition Claims in Zhang Case

On August 1, the California Supreme Court issued its highly-anticipated decision in Zhang v. Superior Court, holding that the California Unfair Insurance Practices Act (Ins. Code §790 et seq.) does not necessarily preempt an...more

Tax Litigation Update: Second Circuit Decision Limits Deductibility of Life Insurance Dividends

A decision by the United StatesCourt of Appeals for the Second Circuit earlier this month strictly interpreted deductibility I.R.C. § 808(c) as it relates to the deductibility of policyholder dividends paid by life insurance...more

Hospital’s State Law Claims against Health Plan Held Preempted by ERISA, Rules NJ Appellate Division

Last month a NJ Appellate Division panel held in three consolidated appeals that a NJ hospital’s state law claims that a health care plan must pay full price for medical services the hospital provided to plan participants are...more

More on new disparate impact suit against HUD

Last week, we reported that a lawsuit was filed on June 26 in federal district court in Washington, D.C. challenging HUD’s final rule formalizing its use of disparate impact liability under the Fair Housing Act (FHA)....more

Supreme Court Holds Federal Law Preempts State Law Allowing Litigation Over Proceeds of Federal Life Insurance Policy

Recently, in Hillman v. Maretta, the Supreme Court of the United States affirmed a Virginia Supreme Court ruling that held that federal law preempts a state law that allowed a deceased federal employee’s spouse to sue a...more

Physician Medicare Data: Has the Drought Ended?

After 34 years, a federal district court in Florida has overturned a 1979 injunction which prevented the Centers for Medicare and Medicaid Services (CMS) from releasing to the public Medicare data related to physician billing...more

State Law Will Not Help Out In All Divorce Situations

Many states, including Florida, automatically terminate former spouses as beneficiaries under life insurance policies, annuities, and other beneficiary-designated accounts upon divorce....more

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