Insurance Civil Procedure

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The Affordable Care Act—Countdown to Compliance for Employers, Week 22: Charting the Future of the Premium Subsidies (and Employer...

On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more

So----You Want to Sue Your Relative?

Barry Goldberg, is asked from time to time whether it is possible to sue a relative and obtain a recovery. While there are definitely times when we would all like to sue one of our relatives, you should be aware that...more

Conflicting Rulings on Health Insurance Subsidies Raise Concerns Among Insurers and Providers

On Tuesday, July 23rd 2014, separate federal circuit court panels issued conflicting rulings regarding whether the government could subsidize health insurance premiums for Americans enrolled in federally-run health exchanges....more

Federal District Court Upholds Foreign Reinsurer’s Right To Remove Action To Federal Court

The Court for the Middle District of Louisiana upheld a magistrate’s ruling denying a motion to remand filed by the Louisiana Commerce and Trade Association of Self Insurer’s Fund (“LCTA”), holding that the defendant foreign...more

Alabama Supreme Court Reverses Course, Finds Insurance Coverage for Faulty Workmanship Claims

Companies such as homebuilders, construction companies and contractors face significant financial risk from bodily injury and property damage claims arising from allegedly faulty workmanship or construction defects. Although...more

Joint Employment Finding Leads to Unexpected $3 Million Liability in Hospital Malpractice Case

When Washington Hospital obtained an insurance policy in 2003 to cover medical claims arising from acts by its employees, its insurer probably did not consider whether hospital employees included workers supplied by a...more

Lerners Personal Injury Lawyers Succeed in Divisional Court Catastrophic Impairment Case

Last week, the Divisional Court released its decision in Security National v. Hodges, 2014 ONSC 3627. This was a judicial review of a Financial Services Commission of Ontario Director’s Delegate decision. The...more

Of Mice and Elephants: Halbig and King and The Struggle of Two Federal Appeals Courts to Find Meaning in Words That May or May Not...

At issue in Halbig v. Burwell and King v. Burwell is whether or not subsidies to buy insurance on an exchange are available in both state and federal exchanges. On its face the Affordable Care Act (“ACA”) provides for...more

Circuit Court Split Casts Doubt on PPACA Subsidies for Individuals and Employer Penalties in 36 States

Two federal appeals courts issued conflicting rulings on July 22 on whether individual premium subsidies under the Patient Protection and Affordable Care Act (PPACA) are available in 36 states that have federally run...more

Federal Courts Make Conflicting Rulings on Premium Assistance for Federal Exchange Plan Participants

Does the Affordable Care Act (ACA) authorize the payment of premium and copayment subsidies, or “premium assistance subsidies,” to individuals enrolled in a federally established Exchange? On July 22, 2014, two federal courts...more

Clash of the Circuits: Federal Exchange Subsidies at Risk?

These four words “established by the state,” at first blush do not appear obtuse or particularly vague. But these four words form the basis for the latest challenges to the Affordable Care Act (ACA) and have resulted in two...more

U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through...

On July 22, 2014, three-judge panels of the U.S. Courts of Appeals for the District of Columbia and Fourth Circuits issued conflicting decisions regarding whether the Affordable Care Act (ACA) permits federal tax credits for...more

Charting the Future of Premium Subsidies under the Affordable Care Act: Halbig v. Burwell and King v. Burwell

On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more

C.D. Cal. Dismisses False Claims Act Qui Tam Suit Against Group of Lenders

On July 15, the U.S. District Court for the Central District of California dismissed a relator real estate agent’s suit against a group of lenders the relator alleged submitted claims for FHA insurance benefits to HUD based...more

Appellate Courts Split on Validity of Key ACA Regulation

In two important decisions issued July 22, 2014, both addressing the validity of a key regulation promulgated under the Patient Protection and Affordable Care Act (ACA), two federal appeals courts reached opposite...more

Washington Insurance Law 2014 Mid-Year Update

During the first six months of 2014, Washington judges issued several notable insurance-related decisions. Some of those decisions were favorable to insurers and could benefit insurers in future insurance claims and lawsuits...more

Defendants Granted Limitations-Based Summary Judgment In Captive Reinsurance Class Action

A putative class of mortgage consumers sued Flagstar Bank and its captive reinsurer alleging that they engaged in an illegal “kickback” scheme with private mortgage insurers, which scheme artificially inflated the price of...more

Prior Publication Precludes Coverage for Advertising Injury

In Street Surfing, LLC v. Great American E&S Ins. Co., 752 F.3d 853 (9th Cir. 2014), the court held that the prior publication exclusion precluded coverage to Street Surfing, LLC (“Street Surfing”) for an underlying lawsuit...more

Important Insurance Coverage Cases On the Horizon

This year, 2014, is lining up with interesting insurance coverage cases pending across the country which may lead to far reaching decisions. In California the Hartford Insurance Company has been dominating the...more

Future of the Affordable Care Act in Jeopardy in Many States

A same-day split decision has created an uncertain future for the Patient Protection and Affordable Care Act (ACA). On Tuesday, two Circuit Courts reached differing conclusions on the availability of premium subsidies for the...more

Will There Be Tax Credit Subsidies for Health Coverage Purchased on the Federal

There is no letup in the intensity of the litigation wars surrounding the Affordable Care Act (ACA) or in the significance of the matters at issue. In 2012, the Supreme Court narrowly upheld the ACA in the face of a...more

Halbig v Burwell: D.C. Appeals Court Strikes Obamacare Health Insurance Subsidies

The U.S. Court of Appeals for the D.C. Circuit ruled, in a 2-to-1 decision, in Halbig v. Burwell that the IRS is not authorized under the Affordable Care Act (ACA) to provide tax credits intended to subsidize the cost of...more

Federal Courts Issue Conflicting Decisions on Affordable Care Act Subsidies

On July 22, 2014, two different federal appeals courts issued conflicting decisions on the availability of subsidies for health insurance purchased by individuals on Exchanges established by the federal government under the...more

In Iowa, Rain is What Gene Kelly Sang In – Not Water From a Burst Drain Pipe

Earlier this year, an Iowa court recognized that rain becomes rainwater once it has fallen, and it held that policy language excluding loss caused by “rain” – without more – will not operate to bar coverage for water from a...more

Federal Appeals Court in D.C. Strikes Down Key Aspect of Health Care Reform (Just Before the 4th Circuit’s Opposite Ruling) – Any...

On Tuesday, the U.S. Court of Appeals for the District of Columbia Circuit, in a 2-1 ruling by a three judge panel, invalidated an Internal Revenue Service regulation that interpreted section 36B of the Affordable Care Act...more

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