Insurance Conflict of Laws

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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

State Law Cannot Reallocate Life Insurance Proceeds That Accrued To Named Beneficiary Under Federal Law

The Supreme Court recently held that federal law pre-empts state law that attempts to reallocate proceeds accruing to the designated beneficiary of a federal life insurance policy. Hillman v. Maretta, 133 S. Ct. 1943 (2013)...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

Federal Law That Provides Death Benefits Be Paid To Named Beneficiary Pre-empts State Law

In Hillman v. Maretta (--- S.Ct. ----, U.S.Va., June 3, 2013), the United States Supreme Court considered whether a state law that provides death benefits from an insurance policy be paid to a current spouse, even if a prior...more

Liquidated Damages For Junk Faxes Are Insurable in Illinois

The Federal Telephone Consumer Protection Act provides that it's unlawful to send unsolicited advertisements to a fax machine. 47 USC 227(b)(1)(C). The statute creates a private right of action, with damages equal to actual...more

US District Court Prohibits Enforcement of California 340B Medicaid Mandatory Carve-In Law

The 340B program permits eligible hospitals and other “safety-net” providers (340B Covered Entities) to purchase outpatient drugs from pharmaceutical manufacturers at significant discounts. To address its fiscal woes,...more

ERISA Litigation Alert: Check Your Plan Subrogation and Reimbursement Language to Eliminate “Contractual Gaps”

In U.S. Airways v. McCutchen, the U.S. Supreme Court upheld the ability of U.S. Airways’ health plan to recover medical expenses that it previously paid to the injured party from a third party settlement, but remanded the...more

Supreme Court “Dooms” Equitable Defenses to Plan’s Reimbursement Provisions

In a prior blog, I discussed the importance of including unambiguous reimbursement rights in health plan documents in order to manage healthcare costs. The enforceability of such rights was confirmed by the United States...more

High Court Rules Equitable Defenses Don’t Override ERISA Plan Terms

On April 16, 2013, the U.S. Supreme Court issued its decision in US Airways, Inc. v. McCutchen (No. 11–1285), deciding the issue of whether equitable defenses, such as the principle of unjust enrichment, can override the...more

U.S. Supreme Court: Equity Cannot Trump ERISA Plan Terms in ERISA Reimbursement Case

The U.S. Supreme Court yesterday strengthened the ability of employer health insurance plans to recoup payments for medical expenses paid for an injured plan participant who later sues to recover damages from a third...more

Attorneys' Fees Reduce ERISA Plan's Recovery From Common Fund

The United States Supreme Court ruled today that absent an express provision to the contrary, the amount an ERISA plan can recover from a plan participant’s lawsuit against a third-party tortfeasor must be reduced...more

ERISA Does Not Preempt State Court Order Requiring Beneficiary to Renounce Right to Employee’s Plan Benefits, Fourth Circuit Rules

The scenario is not difficult to imagine: An employee designates her spouse as the primary beneficiary under her employer’s life insurance and retirement benefit plans. Years later, the couple divorces, and in the marital...more

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