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Land of Confusion: Insurance Coverage for Pre-Suit FCPA Investigation Costs under D&O liability Policies

Bloomberg recently reported that Walmart spent $439 Million in the past two years related to a Foreign Corrupt Practices Act (“FCPA”) investigation . Moreover, Walmart predicts that it will spend an additional $200 Million to...more

More Arrests for Alleged Insurance Fraud

Just weeks before the sentencing of three insurance producers for insurance fraud and STOLI-related conduct in the Southern District of New York (covered here), two insurance producers and several insureds were arrested in...more

Convictions of Life Insurance Producers for Mail and Wire Fraud Result in Lengthy Sentences and Millions in Restitution

Earlier this week, the United States District Court for the Southern District of New York sentenced Michael Binday, James Kergil, and Mark Resnick, and ordered the payment of millions of dollars in restitution. The sentencing...more

Los Angeles County Sues Hospital Owner for False Surgical Implant Claims to County Workers’ Compensation Program

On July 18, 2014, the County of Los Angeles (“the County”) filed a lawsuit in Los Angeles Superior Court again Michael D. Drobot, Sr., his son Michael R. Drobot, Jr. and their controlled entities, Pacific Hospital of Long...more

Credit Crunch Digest

This issue of the Credit Crunch Digest focuses on ongoing civil lawsuits and regulatory investigations into Libor manipulation by large banks, including the possible imposition of new criminal penalties by U.K. authorities...more

STOA Schemes Face Increased Regulatory Scrutiny

Increased SEC and Justice Department prosecution is bad news for stranger-originated annuity (STOA) schemes. The SEC recently announced that enforcement actions were taken against brokers Michael A. Horowitz of California and...more

Why Texas Insurers Need To Report Fraudulent Hail Claims

In Amarillo, Texas, with clipboard, camera and marking chalk in hand, a seasoned insurance company adjuster climbs his ladder onto the roof of an apartment building. He’s looking for hail damage following a recent hailstorm...more

Insurance Antitrust Legal News - July 2014 • Volume 3, Number 4

In This Issue: - COURT DENIES BLUES’ MOTION TO DISMISS IN RE BLUE CROSS BLUE SHIELD ANTITRUST LITIGATION (MDL 2406): On June 18, United States District Court Judge David Proctor (Northern District of Alabama)...more

Case Closed: No More Neasham

As reported in previous Expect Focus issues, People v. Neasham involved an insurance agent’s criminal conviction for felony theft in connection with the sale of an annuity to an elderly woman whom prosecutors claimed had...more

D&O Carrier Allowed to Recoup Defense and Indemnity Costs After Employees Plead Guilty to Misconduct

In Protection Strategies, Inc. v. Starr Indemnity & Liability Co., the U.S. District Court for the Eastern District of Virginia allowed an insurer to recoup more than $670,000 in costs paid for the insured first to respond to...more

Considerations For Insurers In The Aftermath Of The MetLife Consent Decree

MetLife Consent Decree - On March 26, 2014, the New York Department of Financial Services (the "DFS") entered into a consent decree ("Consent Decree") with MetLife, Inc. and its subsidiaries, American Life Insurance...more

New York DFS Obtains Substantial Settlement In Licensing Enforcement Action

On March 31, in an enforcement action with potential implications for a range of financial service providers, the New York State Department of Financial Services (DFS) announced that an insurance holding company agreed to pay...more

Regulatory Risk Update - Defendant's Costs in Criminal Proceedings

The ability of companies to recover costs of defending criminal proceedings has been severely restricted by the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (the "Act"). CHANGES TO THE LAW - The...more

Cyber Espionage And Insurance Coverage

In the United States alone, it is estimated that the cost of “[c]yber-espionage and other malicious cyber crimes...[i s] between $24 billion and $120 billion annually.” In 2008, the U.S. Department of Defense’s classified...more

Slow Down, WA Court Taps the Brakes on Insurer’s Duty to Defend

On January 28, 2014, the Washington Court of Appeals held that an insurer had no duty to defend a motorist under either his homeowners or auto insurance policies when the unambiguous allegations made against the insured...more

Insurance Relationships Revisited

In a recent decision of the NSW Court of Appeal (the Court) in Horsell International Pty Ltd v Divetwo Pty Ltd [2013] NSWCA 368, a firm of insurance brokers (Horsell) was ordered to indemnify an insured (Divetwo) in...more

Legislative Update Report No. 2014-01 -- Jan 13, 2014

In This Article: Federal Government; Alberta; British Columbia; Manitoba; New Brunswick; Newfoundland; Northwest Territories; Nova Scotia; Nunavut; Ontario; Prince Edward Island; Québec/Quebec; Saskatchewan; and Yukon....more

Florida Court Allows Rescission of a Professional Liability Policy

In its recent decision in Zurich American Ins. Co. v. Diamond Title of Sarasota, Inc., 2013 U.S. Dist. LEXIS 170981 (M.D. Fla. Dec. 4, 2013), the United States District Court for the Middle District of Florida had occasion to...more

Washington Appellate Court Holds That Below-Limits Settlement Fails to Trigger Excess Policies

On November 12, 2013, in Quellos Group LLC v. Federal Insurance Company, the Washington Court of Appeals affirmed summary judgment in favor of two excess professional liability insurers because the excess policies “require[d]...more

Medical Identity Theft: New Recommendations By The California Attorney General To Health Care Organizations For Keeping Medical...

Unlike financial identity theft, which targets a victim’s financial health, medical identity theft threatens a victim’s very existence. The unauthorized access of a victim’s medical record not only grants the thief access to...more

Consumer Fraud Complaints Rise With Rollout of Affordable Care Act Exchanges

Criminal Prosecutions Expected in 2014 Related to ACA Fraud - Last month's troubled rollout of HealthCare.gov, the federal marketplace for online health insurance enrollment under the Affordable Care Act (ACA),...more

The Anti-Kickback Statute And The Affordable Care Act: A Law Enforcement Tool Suddenly Goes Missing

With the aggressive pursuit of cases against the pharmaceutical and device industries (including the recent $2.2 billion settlement with Johnson & Johnson), the implementation of Medicare Fraud Strike Forces in major cities...more

Operative Reports May Lead to False Statement Prosecution

You are a hardworking surgeon who is committed to providing quality care to all of your patients, including your Medicare beneficiaries. Because you are so busy, you routinely dictate your pre-operative and post-operative...more

Florida Court Holds Criminal Conduct Exclusion In E&O Policy Applicable

In its recent decision in Certain Interested Underwriters at Lloyd’s v. AXA Equitable Life Insurance Company, 2013 U.S. Dist. LEXIS 159639 (S.D. Fla. Nov. 7, 2013), the United States District Court for the Southern District...more

Ten Steps To Help Insurers Preserve Their Right To Restitution Under Federal Victims’ Rights Statutes

The Crime Victims’ Rights Act and the Mandatory Victims’ Restitution Act provide a wide range of circumstances under which those convicted of federal economic crimes must pay court ordered restitution to their victims. Unlike...more

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