Insurance Criminal Law

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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

Goldman Ordered to Advance Defense Fees for Former Employee Accused of Stealing Computer Codes

On October 16, 2013, the U.S. District Court for the District of New Jersey, in Aleynikov v. The Goldman Sachs Group, Inc., found that a former vice president and computer programmer was an “officer” of Goldman Sachs & Co.,...more

Computer Crime Insurance Coverage: Can It Cover Fraudulent Entries Submitted by an Authorized User?

In a recent decision, New York's appellate court considered whether a "Computer Systems Fraud" insurance policy rider (Policy) covered losses that Universal American suffered as a result of fraudulent claims electronically...more

Insuring Your Company Against Cyber-Attacks

Earlier this month, the Department of Justice announced the indictment of 13 individuals associated with the hacker organization Anonymous for a widespread scheme to disrupt and shut down commercial and government websites....more

Disability Management Company And Principals Not Guilty Of Making False Statement

A disability management company charged under the Ontario Insurance Act with knowingly making false or misleading statements to an insurer has been found not guilty. The charges were brought on behalf of the Financial...more

Insurance Coverage: September 2013

After several years, the Supreme Court has spoken on the issue of whether or not a claim under the Fair Claims Regulations can be “bootstrapped” into litigation through a claim for violation of the Unfair Competition Laws. In...more

Life Insurance Beneficiary Who Murdered Policyholder Is Not Entitled To Benefits

Applying the common law “slayer rule,” a federal district court in New York held that a beneficiary of an ERISA-governed life insurance plan forfeit his claim to insurance proceeds after he pled guilty to murdering the...more

Court Decides Employer Had No Obligation To Pay Employee’s Attorney

Mention indemnification to a corporate lawyer, and you’re like to hear about Section 317 of the Corporations Code, the articles of incorporation and bylaws. But a corporate agent’s indemnification rights are not necessarily...more

Insuring Your Business - September 2013: “Wrongful Acts” and the Jerry Sandusky Scandal

It has been said that “Hard cases make bad law.” On March 1, the Federal District Court for the Middle District of Pennsylvania ruled that Jerry Sandusky is NOT entitled to insurance coverage under the Second Mile’s...more

California Court: Insurer Cannot Avoid Contractual Commitment to Defend Insured Against Federal Criminal Charges

In an important decision for directors, officers, non-profit executives and other insureds under directors and officers (D&O) and other liability insurance policies, the California Court of Appeal has held that an insurer...more

Health Care Fraud Schemes To Defraud Medicare

Recent news agencies in the Chicago areas have reported that area physicians and health clinic owners are among defendants charged in health care fraud schemes to defraud the Medicare program and/or private health insurers of...more

SEC’s Shift in No-Admit-or-Deny Policy Would Create Dilemma for Defendants if Applied in Close Cases

Last Tuesday, new SEC Chairman Mary Jo White said at The Wall Street Journal’s annual CFO Network Event that the SEC “in certain cases” will seek admissions of liability as part of settlements. The statement made headlines,...more

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