Insurance Updates

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Could You Be More Specific . . . About My Excess AI Coverage?

Are you a general contractor who is pretty sure that you have additional insured coverage for some stuff under your sub-subcontractor’s excess policy? Advent, Inc. v. National Union Fire Ins. Co. of Pittsburgh, PA, Case No....more

Thunder and Lightning: Very, Very Frightening

The title for greatest reaper of catastrophe losses in the United States does not go to the hurricane, blizzard or ice storm but to the much more common thunderstorm. Thunderstorms don’t get cute names from The Weather...more

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

A tale of two mergers: Following their losses in DOJ merger challenges, Anthem fights on and Aetna gives up

In the past month, the DOJ and several state governments scored two trial wins in their challenges to mergers among some of the country’s largest health insurers. First, Judge Bates of the District of Columbia blocked the...more

340B Drug Pricing Program: The Withdrawal of Mega Guidance and the Future of Patient Definition

In the wake of a recent directive issued by the Trump administration to halt pending regulations and guidance while the new leadership conducts its own review, the Department of Health and Human Services, on January 30, 2017,...more

New SBC Template Goes Into Effect April 1

The U.S. Department of Labor (DOL) released a new template for the Summary of Benefits and Coverage (SBC) last year. As background, the Affordable Care Act requires health plans and health insurers to annually distribute SBCs...more

Fast Take on House Republicans’ “Obamacare Repeal and Replace” Plan

On February 16, 2017, House Republicans issued an “Obamacare repeal and replace” policy brief for members to use in speaking with constituents during the Presidents’ Day break. This repeal-and-replace plan is not yet a...more

Logos and Branding May Create Additional Parties to Insurance Coverage Litigation

Insurance coverage lawyers, when defending carriers in first-party claims, regularly deal with the real party in interest issue. The insured’s lawyer, in filing the lawsuit, sometimes names the wrong issuing company, the...more

The U.S.-EU Covered Agreement: Different Assessments By Different Audiences

On January 13, 2017, the week before the inauguration of President Trump, the U.S. Department of Treasury and the Office of the U.S. Trade Representative announced that the negotiations between the full text of the agreement...more

Will lawmakers on break get an earful over GOP’s outline for Trumpcare?

Members of Congress are home in their districts for a week-long break, and many lawmakers are expected to get an earful from voters upset over many issues at the start of the Trump Administration, especially this: What the...more

Marketplace Shockwaves: Insurer Exits Leave Marketplaces Vulnerable

Early this month, Aetna announced that in 2018, it will not expand its Health Insurance Marketplace ("Marketplace" or "Exchange") coverage, and is evaluating whether it will completely pull out of the Marketplaces created by...more

Final DFS Cybersecurity Regulation Issued

New York’s Department of Financial Services issued its final Cybersecurity Regulation last night with an effective date of March 1, 2017. ...more

CMS Issues Proposed Rule to Increase Patients’ Health Insurance Choices for 2018

On February 17, 2017, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule aimed at reforming and stabilizing the individual and small group health insurance markets. When (or if) finalized, the...more

Surplus Insurers, Too, Can Rely on the Application to Interpret Policy

Section 627.419 of the Florida Statutes provides that “[e]very insurance contract shall be construed according to the entirety of its terms and conditions as set forth in the policy and as amplified, extended, or modified by...more

Washington Weighs In On The Scope Of Insurance Regulators’ Authority

In January, we reported that California’s Supreme Court had embraced a problematic approach to the state’s Unfair Insurance Practices Act—one that allows the Commissioner of Insurance to create new statutory torts by...more

HHS Makes Its First Move to Stabilize the Individual Health Insurance Market

Wednesday, the Trump Administration released its first proposed regulation seeking to stabilize the individual insurance market – in particular, the Affordable Care Act (ACA) insurance exchange market (or marketplace). Amidst...more

Insurance Industry Exploration of Blockchain Expands

The insurance industry’s exploration of blockchain-based solutions continues to expand, potentially impacting future policies available to commercial policyholders. The Blockchain Insurance Industry Initiative (B3i), an...more

Top 10 Things Corporate Attorneys Should Know About Insurance

Almost every corporate transaction — mergers, purchase and sales, real estate matters, among others — involves some “insurance” related issues. They can range from simple “insurance requirements” in the corporate documents to...more

Phishing in the Insurance Coverage Gap

Many companies that have both commercial crime and cyberliability insurance policies are learning, to their surprise, that they may not be fully covered if their employees fall for social engineering scams. While the...more

ERISA: 7 Things to Know About Limited Discovery in ERISA Long Term Disability Cases

You already know that discovery in ERISA cases is generally limited because of the “significant ERISA policy interests of minimizing costs of claim disputes and ensuring prompt claims-resolution procedures.”...more

Reserving Claims in Latin America

Determining reserve amounts can be a daunting task. The process can be affected by various obstructing factors. Here are a few items that may affect the determination and posting of reserves for Latin American losses. ...more

Real Property & Title Insurance Update: Week Ending February 10, 2017

REAL PROPERTY UPDATE - Foreclosure: where foreclosing bank, who purchased debt from original mortgagee, failed to establish standing to enforce lost note “through evidence of a valid assignment, proof of purchase of the...more

Good Advice for Everyone: Ten Steps to Avoid Big Trouble

On both a business and individual level, there are ten easy steps you can take now to avoid big trouble later. If you address just five of these items this month, you will be half way there. Originally published in the...more

"DOJ Continues Streak of Successful Merger Challenges With Blocked Aetna-Humana, Anthem-Cigna Deals"

In a continuation of recent Department of Justice (DOJ) successes challenging mergers, the U.S. District Court for the District of Columbia recently enjoined two more proposed mergers brought and litigated under the Obama...more

Be Careful What You Wish For, Part II: Would Companies Be Better Off Without the Fraud-on-the-Market Doctrine?

The villain in the fight against securities class actions is the fraud-on-the-market presumption of reliance established by the U.S. Supreme Court in 1988 in Basic Inc. v. Levinson, 485 U.S. 224 (1988). Without Basic, the...more

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