Making Effective Use of the Claims/Disputes Process
On June 6, 2024, the US Supreme Court decided Becerra v. San Carlos Apache Tribe and Becerra v. Northern Arapaho Tribe (Nos. 23-250 and 23-253), holding that the Indian Health Service (IHS) must reimburse Native nations,...more
There are a litany of deadlines an insurer must be mindful of, and this is especially true in Texas, which imposes a number of statutorily prescribed deadlines during the claim adjustment process. The Texas Prompt Payment of...more
The U.S. Supreme Court ruled on June 6, 2024, that the Indian Health Service (IHS) must pay contract support costs with respect to program income – payments from Medicare, Medicaid and private insurers – received by tribes...more
A very large class action settlement has an approaching deadline for class members to file claims. The class is very broad, defined as “all persons, businesses, and other entities that have accepted any Visa-Branded Cards...more
Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more
England has no direct equivalent to US class actions. However, there are various claim models under English procedural rules (CPR) that have similarities. They are summarised in our October 2022 blog post – Data Disputes: How...more
On April 18, 2024, HRSA released its 2024 340B Administrative Dispute Resolution (ADR) Final Rule (2024 ADR Final Rule) and it is largely favorable to covered entities (CEs) with pending ADR claims against drug manufacturers....more
The U.S. Department of Labor (“DOL”) recently filed a lawsuit against UMR, Inc., a third-party administrator and UnitedHealth Group, Inc. subsidiary. The lawsuit alleges that UMR denied thousands of claims based on diagnosis...more
In the October Monthly Minute, we highlight a 6th Circuit decision that puts a spotlight on the adequacy of claim procedures and related judicial standards of review, and review the Supreme Court’s unwillingness to enter the...more
This article discusses the various independent analyses that experts perform and how these analyses should be integrated when involved in a construction dispute that has progressed to international arbitration. While experts...more
The rollout of a statewide electronic court filing system called Odyssey Integrated Case Management System, or Odyssey ICMS, is officially underway....more
In Sturdivant v. NC Department of Public Safety (No. COA22-421), the North Carolina Court of Appeals affirms Full Commission Opinion and Award denying extended benefits under N.C.G.S. 97-29 (c)...more
In international construction contracts, few legal matters are more important than the definitions of "Claim" and "Dispute" or the procedure for the "Dispute Avoidance/Adjudication Board ("DAAB")". These are all the subject...more
The United States District Court for the Eastern District of Oklahoma, applying Oklahoma law, granted an insured’s motion for summary judgment, finding that a claim was sufficiently made and reported during the policy period....more
How can carriers prepare for what is to come after Fiona’s direct impact on Puerto Rico? First and foremost, carriers should begin securing and mobilizing an adequate roster of independent adjusters, ready to respond to...more
“Garbage in, garbage out” is a popular adage in the world of analysis. The general concept is that faulty inputs produce low-quality outputs. This is especially true when it comes to evaluating economic damages claims for...more
Customers and creditors of Voyager Digital Holdings face a deadline to file official “proofs of claim” setting forth the amounts they assert that Voyager owes them. The deadline is 5:00 p.m. ET on October 3, 2022...more
How Do I Know If I Have a Exactech Claim? STEP 1: Obtain Medical Records - We have written extensively about the different types of defects in certain Exactech products, and the various causes of those defects,...more
The U.S. Supreme Court recently declined to review a significant decision of the Second Circuit which (1) clarified the scope of California’s statutory ban on discretionary clauses in life and disability insurance contracts,...more
In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more
A recent statement by the U.S. Department of Veterans Affairs (VA) announced that it is hiring 2,000 new employees to help with processing disability claims, which is welcome news given that the current backlog of claims...more
Contractors' extension of time (EOT) entitlements and associated financial rights are always to be assessed pursuant to the applicable contract mechanism. A recurring question is whether EOT entitlements are to be determined...more
The well-worn adage that “you can’t fight City Hall” does not apply to federal government contractors. The Contract Disputes Act (CDA) provides the statutory framework governing contract disputes between contractors and the...more
Introduction - The Fair Credit Reporting Act (FCRA) was enacted to promote the accuracy, fairness, and privacy of information maintained by Consumer Reporting Agencies (CRAs). In addition to imposing duties on the CRAs,...more
In Microsurgical Tech., Inc. v. Regents of the Univ. of Colorado, No. PGR2021-00026, Paper 12 (P.T.A.B. June 16, 2021), the Patent Trial and Appeal Board (“PTAB”) held that disclaimed claims should be considered for...more