News & Analysis as of

Fraud Insurance Industry

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Bradley Arant Boult Cummings LLP

Does Your Cyber Insurance Cover Social Engineering Fraud?

Most policyholders are aware of the danger of losses from fraudulent instructions and invoices accomplished through what is known as “social engineering” or related methods. Often this is carried out by an email claiming to...more

Marshall Dennehey

Appellate Court Affirms Ruling a Sworn Proof of Loss and Estimate Related to Later Claim Was Inadmissible as Hearsay and...

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Universal Property & Casualty Insurance Company v. Luis Nacimiento, Fla. 3rd DCA, 3D23-0301, Apr. 3, 2024 - The insured reported a claim to Universal Casualty & Property Insurance Company in February 2016 for water damage...more

Benesch

Dental/DSO Intelligence Monthly Report: July/August 2024

Benesch on

Background on Indiana’s “Baby HSR” Law - Indiana passed Senate Bill 9 in March 2024, which requires an Indiana healthcare entity involved in a merger or acquisition with another healthcare entity with a value of at least...more

Pillsbury Winthrop Shaw Pittman LLP

SCOTUS Grants Insurers “Party in Interest” Standing in Chapter 11 Cases

In a rebuke of a common law doctrine that denied insurer standing in chapter 11, the U.S. Supreme Court ruled unanimously that insurers with financial responsibility for claims asserted in bankruptcy are parties in interest...more

Robins Kaplan LLP

AI’s Impact on Property Insurance Coverage

Robins Kaplan LLP on

Artificial Intelligence (AI) is the simulation of human intelligence processes by machines, such as computer systems for assistance in quickly answering complicated questions, researching a specific topic, or creating an...more

Segal McCambridge

Michigan Supreme Court Cracks Down on Fraud in Claims filed with the MAIPF: Honesty Matters Throughout the Process

Segal McCambridge on

Car insurance plays a crucial role in protecting drivers and their finances after an accident. It provides financial support for medical bills, lost wages, and car repairs. However, a recent Michigan Supreme Court decision in...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

King & Spalding

Sixth Circuit Holds that Bank Settlement Payment to Resolve Fraudulent Transfer Liability Is Insurable Loss Under Ohio Law and...

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On February 1, 2024, the U.S. Court of Appeals for the Sixth Circuit, in an unpublished opinion, held that a bank’s professional liability insurance includes coverage for a $32 million settlement payment the bank made to...more

Bradley Arant Boult Cummings LLP

One Phrase, Multiple Interpretations – How Your Scope of Cyber Coverage Can Vary Depending on Your Jurisdiction

This is a deceptively simple question — risk managers rightfully expect to know the scope of their coverages when they build their insurance programs. Unfortunately, judicial interpretation of common policy terms can turn...more

Melito & Adolfsen

Accidents, pain, lawsuits, doctors and lawyers. Is the pain real? The Nail Gun Story.

Melito & Adolfsen on

Anyone injured in an accident allegedly caused by the negligence of another can sue for pain caused by the injury. The increasing number of surgeries injuries from accidents is now a major focus of defendants and the...more

J.S. Held

2024 J.S. Held Global Risk Report: New Laws Addressing the Risks and Rewards of Artificial Intelligence (AI)

J.S. Held on

The race to develop AI and calls to regulate it are heating up around the world. In November 2023, 28 countries, including the United States, United Kingdom, China, and the European Union, met and pledged to work together to...more

Skadden, Arps, Slate, Meagher & Flom LLP

JPEX Is Test Case for Hong Kong’s New Regulatory Regime for Virtual Asset Exchanges

Hong Kong regulators recently brought criminal enforcement actions against virtual asset trading platform JPEX and individuals associated with the platform. This case has become the first opportunity for local authorities to...more

White & Case LLP

The SEC’s Charges Against SolarWinds and its Chief Information Security Officer Provide Important Cybersecurity Lessons for Public...

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On October 30, 2023, the US Securities and Exchange Commission ("SEC") announced that it filed charges against SolarWinds Corp. ("SolarWinds" or the "Company") and its Chief Information Security Officer ("CISO") in connection...more

Hinshaw & Culbertson - Insights for Insurers

Two Cases Directly Impacting Insurers are Currently Pending Before the United States Supreme Court

Rulings by the United States Supreme Court profoundly impact insurers as businesses and corporate citizens. Additionally, decisions from the U.S. Supreme Court can also influence claims and policyholders' liabilities for...more

Bradley Arant Boult Cummings LLP

The Haunting in the Cornfield: Relators’ Qui Tam Claim Confirmed Dead by the Eighth Circuit

The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more

Foley & Lardner LLP

How Companies Can Audit Insurance Policies to Determine PFAS Coverage

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Companies operating in the food and beverage industry are dealing with PFAS-related issues on a daily basis. So far, twelve states have passed legislation regulating PFAS, and each of those twelve states explicitly targets...more

Womble Bond Dickinson

Sam Bankman-Fried Case Provides Lessons on Fraud and D&O Insurance

Womble Bond Dickinson on

Sam Bankman-Fried’s criminal trial started this week; and on the same day, he sued one of his director & officer insurers. And a lot of people are asking, why? Is the timing a coincidence or on purpose? Shouldn’t he be...more

Marshall Dennehey

New Jersey Court Reviews No-fault Law’s Language and Finds That There Was Nothing Preventing an Arbitrator From Hearing Common Law...

Marshall Dennehey on

GEICO, et al. v. Caring Pain Management PC, et al., Case No. 2:22-cv-05017(BRM)(JSA) 2023 WL 3749984 (U.S.D.C. District of New Jersey May 31, 2023) - The defendants (a series of medical providers) filed a motion to dismiss,...more

Mitchell, Williams, Selig, Gates & Woodyard,...

National Association of Insurance Commissioners (NAIC) 2023 Summer Meeting Summary

The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2023 Summer National Meeting which was held in Seattle, Washington. We have prepared a...more

Seward & Kissel LLP

"An Ounce of Prevention"...How to Reduce the Risk of Litigation and Enforcement Proceedings

Seward & Kissel LLP on

To paraphrase what Ben Franklin may have been alluding to nearly 300 years ago in his famous quote, often the best approach when it comes to reducing the risk of litigation and government enforcement proceedings is to take...more

Wiley Rein LLP

Dishonesty Exclusion Bars Coverage For Claim Based On Actions Of Contractor Authorized To Conduct Operations On Behalf Of Insured

Wiley Rein LLP on

Applying California law, a California state appeals court has held that a policy exclusion barring coverage for “any [c]laim . . . [b]ased upon or arising out of any . . . act or omission . . . which is . . . dishonest,...more

Wiley Rein LLP

Fraud Exclusion, California Insurance Code Section 533 Preclude Coverage for Arbitration Award

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A California federal court, applying California law, has held that an employment liability policy does not provide coverage for a judgment against the insured following an arbitrator’s finding of fraud....more

Marshall Dennehey

Why Insurance Carriers’ DPRPs Should Be Specific as to What Claims/actions Are and Are Not Arbitrable to Protect Themselves...

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GEICO filed a complaint against a series of medical providers asserting claims under the New Jersey Insurance Fraud Prevention Act (IFPA), violations of RICO, common law fraud and unjust enrichment. Some of the medical...more

Rivkin Radler LLP

The Title Reporter — Spring 2023

Rivkin Radler LLP on

Here is what we cover in this issue of The Title Reporter: A Legal Update for the Title Insurance Industry: •An appellate court in Arkansas, affirming a trial court’s decision, has ruled that a title insurer had properly...more

Bennett Jones LLP

Court of Appeal Endorses Draconian Deterrent to Insurance Fraud

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In Abbas v Esurance Insurance Company of Canada, 2023 ABCA 36 [Abbas], the Alberta Court of Appeal endorsed what it described as draconian consequences for insurance fraud as consistent with the Insurance Act, RSA 2000 c I-3...more

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