News & Analysis as of

Insurance Contracts

The Polish regulator’s position on insurance companies publishing their standard contracts on their websites

by Hogan Lovells on

Based on the new regulation in the Polish insurance market that entered into force on 1 January 2016, the general terms and conditions of insurance (“GTC“) as well as other standard contracts must be published by insurers on...more

The Future of Discretionary Clauses in California Life and Disability Insurance Agreements

by McDermott Will & Emery on

On May 11, 2017, the United States Court of Appeals for the Ninth Circuit reversed a district court ruling, and upheld a California law that invalidates a plan provision that assigns the final determination on benefit payout...more

Grounding Deferential Review in California – No Preemption for Discretionary Clause Ban

by Seyfarth Shaw LLP on

Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more

Time Is Money: A Remedy for Delay in Settlement of Commercial Insurance Claims in the UK?

by Jones Day on

Section 13A of the Insurance Act 2015 ("Section 13A") implies a term into insurance policies issued or varied after that date that requires insurers to settle claim sums due within a "reasonable time". This new provision...more

French Legal and Regulatory Update – March 2017

by Hogan Lovells on

The Paris office of Hogan Lovells is pleased to provide this English language edition of our monthly e-newsletter, which offers a legal and regulatory update covering France and Europe for March 2017. Please see full...more

A Stitch in Time Saves … An Insured From Incurring Non-Covered Defense Costs

by Carlton Fields on

Timely notice is typically a condition precedent to coverage under an insurance contract, though many states require an insurer to demonstrate prejudice before denying coverage solely based on a failure to comply with a...more

Italy: IVASS once again shines a spotlight on PPI policies

by Hogan Lovells on

After one year from the last coordinated intervention of IVASS and the Bank of Italy in this sector aimed at better protecting policyholders/borrowers, IVASS issued a new letter to the market addressed to insurance...more

Mexico: CONDUSEF issues rules for registration of adhesion contracts

by Hogan Lovells on

The National Commission for the Protection and Defence of Users of Financial Services (CONDUSEF) recently issued the General Provisions for the Registration of Insurance Adhesion Contracts, which regulate the organisation and...more

CPP Disability Benefits: To Deduct or Not to Deduct

by Field Law on

The standard form SEF 44 endorsement (The Endorsement) was recently interpreted by the Supreme Court of Canada in the case of Sabean v. Portage La Prairie Mutual Insurance Co., 2017 SCC 7. The Endorsement indemnifies an...more

Chris Lazarini Comments on Ambiguity in Insurance Policy - Thought Leadership - Bass Berry

by Bass, Berry & Sims PLC on

Bass, Berry & Sims attorney Chris Lazarini commented a case in which a broker-dealer claimed the term "final judgment" in its insurance policy was ambiguous and should be construed against its insurance carrier, as is typical...more

California Supreme Court Leans in Favor of Treating Defense Bills as Privileged Communications

by Farella Braun + Martel LLP on

On October 6, the California Supreme Court heard oral argument in Los Angeles Board of Supervisors v. Superior Court, a case that we have blogged about twice in the past because of its possible impact on policyholders...more

The Insurance Act 2015: Complying with the duty to make a fair presentation and contracting out of the new Act

by Reed Smith on

The Insurance Act 2015 (the new Act) came into force on 12 August 2016 and introduced major changes in English law in relation to insurance and all forms of reinsurance. We drew attention in a previous alert to the key...more

Eleventh Circuit Finds Mere Existence Of Insurance Contract Satisfies Condition Precedent To Action For Double Damages Under The...

The Eleventh Circuit Court of Appeals recently held that a private insurance company/PART C Medicare Advantage Organization (MAO) may sue a Personal Injury Protection (PIP) insurance carrier for reimbursement of medical...more

Tropical Storm Hermine | A Quick Reference Compliance Guide to Adjusting Storm Related Claims in Florida

by Zelle LLP on

..Once a wind storm is named as a hurricane by the National Weather Service, and a warning or watch for any part of Florida is issued, all wind losses in the state from that time until 72 hours after the last warning or watch...more

Contra Proferentem Doesn’t Always Mean ‘Against the Insurer’

by Zelle LLP on

Despite best efforts, ambiguities are inevitable in contracts. The doctrine of contra proferentem shifts the risk of ambiguity to the party that drafted the contract. The doctrine is frequently applied against insurers where...more

Missouri Court Of Appeals Finds Facultative Reinsurance Agreement Between Parties Was Truly A Liability Insurance Contract Which...

by Carlton Fields on

Although the parties had entered into what they called a Facultative Reinsurance Agreement (“FRA”), the Missouri Court of Appeals determined the agreement was a contact of indemnity against liability, and thus, pursuant to...more

‘Sorry, But You Have Nothing in Common’: The New York Court of Appeals’ Recent Rejection of the ‘Common Interest Doctrine’...

by Reed Smith on

The New York Court of Appeals, the state’s highest court, recently rejected an attempt to apply the “common interest doctrine,” an exception to the general rule that communicating privileged information to a third party...more

It’s Insurance: The Financial Institution Bond

by Murtha Cullina on

Formerly known as a bankers blanket bond, and sometimes referred to as a fidelity bond, the financial institution bond as it is commonly known, is simply an insurance policy. Though the term “insurance policy” does not...more

DOJ and North Carolina Challenge Anti-Steering and Tiering Provisions in Managed Care Contracts

by Foley & Lardner LLP on

The Department of Justice’s antitrust division (the “DOJ”)and the State of North Carolina (“NC”) jointly sued, on June 9, 2016, Carolinas HealthCare System (“CHS”), the largest healthcare system in North Carolina, over...more

What Constitutes an Unequivocal Denial of Coverage? New Jersey District Court Provides Some Guidance

Like most jurisdictions, New Jersey allows parties to an insurance contract to shorten the six-year statute of limitations for contract actions. See N.J.S.A. 2A:14-1 (“Every action at law . . . for recovery upon a...more

Taking Rights over Third Party Insurances

by Reed Smith on

Following the publication of our client alert dated 20th January 2016, we have been asked to consider a series of issues relating to insurance arrangements designed to maximise the benefit of cover for the interests of a...more

Employee Assistance Programs and State Insurance Regulation Structuring EAPs to Ensure Compliance

by Foley & Lardner LLP on

Employee Assistance Programs (or EAPs) have served employers and their employees for decades, providing a variety of benefits to address issues that might otherwise adversely affect the overall health and work of employees. A...more

Damages for Late Payment of Insurance Claims – A Major Advance for Policyholders

by K&L Gates LLP on

The late payment of insurance claims has been a particular problem for commercial policyholders for many years. Any business which is the target of multiple claims or criminal or regulatory investigations or proceedings, or...more

Product Recalls and Insurance: Considerations to Maximize Covered Expenses

by McCarter & English, LLP on

Berries. Walnuts. Wholesome. Healthy. But not when they may be contaminated with harmful bacteria. On May 10, 2016, grocery store chain Publix announced a voluntary recall of its cranberry nut and seed mix. Publix learned of...more

New York High Court Gives the Bronx Cheer to Insurers’ Pro Rata Allocation and Exhaustion Arguments

Over time, New York’s courts have erected multiple barriers to policyholders seeking to recover insurance for long-tail, progressive injury claims—such as environmental or asbestos liabilities—that can implicate multiple...more

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