The United States District Court for the Eastern District of Michigan, applying Michigan law, has held that, even absent an express policy provision regarding recoupment, an insurer was entitled to recoup defense costs after...more
SIU stands for Special Investigation Unit, and nearly all insurance companies have one, especially health insurers. SIUs exist to investigate complaints of fraud, waste or abuse, and train claims personnel to recognize and...more
Applying Delaware Law, the United States District Court for the District of Delaware has held that there is no coverage for acts undertaken by an insured’s directors and officers that occurred prior to the formation of the...more
In situations where there is a dispute over a duty to defend, an insurer may provide a defense to its insured, subject to a reservation of rights, to not only deny coverage for a defense, but also to file a declaratory...more
Answering a certified question regarding a matter of first impression, the Nevada Supreme Court has held that an insurer is entitled to reimbursement of defense costs expended in defense of an insured where a determination is...more
Carriers rely on application representations regarding the existence of potential claims. Sometimes, the carrier learns after the fact that an applicant may not have reported all known potential claims. What can/should the...more
New York Federal Court Rejects Insurer’s Request for Recoupment - Why it matters: The federal court, applying New York law, held that an energy drink manufacturer’s advertising coverage claim—arising from underlying...more