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Administrative Agency Insurance

Read need-to-know updates, commentary, and analysis on Administrative Agency issues written by leading professionals.

Zenefits’ Saga in Washington State Continues: Reviewing Officer Reverses ALJ and Finds that Provision of Free Software to General...

• Zenefits’ practice of providing free software to the general public constitutes an improper rebate under the state’s anti-rebate provisions • Ruling could have significant impact on brokers’ ability to provide...more

Washington Administrative Law Judge: Zenefits’ Provision of Free Software to General Public Does Not Constitute an Improper...

• Washington Administrative Law Judge rules that Zenefit’s provision of free software to general public does not infringe on the state’s anti-rebate laws due to value it provides to Washington businesses; however,...more

SDNY Rules SEC Investigation Is A “Claim” Within Pending And Prior Acts Exclusion

by Carlton Fields on

The U.S. District Court for the Southern District of New York has held that a long-running investigation by the SEC constituted a “Claim” triggering the pending and prior claims exclusion in an excess directors and officers...more

A Seemingly Important Win for Wisconsin Worker’s Compensation Insurance Carriers and Employers

by Ruder Ware on

On its face the decision of the Wisconsin Supreme Court in Flug v. LIRC, 2017 WI 72 (decided on June 30, 2017), is a clear, important win for the employer side in common injuries that involve pre-existing degenerative...more

NLRB Rules That Employers Have a Duty to Bargain Over ACA-Mandated Group Health Benefit Changes

On May 16, 2017, the National Labor Relations Board (“NLRB”) issued a decision holding an employer has the duty to bargain with a union over changes to a group health plan even though the changes were mandated by the...more

The D.C. Court of Appeals Just Scrapped the Drone Registry and May Have Also Turned Homeowners Insurers into Aviation Insurers

Model-aircraft hobbyist John Taylor didn’t want to register his model aircraft with the FAA pursuant to the newly created drone registry. So he took on the FAA, challenging new regulations aimed at unmanned aircraft...more

Top 10 Things Defense Lawyers Need to Know About Lack of Good Faith Claims

by Pessin Katz Law, P.A. on

By now, every Maryland defense lawyer knows that there is a cause of action that can be leveled against insurers for lack of good faith. Most even know that this cause of action is based on Md. Code Ann., Cts. & Jud. Proc. §...more

FAA Drone/Human Collision Analysis Study Helpful for Drone Insurance

by Rumberger Kirk & Caldwell on

The FAA recently published the results of a study that was designed to evaluate the risks of serious injury to a pedestrian resulting from a drone collision. ...more

New Jersey’s Unemployment Compensation Act Definition Of “Simple Misconduct” Deemed Arbitrary And Capricious

New Jersey’s Unemployment Compensation Act (the “Act”) provides for three different levels of misconduct that will result in disqualification for benefits. “Simple misconduct” disqualifies employees for benefits for the week...more

Changes to Stabilize HealthCare.gov Have Implications for Employer Sponsored Health Plans

by Winstead PC on

We learn early on that for any action there is a reaction. On Friday, the Department of Health and Human Services released “Market Stabilization” final regulations that will impact group health plans as they plan for 2018....more

Have You Noticed the Increase in Food Recalls?

by Robins Kaplan LLP on

Almost every day, the FDA announces a new recall or safety alert for a potentially dangerous food. Earlier this month, Trader Joe’s recalled some SKUs of apple sauce due to complaints that they may contain small pieces of...more

Connecticut Supreme Court Issues Important Clarification For Independent Contractor Test

On March 21, 2017, the Connecticut Supreme Court issued an important ruling, finding that an individual may be still considered an independent contractor under the state’s Unemployment Insurance Act even if he/she only...more

Wisconsin Unemployment Insurance Benefits Upon Discharge for Absenteeism – the Employer’s Policy May Be More Generous, But Not...

by Ruder Ware on

The Wisconsin Court of Appeals issued a decision in an unemployment insurance benefits case on March 8 that provides clarity where an employee is discharged for absenteeism. The case is Wisconsin Department of Workforce...more

Labor Department Boosts Disability Claimant Protections

by Fisher Phillips on

The U.S. Department of Labor (USDOL) recently issued a final rule addressing disability benefit claims and appeals (see 81 FR 92316). The rule adds new procedural protections and safeguards meant to ensure disability...more

Final Disability Claims and Appeals Regulations – Be Prepared to Comply

by Foley & Lardner LLP on

In December 2016, the Department of Labor issued final regulations under ERISA governing claims procedures for group disability plans, which will become effective January 1, 2018. Generally, these regulations were drafted to...more

California Supreme Court Upholds Public Retirement Boards' Fiduciary Role When Adjudicating Disability Retirement Applications

by Nossaman LLP on

In a victory for the San Bernardino County Employees’ Retirement Association (“SBCERA”) and the nineteen other county retirement systems administered under the County Employees Retirement Law of 1937 (Gov. Code, § 31450 et...more

ERISA: Winning Tactic on Summary Judgment to Prove Claimant Received the Policy: Get Key Evidence into the Administrative Record

You know that to apply an exclusion in a policy, the claims administrator must show that the claimant received the policy. But what happens when the claimant submits a declaration disputing your proof that she received...more

Minnesota Discovers Limits To Its Regulator’s Power Over Insurers

by Carlton Fields on

In Minnesota, the Commissioner of the Department of Commerce regulates the insurance industry, and he has a statutory right to conduct investigations “related to the duties and responsibilities entrusted to” him. Last month,...more

SEC Watchdog to Watch Watchdog

by Carlton Fields on

The SEC’s Office of Compliance Inspections and Examinations (OCIE) has established a dedicated team charged specifically with inspecting FINRA and other FINRA-related work. This follows through on the SEC’s...more

US Federal Regulatory Agencies Request Comment on Proposed Private Flood Insurance Rule

by Shearman & Sterling LLP on

The US Federal Reserve Board, the Farm Credit Administration, the FDIC, the National Credit Union Administration and the OCC issued a joint notice of proposed rulemaking to implement provisions of the Biggert-Waters Flood...more

New York’s Highest Court Rules that Yoga Instructors are Independent Contractors: But Can Other Employers Hold that Pose?

The New York State Court of Appeals and New York City recently provided additional guidance for – and imposed additional requirements on – New York employers that use independent contractors. In In re Yoga Vida NYC, Inc....more

Yoga Instructors Can Be Independent Contractors, Says NY Court of Appeals

Earlier this week, the New York State Court of Appeals in Yoga Vida NYC, Inc. v. Commissioner of Labor., No. 130 (N.Y. Oct. 25, 2016), issued a rare decision concerning an unemployment determination, reversing the Appellate...more

New York’s Highest Court: No “Stretch” in Yogi’s Independent Contractor Classification

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The New York Court of Appeals recently rejected the narrow view of the Unemployment Insurance Appeal Board and found that substantial evidence did not support a finding that certain yoga instructors were...more

HUD Advocates Broad “Disparate Impact” Liability for P&C Insurers

by Pullman & Comley, LLC on

In February 2013, the U.S. Department of Housing and Urban Development adopted a “Discriminatory Effects Rule,” which established liability under the Fair Housing Act for conduct that is otherwise lawful, but which has a...more

A Question of Timing – Social Security Disability Determinations and the Administrative Record

by Seyfarth Shaw LLP on

Seyfarth Synopsis: Court excludes evidence of Social Security disability award issued after the final decision issued on plaintiff’s claim for plan disability benefits. The decision accentuates the importance of fighting to...more

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