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Dismissal of Medicare Advantage FCA Suit Marks Significant Defeat for Government

by Bass, Berry & Sims PLC on

The U.S. District Court for the Central District of California recently dismissed a complaint-in-intervention filed by the U.S. Department of Justice (DOJ) in U.S. ex rel. Swoben v. Secure Horizons. As previously reported,...more

SC Supreme Court Says Insurers Can’t Cloud Allocation of Covered and Non-Covered Damages

The South Carolina Supreme Court’s decision in Harleysville Insurance Co. v. Heritage Communities, Inc., modified July 27, 2017, continues a trend of decisions aimed at preventing an insurer from acting in its own interest to...more

Court Dismisses Suit By Rehabilitator For PMI Insurer Against Captive Reinsurer And Affiliated Bank

by Carlton Fields on

A district judge in the Northern District of Illinois has dismissed all claims brought by the Illinois Director of Insurance, acting as rehabilitator for Triad Guaranty Insurance Corporation and Triad Guaranty Assurance...more

Arizona District Court: Insurer Expert's Deposition Testimony Impliedly Waived Attorney-Client Privilege in Bad Faith Case

by Jaburg Wilk on

The Takeaways - Bad faith defense counsel should caution their bad faith experts not to speculate that an insurer’s claim decisions were based on advice of counsel. - The Hunton case continues the trend of Arizona...more

Michigan No Fault Auto Insurance Benefit Denials up 236%

by Michigan Auto Law on

Insurers scream “No-Fault fraud,” even as they cause huge spike in Michigan No-Fault benefit denials and cut-offs of car crash victims - There’s going to be a number of No-Fault reform legislative proposals expected to be...more

Beware of Prior Act Exclusions and Retroactive Dates When Procuring or Renewing Coverage

An 11th Circuit decision issued earlier this year serves as a reminder of the importance of carefully evaluating time-based exclusions and retroactive dates when procuring or renewing coverage. Liability policies such as...more

New Jersey Supreme Court Reminder – Don’t Forget about the Corporate Practice of Medicine

A New Jersey Supreme Court case earlier this summer has New Jersey lawyers re-examining their clients’ business structures under the State’s corporate practice of medicine doctrine....more

Employee Benefits Developments - July 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of July, 2017. Class Action Plaintiffs Target University 403(b) Plans - In June, an ERISA action – a proposed...more

Recent Ninth Circuit Rulings Uphold Plaintiffs’ Efforts to Predicate Claims on Alleged Insurance Code Violations — Likely More to...

by Carlton Fields on

Recent rulings suggest insurers face increased risk of suits predicating breach of contract and state unfair trade practices claims on alleged violation of state insurance laws, notwithstanding the lack of an express private...more

Dechert's Global Private Equity Newsletter - Summer 2017 Edition: D&O Insurance Coverage - How Careful Should the Drafting Be?...

by Dechert LLP on

Directors are required to review and approve transformative M&A transactions. The power to approve, however, comes with the potential liability that could be asserted if the transactions do not turn out as projected....more

Restructuring and Insolvency Bulletin Issue 1 - 2017: United States: D&O Insurance Policies – a cautionary tale: the Peril of...

by Dechert LLP on

Directors and officers (D&Os) of troubled companies should be highly sensitive to D&O insurance policies with Prior Act Exclusion. While policies with such exclusion may be cheaper, a recent decision by the U.S. Court of...more

Sixth Circuit’s holding that debtor in possession and liquidating trustee are one in the same for purposes of...

by Butler Snow LLP on

The Sixth Circuit Court of Appeals recently took up the controversial issue of whether a liquidating trustee’s lawsuit, alleging breach of fiduciary duty against a corporate debtor’s officers, falls within the...more

Absolute Pollution Exclusion—Not So Absolute

by Perkins Coie on

Slapping insurers with breach of contract and bad faith, Washington state’s highest court recently found that a general liability policy’s so-called “absolute” pollution exclusion may not be so absolute. In Xia et al. v....more

Insured May Bear the Consequences of Insurer’s Negligence

For decades, California courts have mandated that an insurer is obligated to accept a “reasonable” settlement demand within policy limits on behalf of its insured. If it fails to do so, it is liable for the entire judgment,...more

Torts & Insurance Cases from the 4th Circuit Court of Appeals

by Nexsen Pruet, PLLC on

Each month, Nexsen Pruet attorney Marc Manos, a member of the SC Bar Torts and Insurance Practice Section Council, sheds light on a few recent cases from the Fourth Circuit Court of Appeals, focused in the area of Torts &...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

Eleventh Circuit Deems Voluntary Dismissal of a Coverage Action Sufficient to Award Attorneys’ Fees to a Policyholder as the...

by Carlton Fields on

In a recent unpublished opinion, the Eleventh Circuit issued a decision that should serve as a warning to insurers to be sure to resolve all issues before dismissing a coverage action, particularly when involved in the...more

Back to Basics – Costly Consequences of Ignoring Process in Benefits Administration

The stories of an employer and a long-term disability insurer and claims fiduciary for an ERISA plan, defendants in two recent cases, ring so true. In the first case, the insurer was designated as claims fiduciary for an...more

FCA Issues to Watch: Pharmaceutical and Device Developments | INSIDE THE FCA

by Bass, Berry & Sims PLC on

The government’s FCA enforcement efforts have continued to focus on key areas concerning the pharmaceutical and medical device industries. In fact, drug and device manufacturers accounted for nearly half of the enforcement...more

Law Firm Sues Insurer Over $700K in Lost Billings Due to Ransomware Attack: eDiscovery Trends

by CloudNine on

A small Rhode Island law firm has filed a lawsuit against its insurance company after the insurer refused to pay $700,000 in lost billings following a ransomware attack on the firm that locked down the firm’s computer files...more

Suit Limitation Period In Standard Flood Insurance Policy Is Not Tolled By Filing In State Court: Hurricane Irene Claim Dismissed...

The terms and conditions of the Standard Flood Insurance Policy (“SFIP”) are specified by regulations promulgated under the National Flood Insurance Act (“NFIA”). One of the terms in the SFIP provides that the insured cannot...more

Second Circuit Affirms Dismissal of FCA Cases

by Jones Day on

The Second Circuit affirmed the dismissal of two False Claims Act ("FCA") cases brought by private relators against insurance and other companies based on the alleged failure to reimburse the Centers for Medicare & Medicaid...more

Navigating Yates Memo Minefield and Broadening of Excess Side-A DIC D&O Insurance Policies

by Perkins Coie on

Former Deputy Attorney General Sally Yates issued a memorandum (the Yates Memo) in September 2015 setting forth guidance on how the U.S. Department of Justice would handle future corporate investigations and, to the extent...more

A Common Interest Agreement May Not Be Worth the Paper It’s Written On

by Wilson Elser on

It is a very common practice for counsel to co-defendants or co-plaintiffs to enter into agreements that shield their communications. The agreements are expressions of intent that the communications will be protected by the...more

Labor Depreciation: Growing Trend Can Result In Trouble for Individual and Commercial Policyholders

by Hellmuth & Johnson PLLC on

A trend in insurance called labor depreciation could leave you holding the proverbial bag when it comes time for a covered repair. The practice, which only continues to grow, can leave claimants without the necessary funds...more

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