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Carlton Fields

NAIC Still Juggling Multiple AI and Machine Learning Initiatives

Carlton Fields on

The many balls that the various National Association of Insurance Commissioners groups currently have in the air focusing on life insurers’ use of artificial intelligence and machine learning were reflected in the reports...more

Manatt, Phelps & Phillips, LLP

CMS Releases Guidance Outlining Expectations for State Compliance with Medicaid & CHIP Renewal Requirements

On September 20, 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance detailing the timeline and expectations for states to fully comply with federal Medicaid and Children’s Health Insurance Program (CHIP)...more

Downs Rachlin Martin PLLC

CMS – the Federal Agency that Administers Medicare and Medicaid – Recognizes Traumatic Brain Injury as a “Chronic Health...

For more than a decade this blog has covered the growing recognition by policy makers and in the peer reviewed literature that traumatic brain injuries (TBIs) of all kinds should not be treated as a static event from which...more

Goldberg Segalla

Wrongful Death Claim Dismissed in Case Involving Louisiana Statute of Limitations Rule

Goldberg Segalla on

The U.S. District Court for the Eastern District of Louisiana — in Ragusa v. Louisiana Insurance Guarantee Association (October 8) — weighed in whether the state’s LIGA statutes violated the Louisiana Supreme Court rule that...more

Brownstein Hyatt Farber Schreck

2025 Deadline for Health Insurance Subsidies Looms Over Elections

As part of the Inflation Reduction Act (IRA), signed into law in August 2022, Congress passed a three-year extension of enhanced subsidies for individuals purchasing their own health coverage on the Affordable Care Act (ACA)...more

Epstein Becker & Green

Final Mental Health Parity Rules Released: Next Steps for Employers

Epstein Becker & Green on

On September 23, 2024, the U.S. Departments of Health and Human Services, Labor, and the Treasury (collectively, the “Departments”) issued a final rule (“Final Rule”) implementing amendments made by the Consolidated...more

Bradley Arant Boult Cummings LLP

When Is “Yours” Not Yours? Pennsylvania Superior Court Interprets “Your Computer” Definition in Commercial Property Policy

Sometimes defining the simplest phrases proves anything but simple. So learned the insurer in a property loss and bad faith case brought by its insured and decided earlier this year by the Pennsylvania Superior Court...more

Pillsbury - Policyholder Pulse blog

Hurricane Insurance Checklist

The below checklist includes essential considerations and steps to take for property owners and businesses that stand to be affected by hurricanes....more

Pillsbury - Policyholder Pulse blog

Hurricanes Helene and Milton: Insurance Implications

Hurricane Helene struck Florida’s Big Bend region as a category 4 hurricane on September 25, 2024, and continued to move northeast. The storm caused widespread power outages and catastrophic damage across Florida, the...more

Ward and Smith, P.A.

Lessons Learned: Wisdom from Professional Licensing Attorneys

Ward and Smith, P.A. on

Having been in the company of literally thousands of physicians, dentists, psychologists, nurses, and just about every other kind of health professional as they undergo investigations, reviews, and prosecutions of their...more

Cozen O'Connor

When the Appraisal Says One Thing, But the Policy Says Another: A Florida Insurance Case Study

Cozen O'Connor on

In a recent decision by the U.S. District Court for the Middle District of Florida, Wood v. GeoVera Specialty Insurance Company (2024 WL 3952571), the court affirmed that unambiguous policy limits remain enforceable even when...more

Carlton Fields

Up, Up, and Away for RILA Regulation: SEC Adopts Long-Awaited Framework

Carlton Fields on

On July 1, 2024, pursuant to congressional mandate, the SEC adopted a new registration framework for registered index-linked annuities (RILAs). In addition, the SEC has extended the ambit of this framework to include...more

Buchalter

Actual Loss Under A Title Insurance Policy Is Calculated Based On The “Highest And Best Use” Of The Insured Real Property

Buchalter on

In a victory for all insureds who have title insurance policies, and possibly a victory for insureds under other real property related insurance policies, the California Court of Appeal in Tait v. Commonwealth Land Title...more

Mintz - Bankruptcy & Restructuring Viewpoints

Early- and Growth-Stage Companies in Distress: What Directors Need to Know about their Fiduciary Duties

Most high-growth companies find themselves in a race against the clock, trying to use whatever capital they may have to achieve milestones prior to hitting their cash-out date. When markets are tight, as they have been over...more

Searcy Denney Scarola Barnhart & Shipley

Proving a Hit and Run in Florida: What Evidence is Needed?

If you were injured in a hit-and-run accident in Florida, you will need evidence to file an insurance claim. While your personal injury protection (PIP) policy should provide a small amount of coverage regardless of what...more

Marshall Dennehey

Commonwealth Court Holds That Claimant Who Was Sole Proprietor is Required to Provide Notice of Work-related Injury to Workers’...

Marshall Dennehey on

Erie Insurance Property & Casualty Company v. David Heater (WCAB), No. 148 C.D. 2023; filed May 29, 2024; President Judge Cohn Jubelirer - In this case, the claimant was the owner of the employer and the sole employee. He...more

Wiley Rein LLP

California Court of Appeal Affirms Dismissal of Claims against Excess Insurers for Insureds’ Failure to Allege Exhaustion

Wiley Rein LLP on

The California Court of Appeal, applying California law, has affirmed a trial court’s decision dismissing claims with prejudice against two excess carriers for the insureds’ failure to allege exhaustion of the underlying...more

Davis Wright Tremaine LLP

Anything But Routine: New UnitedHealthcare Line-Item Denial Process May Significantly Impact Hospital Reimbursement

UnitedHealthcare recently announced that it will implement a process effective December 1, 2024, under which United may deny charges for inpatient and outpatient facility services that United considers "routine."...more

Locke Lord LLP

Massachusetts Appoints New DOI Commissioner: Michael Caljouw

Locke Lord LLP on

On October 3, Governor Maura Healey appointed Michael T. Caljouw as the new Commissioner of the Massachusetts Division of Insurance (DOI). Starting November 4, 2024, Caljouw will bring over 30 years of experience in insurance...more

J.S. Held

Cyber Business Interruption Playbook: A Guide to Response and Recovery

J.S. Held on

Over the past 20 years, technology has changed the way we communicate, conduct business, and live. It is rare to walk down a city street and not see a person using some type of technology. It has become an integral and...more

DLA Piper

California Implements New AI and Software Regulations for Insurers

DLA Piper on

On September 28, 2024, California enacted SB 1120, which regulates the use of artificial intelligence (AI), an algorithm, or “other software tool” in utilization review and utilization management (UR/UM) functions by...more

Morgan Lewis

Update: NAIC Proposals to Challenge Credit Ratings for Structured Securities

Morgan Lewis on

The National Association of Insurance Commissioners’ (NAIC’s) proposed changes to credit ratings for structured finance instruments aim to increase regulatory scrutiny and reduce risks tied to perceived arbitrage. These...more

McGuireWoods LLP

Tips for Pursuing Insurance Claims and Disaster Relief Funding in North Carolina After Hurricane Helene

McGuireWoods LLP on

Hurricane Helene made landfall in Florida on September 26, 2024, eventually making its way up to western North Carolina where it caused unprecedented damage. The estimated costs associated with these damages grow daily, with...more

Lathrop GPM

Understanding Business Insurance in the Wake of Hurricane Helene

Lathrop GPM on

Current reports estimate there will be over $5 billion in insured losses from Hurricane Helene, as the devastating hurricane tore through at least six states and has resulted in over 100 deaths since Thursday, September 26,...more

McDermott Will & Emery

Reciprocal Jurisdiction Reinsurers: Where Are They Now?

McDermott Will & Emery on

In September 2017, the European Union and the United States executed a bilateral treaty called the US-EU Covered Agreement, which for the first time ever permitted US ceding insurers to receive 100% credit on their statutory...more

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