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Insurance Health Civil Procedure

Read Insurance Law updates, alerts, news, and legal analysis from leading lawyers and law firms:

Aetna $17.2 Million Breach Settlement Brings Lessons for Handling Health Data

by Hogan Lovells on

Aetna will pay almost $17.2 million to settle a federal class action lawsuit stemming from a 2017 mailing that disclosed the HIV status of health plan members. ...more

Arizona District Court Rejects Discovery of Medical Expert's Previous Reports in Bad Faith Case

by Jaburg Wilk on

The Holding - In Cheatwood v. Christian Brothers Services, 2018 WL 287389 (D. Ariz. Jan. 4, 2018) (Unpublished) (Order), a bad faith case arising from a health benefits claim, the Arizona District Court quashed portions of...more

Virginia Supreme Court Considers Terms Of Assumption Reinsurance Transaction In Determining Obligations Of Insolvent Insurer

by Carlton Fields on

A group of Kentucky hospitals sought reimbursement for legal fees incurred in two lawsuits related to the insolvency of their insurer, Reciprocal of America (“ROA”). In the 1970s and 1980s, the hospitals created two trusts to...more

Massachusetts Appeals Court Upholds Liability Insurer’s Contractual Right to Settle

by Mintz Levin on

On Tuesday, December 12, 2017, the Massachusetts Appeals Court, applying New Hampshire law, held that a professional liability insurer did not breach the implied covenant of good faith and fair dealing by settling a New...more

Appeals Court: No Bad Faith For An Insurer’s Legitimate Exercise Of A Contractual Right Or Its Settlement Within The Policy Limit...

In a Rule 1:28 decision applying New Hampshire law, the Appeals Court affirmed the entry of summary judgment dismissing a doctor’s suit accusing her professional liability insurer of improper settlement of a claim without her...more

Tennessee Supreme Court Rejects Efforts to Alter Existing Law on the Collateral Source Rule in Personal Injury Cases

Last month the Tennessee Supreme Court, in Dedmon v. Steelman, affirmed the long-standing collateral source rule in personal injury cases. As long as an injured plaintiff can establish that the medical expenses they incurred...more

Superior Court Sets Out Rules For Class Certification

by Morris James LLP on

Wilmington Pain & Rehabilitation Center P.A. v. USAA General Indemnity Insurance Co., No. N15C-06-218 JRJ CCLD (October 17, 2017) - This is an important decision became it sets out the most recent rules for determining...more

Insurer Liable Though Physician Skips Med Mal Trial

by Faegre Baker Daniels on

Lancet Indemnity’s $1 M med mal policy had a standard clause requiring the insured, Dr. Ishtiaq Malik, to cooperate and assist Lancet and appointed counsel in investigating and defending claims. But when the family of...more

Reaping the Jurisdictional Whirlwind

by Reed Smith on

Literally for decades plaintiffs in mass torts have employed the business model of flooding jurisdictions seen as friendly to them with more solicited plaintiffs than any court system can possibly handle. They have employed...more

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

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: September 2017

by Mintz Levin on

In this month’s issue of our Qui Tam Update, we review an unusual cluster of five cases alleging that common defendants — a health care provider and its subsidiaries — provided medically unnecessary services to hospice,...more

D.C. Circuit Holds Cyber-Theft of Customers’ Medical Identifying Information Created Sufficient Increased Risk of Harm to...

Earlier this month, an appellate panel of the federal DC Circuit unanimously held that individuals affected by a healthcare insurer’s data breach in 2014 could pursue claims against the insurer stemming from the cyberattack....more

Specialty Pharmacy's Antitrust Claim against Humana Fails

by Baker Ober Health Law on

On August 9, District Judge Susan Wigenton (D. NJ) issued a ruling in Prime Aid Pharmacy v. Humana, Civ. No. 16-2104, granting Humana's motion to dismiss the plaintiff's Second Amended Complaint, finding that the plaintiff...more

Aetna and its Vendor Face Class Action Lawsuit over HIV Disclosure

A Pennsylvania man has filed a class action lawsuit against Aetna Inc., accusing it of violating his privacy rights when the insurer mailed him prescription information in an envelope with a large, clear window that disclosed...more

Ripeness: A Question of Subject Matter Jurisdiction - Allied World Surplus Lines Insurance Company v. Blue Cross and Blue Shield...

by Nexsen Pruet, PLLC on

Addressing a contractual requirement to exhaust Alternative Dispute Resolution (ADR) prior to commencing litigation, the United States District Court for the District of South Carolina chose to forge its own path, rejecting...more

The Ninth Circuit Weighs in on ERISA’s Plan Document and Summary Plan Description Requirements: Mull v. Motion Picture Ind. Health...

Mull v. Motion Picture Ind. Health Plan educates employers on the basics of the requirements of the Employee Retirement Income Security Act (ERISA) governing plan documents and summary plan descriptions. The lessons are...more

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

by K&L Gates LLP on

The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

Failure To Hold Back Settlement Funds Subject To A Medical Lien Can Expose An Insurer To Treble Damages

by Ellis & Winters LLP on

A court’s decision to impose liability for committing an unfair or deceptive trade practice in a particular case may have wide-ranging implications—even when the amount in dispute in the matter itself is relatively...more

Torts & Insurance Cases from the 4th Circuit Court of Appeals - May 2017

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

Admissibility of Insurance Coverage: Sauce for the Goose

by Faegre Baker Daniels on

When Kerrie Evans’s child was born with cystic fibrosis, she sued her nurse practitioner and doctor for failure to adequately inform her about prenatal testing for CF, making concerns about cost the centerpiece of her...more

10th Circuit Affirms Dismissal of Antitrust Case Against Health Insurer

by Baker Ober Health Law on

On May 31, the Tenth Circuit Court of Appeals affirmed the dismissal of plaintiff's claims in Bristow Endeavor Healthcare v. Blue Cross Blue Shield Association et al., handing Blue Cross Blue Shield of Oklahoma, and its...more

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA and thus remanded the claim to state court for further proceedings. The...more

Fifth Circuit’s Pierre Deference In ERISA Cases Trumps Texas’s Anti-Discretionary Language Statute

by DeWitt Law, LLC on

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174, 2017 U.S. App. LEXIS 7072(5th Cir. Apr. 21, 2017), which involved a claim for benefits under an ERISA-governed health policy, the Fifth Circuit held that...more

$4 Million Liability for Bad Legal Advice to a Chiropractor

by Faegre Baker Daniels on

Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state...more

The North Carolina Business Court Hands Down An Important Healthcare Antitrust Decision, Part 2

by Ellis & Winters LLP on

In a recent blog post, we discussed a new antitrust decision from the North Carolina Business Court that involves healthcare providers and health insurers. In that post, we examined the significance of that opinion to...more

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