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DLA Piper

California Implements New AI and Software Regulations for Insurers

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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

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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

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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

Goldberg Segalla

What the Port Strike Means for Contractors

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The International Longshoremen’s Association (ILA) went on strike this week which affects ports from Texas to Maine. The impacted ports are some of the main points of entry for construction materials, heavy machinery, food,...more

Lathrop GPM

Understanding Business Insurance in the Wake of Hurricane Helene

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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?

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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

Searcy Denney Scarola Barnhart & Shipley

Personal Injury Claims: A Passenger's Rights

If you were injured in an auto accident as a passenger in Florida, what are your legal rights? This is a critical question. Accident-related injuries can prove incredibly expensive, and you shouldn’t have to bear the costs of...more

Perkins Coie

Responding to Hurricane Helene: Making Insurance Claims That Get Paid

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Hurricane Helene has carved a path of devastation through the American Southeast, exposing continued shortcomings in local, state, and federal infrastructure and causing harm to both persons and property....more

Ballard Spahr LLP

Tobacco Surcharge Lawsuits Lighting Up Common Wellness Program Designs

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A new and unprecedented wave of class action complaints is targeting a common feature of many employer-sponsored benefit plans: tobacco-user surcharges. These surcharges are often part of a wellness program that charges...more

Carlton Fields

Aerial Overview: Recent Developments in Life, Accident, and Long-Term Care Litigation

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In Meyer v. Massachusetts Mutual Life Insurance Co., the U.S. District Court for the District of Colorado entered summary judgment for an insurer after video evidence showed that the insured was not entitled to the benefits...more

Woodruff Sawyer

Large Derivative Suit Settlements and Your Side A D&O Insurance

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Traditionally, this has been the main type of derivative suit that has resulted in large settlements. Merger and acquisition cases are common here. Examples of these types of suits include Paramount Global (CBS-Viacom merger)...more

Epstein Becker & Green

Application of New Mental Health Parity Rules to Provider Network Composition and Reimbursement: Perspective and Analysis

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On September 23, 2024, the U.S. Departments of Labor, the Treasury, and Health and Human Services (collectively, the “Departments”) released final rules (the “Final Rules”) that implement requirements under the Mental Health...more

Kennedys

Pennsylvania Supreme Court finds no coverage for COVID-19 business interruption losses

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In a long-awaited decision, the Pennsylvania Supreme Court ruled in favor of the insurance companies in two appeals involving the availability of business interruption insurance coverage for losses stemming from the COVID-19...more

Jackson Lewis P.C.

Health Plan Hygiene Part 4 – Show Me the Money

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Our “health plan hygiene” series has focused on steps that fiduciaries of employer-sponsored group health plans can take to ensure they meet their fiduciary responsibilities. This issue has been brought to the forefront...more

Searcy Denney Scarola Barnhart & Shipley

Common Mistakes to Avoid When Filing an Auto Accident Claim in Florida

If you have a claim after an auto accident in Florida, it is up to you to make sure you receive the financial compensation you deserve. You need to take action promptly, but you also need to be very careful to avoid mistakes...more

Shumaker, Loop & Kendrick, LLP

Client Alert: Tips to Preserve and Maximize Insurance Recovery for Your Business Following Hurricane Helene

The immediate days following a major hurricane can be a stressful and confusing time for companies and businesses dealing with storm-related losses. It can also be expensive. Insurance will often help pay for these expenses...more

Foley & Lardner LLP

Medicare: Prescriptions Now May Be Used to Support Medical Necessity of Durable Medical Equipment

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On September 26, 2024, the Centers for Medicare & Medicaid Services’ (CMS) Durable Medical Equipment (DME) Medicare Administrative Contractors (DME MACs), Noridian Healthcare Solutions, LLC and CGS Administrators, LLC,...more

Marshall Dennehey

Understanding Reimbursements for CPT Code 97039

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CPT code 97039 has been in a state of constant flux in Florida and recent rulings have created greater change. First, one must understand what 97039 is and its history. According to the American Medical Association (AMA), CPT...more

Marshall Dennehey

Class Action Out of Minnesota with Potential Impacts on Litigating and Negotiating Major Case

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A class action suit is brewing in Minnesota which has the potential for major implications in the way major case investigations are litigated and negotiated. In Taqueria El Primo LLC et al. v. Illinois Farmers Ins. Co. et...more

Manatt, Phelps & Phillips, LLP

HRSA Threatens to Sanction J&J Absent Withdrawal of 340B Rebate Plan

On September 17, the Health Resources and Services Administration (HRSA), which administers the prescription drug discount program established under Section 340B of the federal Public Health Service Act, sent a letter to...more

Carlton Fields

Illustration Requirements May Be Up in the Air Again

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At the National Association of Insurance Commissioners’ Summer 2024 National Meeting, the Life Insurance and Annuities (A) Committee received a report of its Life Actuarial (A) Task Force and a presentation on indexed...more

Troutman Pepper

California Governor Signs Legislation Impacting Health Care Claim Reimbursement and DMHC Requests for Records

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On September 27, California Governor Gavin Newsom signed into law two bills that will impact health care service plans and insurers in the state....more

Carlton Fields

A Bird's-Eye View of the Current Standings of AI Guidance and Requirements by States

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Since the 2023 adoption by the National Association of Insurance Commissioners of its model bulletin on the use of AI systems by insurers, states have been adopting the model bulletin or draft requirements of their own. Below...more

A&O Shearman

Funded reinsurance - The PRA's final policy

A&O Shearman on

The PRA published Policy Statement 13/24 (PS13/24) on 26 July 2024 providing feedback on the PRA’s Consultation Paper 24/23 (CP24/23) on Funded Reinsurance (FundedRe). PS13/24 is published alongside the PRA’s final policy in...more

Presley & Presley

Retained Counsel Beware: Insurer Tactics to Recover Excess Payments

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Most jurisdictions, at least in theory, permit insureds to recover extra-contractual payments/judgments from their insurers under bad faith or negligence theories. Jurisdictions are less uniform on whether or under what...more

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