AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Best Practices for Negotiating Manuscript Exclusions
Coverage Issues Arising Out of Assault and Battery Claims
Long-Term Effects of Russia/Ukraine on Insurance
Mediating Complex Insurance Coverage Disputes Series Part 3 – Breaking the Log Jam
Cyberside Chats: There is a war in Europe. What does that mean for your cyber insurance policy?
Mediating Complex Insurance Coverage Disputes Series Part 2 – What Goes on in Mediation?
Mediating Complex Insurance Coverage Disputes Series Part 1 – Preparing For The Mediation
Out With a Bang: Current State of Play on Coverage for COVID-Related Losses
Settling a Claim: Get Comfortable With Being Uncomfortable
NGE OnDemand: The Importance of Timely Reporting Occurrences, Claims and Suits to Insurers with Paul Walker-Bright
Lowenstein’s New Insurance Recovery Podcast Series, “Don’t Take No for an Answer”
Ledgers and Law: Roadblocks Facing the Cannabis Industry
Subro Sense - The ABC's of RCV and ACV
WEBINAR: COVID-19 Insurance Coverage Class Actions
What to Do When Your Insurance Carrier Says No: How to Protect Yourself from Coverage Denials
The Ninth Circuit is considering the enforceability of a choice of law provision in an ERISA plan in William White v. Guardian Life Insurance Company, et al., Case No. 24-2681, appeal pending from the United States District...more
Case Background - When she was a preteen, E.D. began experiencing symptoms of anorexia nervosa. Her condition worsened, and her parents, the Dwyers, took her to Avalon Hills, a residential treatment facility....more
The U.S. Department of Labor (DOL) announced two settlements with major insurance companies this month that highlight the importance of employers avoiding the collection of group life insurance premiums from employees until...more
A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more
Life Policy Lapse Shortly Before Insured’s Death - In Simon v. USAA Life Insurance Co. (Mar. 29, 2024), the insurer denied death benefits under a term life insurance policy, which had lapsed for nonpayment of premium two...more
In Steigleman v. Symetra Life Ins. Co., 2023 WL 7413668 (D. Ariz. 2023), a court considered whether a package of various welfare benefit insurance policies an individual business owner arranged for herself and her employees...more
The United States District Court for the Northern District of Georgia, applying Georgia law, has held that a commercial liability policy covering “sums that the ‘insured’ becomes legally obligated to pay as damages” provides...more
A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more
In Calkin v. United States Life Ins. Co., 2021 U.S. Dist. LEXIS 82110 (S.D. TX., April 29, 2021), a Texas district court affirmed the insurer’s denial of LTD benefits, holding that while a claimant established diagnoses, he...more
In a June 14, 2021 information letter, the US Department of Labor (DOL) opined that a claimant appealing an adverse benefit determination under a plan covered by the Employee Retirement Income Security Act of 1974, as amended...more
In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more
Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more
In Cal. Spine & Neurosurgery Inst. v. Blue Cross of Cal., 2020 U.S. App. LEXIS 20533 (9th Cir. June 20, 2020), the Ninth Circuit held that a surgical provider's complaint sufficiently alleged that Blue Cross of California...more
A federal district court in Ohio recently attempted to shed some light on when internal communications between an ERISA plan administrator and its in-house counsel are discoverable and when they are protected by the...more
Seyfarth Synopsis: A provider that is not seeking benefits based upon an assignment of a patient’s claims under ERISA but instead is pursuing state law claims based solely on agreements and representations made directly by...more
In Dowdy v. Metro. Life Ins. Co., 16-15824, 2018 U.S. App. Lexis 12648 (9th Cir. May 16, 2018), the Ninth Circuit ruled that an accident plan that covers “accidental injury that is the Direct and Sole Cause of a Covered Loss”...more
Banner Health and the Kaiser Foundation were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage...more