News & Analysis as of

False Claims Act (FCA) Insurance Industry

Bradley Arant Boult Cummings LLP

The Haunting in the Cornfield: Relators’ Qui Tam Claim Confirmed Dead by the Eighth Circuit

The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more

Rivkin Radler LLP

Insurance Update - October 23, 2023

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Here’s what we discuss in our October Insurance Update. Illinois: Environmental Suits Alleging Non-Compliance with Laws and Regulations Did Not Assert an “Occurrence”- Massachusetts (federal): Insurer May Consider Sums...more

Wiley Rein LLP

D&O Policy’s Professional Services Exclusion Does not Bar Coverage for False Claims Act Settlement

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The Delaware Supreme Court has held that a professional services exclusion in a D&O policy does not bar coverage for a False Claims Act settlement. In 2017, a former employee of the insured mortgage loan company brought a...more

Bradley Arant Boult Cummings LLP

Seventh Circuit Requires Proof in FCA Suits That False Statement in Mortgage Insurance Application Caused Subsequent Default

In its June 14, 2023, decision in United States ex rel. Michelle Calderon v. Carrington Mortgage Services, LLC, No. 22-1553, 2023 WL 3991013, (7th Cir. 2023), the Seventh Circuit explained the high bar for relators to prove...more

Wiley Rein LLP

Seventh Circuit Holds Settlement Arising From Alleged False Claim Act Violations Does Not Necessarily Constitute Uninsurable...

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The United States Court of Appeals for the Seventh Circuit, applying Illinois law, has held that a $100 million settlement between the United States government and a pharmaceutical company for claims arising under the False...more

Bradley Arant Boult Cummings LLP

Insurance May Cover Your False Claims Act Settlement

On May 3, 2023, the Seventh Circuit affirmed $10 million in insurance coverage for a False Claims Act (FCA) settlement in a case based on alleged Anti-Kickback Statute violations. Astellas US Holding, Inc. v. Federal...more

Rivkin Radler LLP

Insurance Update - May 2023

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Additional insured disputes can sometimes get complicated. How much coverage the additional insured gets is often a hotly contested issue, especially when the named insured has coverage above the minimum limits it promised...more

Farella Braun + Martel LLP

A Promise To Pay Is Just That: Two Courts Reject Insurers’ Bids To Escape Their Coverage Obligations by Complaining About Third...

An insurer in Washington could not eliminate its coverage obligation based on its insured’s recovery from a third party. T-Mobile USA, Inc. v. Steadfast Ins. Co., et al., No. 82704-9-I, 2022 WL 17246715 (Wash. Ct. App., Nov....more

Wiley Rein LLP

Claims under Illinois False Claims Act Not Uninsurable under Illinois Law

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The Northern District of Illinois has held that claims brought under the Illinois False Claims Act (“IFCA”) are not uninsurable as a matter of Illinois law. The insured, a telecommunications company with $2 million in...more

Pillsbury - Policyholder Pulse blog

In Another Blow to the “Uninsurability” Defense, Court Holds that Settlement Labeled “Restitution” Is Insurable

In previous posts, we have emphasized the continued judicial trend rejecting insurer arguments that losses purportedly sounding in restitution or disgorgement are “uninsurable” under D&O policies. Despite that trend, insurers...more

Lowenstein Sandler LLP

In the Know: The Lowenstein Insurance Recovery Group’s Tip of the Month - October 2021

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A recent coverage case from Illinois is a helpful reminder to policyholders that they should not take no for an answer when insurers deny a claim based on uninsurability, restitution, disgorgement, or fraud. In fact, those...more

Wiley Rein LLP

Written Consent Must be in Writing: Insured Breaches Consent Requirement and Loses Coverage

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Applying Georgia law, a federal district court has held that an insured’s failure to seek consent to incur defense costs pursuant to a consent provision relieved the insurer from any obligation to provide coverage for those...more

Rivkin Radler LLP

Insurance Update - October 2021

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Here’s our October Insurance Update. The Sixth Circuit had insurance on its mind this past month. Three of the decisions we discuss in our update are from that court. First, the Sixth Circuit joins the Eighth and...more

ArentFox Schiff

Investigations Newsletter: Pharmacy Owner and Accountant Indicted in $134m Health Care Fraud Scheme

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Pharmacy Owner and Accountant Indicted in $134m Health Care Fraud Scheme - Mohamed Mokbel and Fathy Elsafty, of Houston, Texas, were arrested on charges of money laundering, health care fraud, and conspiracy to commit...more

Harris Beach PLLC

New York’s Department of Financial Services Urges Cyber Insurance Companies to Require Insureds to Implement Robust Cybersecurity...

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The New York State Department of Financial Services (DFS) issued a letter to the cyber insurance community on February 4, 2021 that should signal a warning to many other businesses seeking to obtain or keep their...more

Pillsbury - Policyholder Pulse blog

Is Your Insurance Program Ready for the Biden Administration?

The Biden administration has hit the ground running with executive orders, regulatory and legislative priorities, and cabinet-level and other top posts being announced on a daily basis. Our public policy colleagues have been...more

King & Spalding

Recent Court Ruling Illustrates The Perils Insurers Face When Sending Boilerplate Coverage Letters To Georgia Policyholders

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Federal Court in Georgia Applies Hoover Rule Finding that Insurers Who Sent Denial Letters Waived Right to Assert Other Coverage Defenses Later. Eight years ago in Hoover v. Maxum Indemnity Co., 730 S.E.2d 413 (Ga. 2012),...more

Morrison & Foerster LLP

COVID 19 – Business Interruption Insurance Test Case

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The High Court’s recent judgment[1] in a test case brought by the Financial Conduct Authority (“FCA”) in relation to certain non-damage business interruption (“BI”) insurance policies found that most (but not all) of the...more

Fox Rothschild LLP

Petition Tracker Updated

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In its most recent set of petition rulings, the Supreme Court of North Carolina added five new cases to its discretionary docket. These cases involve: •the scope of the North Carolina False Claims Act; •the evidence...more

King & Spalding

Insurers Now Offering PPP Loan Insurance

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As additional and conflicting guidance on Paycheck Protection Program (PPP) loans is released by the Small Business Administration (SBA), uncertainty about eligibility and loan forgiveness has persisted. In connection with...more

Cooley LLP

Blog: FCA BI insurance test case: case management conference on 26 June highlights the difficulties in determining the issues and...

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On 26 June, there was a further case management conference (CMC) in the FCA’s COVID-19 BI insurance test case. The CMC was before Lord Justice Flaux and Mr Justice Butcher. These two judges will sit together to hear the...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

Skadden, Arps, Slate, Meagher & Flom LLP

Privacy & Cybersecurity Update - August 2019

In this month's edition of our Privacy & Cybersecurity Update, we examine the European Parliament's report on whether and how the use of blockchain technology can comply with the General Data Protection Regulation, as well as...more

King & Spalding

California Federal Judge Rules Insurer Not Obligated to Pay Los Angeles Hospital’s $42 Million Settlement and Investigation Costs...

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On February 12, 2019, U.S. District Court Judge Stephen V. Wilson dismissed a suit brought by Pacific Alliance Medical Center (PAMC) alleging, among other counts, breach of contract against its insurer for failure to cover...more

Carlton Fields

Professional Services Exclusion Precludes Coverage for False Claims Act Suit

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It is not unusual for a directors and officers liability policy to have an exclusion for professional services. A such, a question often arises regarding whether the claimed wrongful conduct involved the rendering or failure...more

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