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Insurance Fraud Insurance Claims

Rivkin Radler LLP

New York Insurance Coverage Law Update - December 2023

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Jason Brand made a claim for disability benefits under his disability policy with Principal Life Insurance Company on the basis that he was totally disabled by extreme anxiety that began in July 2014 after a warrant was...more

J.S. Held

Auto Insurance Fraud Investigation: Perspectives from Experts in Accident Reconstruction

J.S. Held on

As interest rates and financial pressures on families continue to mount, more and more drivers may be unable to pay their repair bill for damage they caused or for mechanical issues on their vehicles. A common response is...more

Kaufman & Canoles

Federal Cooperative Disability Investigations Program Establishes New Unit in North Carolina

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The North Carolina Department of Insurance recently announced that a new investigative unit formed as part of the Cooperative Disability Investigations (CDI) Program will be located in Raleigh, North Carolina, with the goal...more

J.S. Held

Detecting Inflation-Driven Fraud in Marine Stock Throughput Insurance Claims

J.S. Held on

Following the easing of Covid pandemic restrictions, we are now facing a fresh “cost of living crisis” created by rising inflation and soaring energy bills. The Guardian newspaper reported that forecourts at petrol...more

Cozen O'Connor

California Court of Appeal: Insurers Not Liable Under the California Insurance Frauds Prevention Act

Cozen O'Connor on

In its recent decision, People ex rel. Ellinger v. Magill, et al., —Cal.Rptr.3d—, No. E076378, 2022 WL 1077988 (Cal. Ct. App., Mar. 18, 2022), the California Court of Appeal refused to extend liability under California’s...more

ArentFox Schiff

Investigations Newsletter: Archegos Executives Charged With Conspiring To Defraud Banks Out of Billions

ArentFox Schiff on

Archegos Executives Charged With Conspiring To Defraud Banks Out of Billions - On Wednesday, April 27, 2022, the US Attorney’s Office for the Southern District of New York unsealed an indictment charging Sung Kook “Bill”...more

Cozen O'Connor

Pennsylvania District Court Holds Materiality Does Not Require Fraud

Cozen O'Connor on

A District Court in the Eastern District of Pennsylvania recently held that an insured’s submission of  invoices altered to inflate replacement costs for water-damaged inventory constituted material misrepresentations. ...more

Burr & Forman

Florida’s Second District Court of Appeals Adopts a Dual-Track Approach For the Appraisal of Property Insurance Claims

Burr & Forman on

When an owner seeks the appraisal of a property insurance claim, insurers commonly object by demanding that the trial court must first rule on defenses to coverage before allowing appraisal panel to value the total claim...more

Seyfarth Shaw LLP

California’s Insurance Frauds Prevention Act Allows Insurer-Whistleblowers To Sue Defendants For Fraudulent Claims Presented To...

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I. INTRODUCTION - Insurance fraud - whether in the auto, workers’ compensation, or health insurance arenas - is an enormous and costly national problem.  It hurts policyholders who have to pay increased premiums to offset...more

Steptoe & Johnson PLLC

First Look - Summer 2020: Insurance Newsletter

Steptoe & Johnson PLLC on

According to the FBI, “The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S.family between $400 and $700 per year in the...more

Seyfarth Shaw LLP

Insurers, ERISA Plans and Other Payors: Beware of COVID-19 Fraud Schemes!

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On March 23, 2020, the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) issued an alert to the public about fraud schemes related to the novel coronavirus (COVID-19)....more

Carlton Fields

Intentional Killing a Grave Mistake Under Slayer Statutes

Carlton Fields on

Recent decisions provide worthwhile guidance for insurers handling slayer claims. According to traditional inheritance law, a “slayer” is one who intentionally kills, or conspires to kill, feloniously or unjustifiably,...more

Saul Ewing LLP

On Demand Insurance is Here But Will it Stay?

Saul Ewing LLP on

On demand insurance allows insurance policies to be purchased via the internet or smartphone applications. Millennials are more than twice as likely as prior generations to purchase an insurance policy in this manner. Valerie...more

Zelle  LLP

[Webinar] Managing Insurance Claims in the Wake of Catastrophes - July 22nd-26th, 10:00am CT, 16:00 GMT

Zelle LLP on

Zelle LLP invites you to join us for a week of webinars featuring insurance topics that are of critical importance to adjusters and insurance professionals. This series will cover managing insurance claims in the wake of...more

Cozen O'Connor

Key Questions to Consider in Light of Operation Rubicon’s Investigation into Insurance Fraud in South Florida

Cozen O'Connor on

Law enforcement in Miami-Dade County, Florida recently arrested nine individuals described by Florida Chief Financial Officer Jimmy Patronis as the “ringleaders of an elaborate fraud scheme” led by Barbara Maria Diaz de...more

Locke Lord LLP

Insurance Industry Primer for InsurTechs

Locke Lord LLP on

Insurance Industry for InsurTech Noobs - So you developed the newest insurance innovation that is going to revolutionize the industry – congratulations! But we also have a couple of questions: What sector of the...more

Carlton Fields

Another Sentinel Strike: California District Court Dismisses Financial Elder Abuse and Fraud Claims

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The Hartford affiliate Sentinel Insurance Company continued its successful campaign to limit dubious claims by securing another favorable decision – this time in California in the rapidly developing area of financial elder...more

Searcy Denney Scarola Barnhart & Shipley

Are You Being Scammed? — Assignment of Benefits in Property Losses

Assignment of Benefit Scams - According to the Coalition Against Insurance Fraud, about $80 billion is stolen every year by unscrupulous companies supposedly acting in the best interests of U.S consumers during critical...more

Robinson+Cole Property Insurance Coverage...

Failure to Cooperate and Misrepresentation: New York Federal Court Grants Summary Judgment Finding Insured Explanations for False...

While issues of fact can preclude summary judgment in some cases involving failure to cooperate and misrepresentation, a New York federal court recently granted summary judgment to an insurer in this context. ...more

Bradley Arant Boult Cummings LLP

Insurance and blockchain: What policyholders need to know

Distributed Ledger Technology, commonly referred to as “blockchain,” is a secure way for companies and individuals to share information without third-party oversight. Blockchain decentralizes electronic record-keeping so...more

Butler Weihmuller Katz Craig LLP

Florida's SIU Tool Belt Is a Bit Lighter Today

Florida has been plagued with insurance fraud for decades.  All insurance coverages are susceptible to fraud, but scams are especially prevalent in the context of automobile accidents.  Staged crashes, patient brokering,...more

Robinson+Cole Property Insurance Coverage...

What Is Prompt Notice? Second Circuit Analyzes Late Notice In New York

Property insurance policies typically require that, once an insured suffers a loss, the insured report the loss to the insurance carrier promptly. The purpose of such a provision is to allow an insurer to investigate a claim...more

Butler Weihmuller Katz Craig LLP

Adjuster Tools for Water Losses

Lois Chamberlain sat down at her desk, adjusted her reading glasses, and stared at the screen filled with columns of check requests — each supported by a claim summary. Lois was two weeks from her retirement party. She...more

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