Law Brief®: Steve Polyakov and Richard Schoenstein Explore Healthcare Agreements
On Demand Insurance is Here But Will it Stay?
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
For years, plaintiff’s attorney Montie S. Day has sued California auto insurers, arguing that the policy exclusion precluding coverage for first-party diminution of value damages claims is unenforceable. On November 30, 2023,...more
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
Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more
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
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
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
The 10th Circuit endorsed a clever way for an insurer to avoid a bad faith claim where there were potential misrepresentations in the policy application. In Evanston Insurance Company v. Aminokit Labs, Inc., the court...more
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
In People ex rel. Allstate v. Suh (No. B280293; filed 6/17/19), a California appeals court upheld a jury’s award of over $6 million in civil penalties for insurance fraud under Insurance Code section 1871.7....more
A California district court issued its latest decision arising from Odyssey Reinsurance Company’s ongoing effort to collect a $3.2 million default judgment against insurance agency Cal-Regent, its successor PBIS, and their...more
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
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
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
Defendants wanted to examine GEICO’s Rule 30(b)(6) witness about GEICO’s special investigation unit practices, protocols and guidelines, as well as its resources and procedures devoted to claim verification and fraud...more
In a March 15, 2018 order, noting that only state law claims remained in the case, a California federal court remanded to state court a lawsuit against an insurance company and its affiliates, which alleged that they...more
Insurance fraud negatively impacts everyone. It drives up the costs of doing business, along with everyone’s premiums. In fact, according to the National Insurance Crime Bureau, insurance companies saw a 102% increase in this...more
On March 31, in Chambers v. N. American Co. for Life & Health Ins., an action alleging RICO violations and other claims in the sales of deferred annuities to seniors, the Southern District of Iowa granted the insurer’s motion...more
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
On May 13, 2006, Edward Feierstein was driving home from his Philadelphia fitness club when his car was rear-ended. Two days later, Feierstein filed a claim with the tortfeasor’s liability insurer seeking reimbursement for...more
Texas is in the midst of a hail lawsuit crisis. Tens of thousands of lawsuits have been filed across the state, with dozens more being filed every day. Many of the lawsuits involve meritless claims solicited by case-runners...more
Last month, in State Auto Property & Casualty Ins. Co. v. Hargis, No. 13-5020 (6th Cir. May 6, 2015), the U.S. Court of Appeals for the Sixth Circuit predicted that the Kentucky Supreme Court would not allow insurers to sue...more