Mediating Complex Insurance Coverage Disputes Series Part 4 - How to Seal the Deal
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Subro Sense - The ABC's of RCV and ACV
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Subro in Seconds | VLOG 2
Subro Sense Podcast - Hosted by Aaron Jacobs
QUICK INVESTIGATING TIPS FOR FIRE SPRINKLER CLAIMS
What is Subrogation and How Does it Affect Settlement Amounts?
Supreme Court’s Recent ERISA Subrogation Ruling is Shortsighted, Makes Personal Injury Settlements More Difficult
A recent decision by the U.S. Court of Appeals for the Sixth Circuit (Patterson v. United HealthCare Ins. Co., No. 22-3167, 2023 WL 4882436 (6th Cir. Aug. 1, 2023)) illustrates the importance of clearly describing key plan...more
What is subrogation? Why am I being asked to waive it? Should I care? To answer that last question, let’s take a quick run at the first two. What Is Subrogation? “Subrogation” refers to the act of one person or party standing...more
On November 28, 2022, the Illinois Supreme Court unanimously reversed the appellate court’s decision that an insurer would have to defend a rental property’s tenants against a third-party negligence claim arising from a fire....more
Claims adjusters are frequently warned to identify and resolve Medicare and Employee Retirement Income Security Act (“ERISA”) liens before finalizing settlements in personal injury claims. But there is another federal law...more
When the direct door to a subrogation recovery closes, the reimbursement door remains open. The United States District Court for the Northern District of Illinois, construing Indiana law, recently clarified the...more
The Made Whole Rule and the handling of the insured’s deductible and uninsured losses alongside the subrogation claim remain ever-present topics of discussion amongst subrogation professionals and within subrogation case law....more
Inverse condemnation litigation and liability has become a particularly hot topic in California over the last several years. Not many attorneys specialize in this area, and there are a number of traps for the unwary lawyers,...more
In a recent case, decided on June 19, the Supreme Court of Pennsylvania granted appeal to clarify the scope of subrogation reimbursement under the Pennsylvania Workers Compensation Act (the “Act”)....more
The Fifth Circuit upheld the reimbursement and subrogation terms found in a welfare benefit plan’s one-page SPD that also served as the plan document. Plaintiff, a plan beneficiary, received $71,644.77 from the plan to cover...more
Strange as it sounds, Missouri state law allowed federal workers to recover medical bills twice: once under their federal health insurance plan and again from the person (or person’s insurer) responsible for their injuries. ...more
Editor’s Overview - This month we review the U.S. Supreme Court’s decision in Montanile v. Board of Trustees of National Elevator Industries Health Benefit Plan where the Supreme Court considered the scope of...more
I blogged a few days ago about the U.S. Supreme Court decision making it harder for plans to recover from a third-party settlement fund for the amount the plan paid when a participant is injured by that third-party. A recent...more
On January 20, the Supreme Court released its decision in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, concluding that although health plan fiduciaries can generally seek subrogation...more
ERISA Section 502(a)(3) empowers plan fiduciaries to file suit “to obtain … appropriate equitable relief … to enforce … the terms of the plan.” In 1993, the Supreme Court of the United States interpreted this ERISA provision...more
On January 20, 2016, the United States Supreme Court held that an ERISA plan could not satisfy its reimbursement rights from a participant’s general assets. ERISA plans’ reimbursement rights are now so limited that...more
Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more
Where an ERISA plan specifically sets forth in the plan document its rights to reimbursement/subrogation vis-à-vis a plan participant then there is no requirement that recovery be conditioned on the plan being able to trace...more
The Eleventh Circuit recently concluded that Robert Montanile, a welfare plan participant, could not avoid reimbursing the National Elevator Industry Health Benefit Plan for benefits it paid on his behalf after he recovered...more
In U.S. Airways v. McCutchen, the U.S. Supreme Court upheld the ability of U.S. Airways’ health plan to recover medical expenses that it previously paid to the injured party from a third party settlement, but remanded the...more
Health Care Reform: Guidance on Required Future Modifications to SBC, Other Issues - The Internal Revenue Service (IRS), Department of Labor (DOL), and Department of Health and Human Services (HHS) issued new guidance...more
The U.S. Supreme Court has ruled that the clear terms of an employer's group health plan override an employee's equitable defenses in determining the plan's right to recover amounts from a third party. This decision points...more