Insurance

  • March 31, 2015

    NJ Appeals Court Backs State's New PIP Rules

    The New Jersey Appellate Division upheld regulatory changes to how personal injury protection benefits under auto insurance policies are handled, ruling Tuesday that the regulations do not represent an abuse of discretion and are within the state insurance agency's purview.

  • March 31, 2015

    5th Circ. OKs Health Exec’s Conviction In $100M Kickback Case

    A former health insurance executive convicted for providing kickbacks to government officials to secure roughly $100 million in contracts lost an appeal on Monday before the Fifth Circuit, which ruled his lawyer's representation of a co-defendant in the scheme did not prove a conflict of interest. 

  • March 31, 2015

    Aetna Ignoring Key Claims In $120M Kickback Suit, Court Told

    A Houston-area hospital on Monday labeled as “lackluster” Aetna Life Insurance Co.’s response to claims that it is judge-shopping in a $120 million lawsuit over alleged kickbacks and exorbitant billing, telling a Texas federal court that Aetna essentially ignored the bulk of the hospital’s claims. 

  • March 31, 2015

    Insurers Prevail In $18M Junk Fax Deal Coverage Dispute

    An Illinois federal judge on Tuesday ruled that Hartford Casualty Insurance Co. and Twin City Fire Insurance Co. don't have to cover a policyholder's nearly $18 million junk fax class settlement, holding that exclusions in the policies for Telephone Consumer Protection Act violations clearly apply to bar coverage.

  • March 31, 2015

    Triad Officers Cleared In Securities Class Action Suit

    A North Carolina federal judge on Monday dismissed a proposed securities class action accusing officers of mortgage issuer Triad Guaranty Inc. of misleading investors over the soundness of its modified insurance pools and the inherent risks involved, saying that the complaint did not sufficiently plead scienter, among other deficiencies.

  • March 30, 2015

    Med Mal Arbitration Rule Waives Consumer Rights, Attys Say

    The Texas chapters of the American Board of Trial Advocates on Friday told the state Supreme Court that allowing the Federal Arbitration Act to preempt state malpractice law secretly takes away a patient's right to a jury trial, urging the court to reconsider its decision that the state law isn’t an insurance law shielded from the act.

  • March 30, 2015

    Mid-Continent Says Magistrate Erred In $63M Coverage Fight

    Mid-Continent Casualty Co. on Friday urged a Texas federal court to reject a magistrate judge's recommendation and grant its bid to dismiss a suit claiming it must pay part of a $63 million judgment an architectural firm won after suing a defunct homebuilder for using its designs without permission.

  • March 30, 2015

    Insurer Must Cover Hawaii Collapsed Dam Litigation

    James River Insurance Co. must cover C. Brewer & Co. Ltd. in a suit over a disastrous 2006 dam collapse that killed seven people and caused extensive property damage in Kauai, the Hawaii Supreme Court ruled Friday, holding that coverage under the relevant policy isn't limited to a list of specified locations.

  • March 30, 2015

    Del. Justices Nix NorthPointe's $15M Award In Contract Row

    The Delaware Supreme Court on Friday tossed a $15.1 million award to NorthPointe Capital LLC managers in a breach of contract dispute stemming from their $25 million buyout of Nationwide Mutual Insurance Co.’s controlling stake in NorthPointe, saying that a lower court muddied the contract terms.

  • March 30, 2015

    The 2015 Rising Stars, By Firm

    Law360's Rising Stars recognizes attorneys under 40 who have demonstrated outstanding career accomplishments. This year, King & Spalding LLP and Sidley Austin LLP led the pack with seven Rising Stars each, followed by Gibson Dunn and Sullivan & Cromwell LLP with six Rising Stars each, and Jones Day and Kirkland & Ellis LLP with five Rising Stars apiece.

  • March 30, 2015

    Washington Nationals Sues Lloyds For Ticket Refunds

    Washington Nationals Stadium LLC took a swing at Certain Underwriters at Lloyd’s London on Friday, saying the insurer wrongly denied coverage for ticket vouchers for a rained-out exhibition game.

  • March 30, 2015

    Justices Told To Defer To Voters On Same-Sex Marriage Bans

    Four states looking to keep in place bans on same-sex marriage told the U.S. Supreme Court on Friday that it should be up to their voters to define marriage, not the federal judiciary.

  • March 30, 2015

    Dioceses Seek Another Birth Control Showdown In 3rd Circ.

    A pair of Pennsylvania dioceses and affiliated nonprofits are asking the Third Circuit to reconsider requiring them to comply with the Affordable Care Act’s contraceptive coverage mandate, saying the court misunderstood the Catholic faith when ruling that merely waiving participation in the program wasn’t a substantial burden on their religious beliefs.

  • March 30, 2015

    Insurer Didn't Breach Defense Duty In Loan Fraud Case

    United States Liability Insurance Co. didn't improperly deny coverage to defendants in a mortgage loan fraud suit, a California appeals court affirmed on Friday, agreeing with a lower court that the policy unambiguously excludes coverage for both real estate sales and fraudulent transactions.

  • March 30, 2015

    Calif. Surgery Centers Say Aetna Staged Boycott Of Services

    Bay Area Surgical Management LLC and other ambulatory surgical centers sued Aetna Life Insurance Co., United Healthcare Services Inc. and rival companies affiliated with the insurers in California federal court Friday, alleging an anti-competitive conspiracy to crush the plaintiffs' businesses.

  • March 30, 2015

    NJ Justices To Mull Coverage Question For Law Firm Partners

    The New Jersey Supreme Court granted certification Friday to hear an appeal in a legal malpractice suit against a New Jersey intellectual property attorney, in order to determine whether an LLP partner loses liability protection if the partnership fails to maintain professional liability insurance.

  • March 30, 2015

    Travelers Says Farmers Is Infringing Red Umbrella Logo

    Travelers Indemnity Co. kicked off an insurance industry trademark showdown Friday, filing a lawsuit against Farmers Group Inc. that will pit Traveler’s trademark rights in its famed red umbrella logo against the rival’s marketing for “umbrella insurance.”

  • March 30, 2015

    Premera Blue Cross Facing Five Lawsuits Over Data Breach

    At least five proposed class action lawsuits have been filed by Premera Blue Cross customers in federal court in Washington state following the health insurance company’s recent announcement of a data breach affecting about 11 million people.

  • March 30, 2015

    High Court Won't Hear Attack On ACA Cost-Control Panel

    The U.S. Supreme Court on Monday refused to hear a constitutional challenge to the Affordable Care Act’s controversial cost-control board, leaving intact a Ninth Circuit ruling that called the lawsuit premature.

  • March 27, 2015

    3rd Circ. Should Uphold Horizon Settlement, Attys Say

    Horizon Blue Cross Blue Shield of New Jersey and counsel for a class of health care service providers have urged the Third Circuit to preserve a class action settlement resolving claims over unpaid reimbursements, saying the deal provides the best solution to the dispute, even for the objectors who appealed.

Expert Analysis

  • Following The FCA's Public Disclosure Bar

    Lori L. Pines

    Although further clarification is needed, courts appear to be leaning toward interpreting the Affordable Care Act's amendments to the False Claims Act's public disclosure bar as a nonjurisdictional defense. Litigants in FCA cases must therefore be prepared for corresponding changes in motion practice, timing and overall burdens, say Lori Pines and Shireen Nasir at Weil Gotshal & Manges LLP.

  • Mediation And The Thorny Issue Of Settlement Authority

    Douglas H. Flaum

    Many mediation orders state that attendees must have “full settlement authority” without providing clarity as to what that term actually means. Attendance by just outside counsel or a corporate spokesperson is not enough, even if someone else with full settlement authority is just a phone call or keystroke away, say Douglas Flaum and Kevin Broughel of Paul Hastings LLP.

  • This Week In Congress: A Few Hearings Outside Of DC

    Richard Hertling

    The statutory deadline by which Congress must pass a budget is April 15, which means the House and Senate must work quickly to iron out the differences between their two proposals when they return to Washington in two weeks. A significant issue of disagreement will be between the defense and deficit hawks over military funding, say Richard Hertling and Kaitlyn McClure of Covington & Burling LLP.

  • What Experts Can Say About Inadmissible Facts During Trial

    Jason McDonell

    For reliance material that is not admitted on the stand, consider bolstering the testimony by having the expert describe the evidence generally, but in a way that signals to the jury that the expert has a strong foundation of supporting facts and data. If done well, such testimony can open the door to admitting the evidence, say Jason McDonell and Heather Fugitt of Jones Day.

  • 5 Key Privacy Considerations For All Companies

    Adam Solander

    Privacy and security are closely intertwined, but securing information from outside intrusion may not provide the privacy protections you need, say Adam Solander and Patricia Wagner of Epstein Becker & Green PC.

  • A Primer On Defending Your Calif. Insurance License

    Sanford L. Michelman

    A special notice of defense lays the foundation for insurance licensees to go on the offensive, not only demanding that the California Department of Insurance provide evidence supporting its allegations but also raising potential shields to its allegations, say Sanford Michelman and David Samuels of Michelman & Robinson LLP.

  • IRS Gives Good Directions On ACA Cadillac Tax

    Sarah L. Fowles

    An employer can use the Internal Revenue Services' recent notice on the Affordable Care Act's so-called Cadillac tax to approximate the cost of coverage for employees. Since the cost will likely vary by employee, employers may want to estimate costs under a range of coverage scenarios, say attorneys at Quarles & Brady LLP.

  • High Court May Take On Corporate 5th Amendment Privilege

    Ramzi Abadou

    A festering but virtually unnoticed circuit split over a legal doctrine the U.S. Supreme Court first recognized early last century may provide the Roberts court with the opportunity to grant corporate persons privilege against self-incrimination for the first time in U.S. history, says Ramzi Abadou of Kahn Swick & Foti LLP.

  • 7th Circ. Title Policy Ruling Brings Risks For Lenders

    Sarah R. Borders

    The Seventh Circuit’s recent interpretation of Exclusion 3(a) in the standard-form construction lender’s title policy, in the context of a failed project, places the risk of loss associated with unpaid subcontractors arising from a lender’s decision to stop funding squarely on the construction lender, not the title insurer. There are, however, steps that a lender can take to mitigate this risk of loss, say Sarah Borders and Jeffrey... (continued)

  • Trending: A Principles-Based Approach To US Financial Regs

    Manley Williams

    While the U.S. has traditionally utilized rules-based policies, there has been a recent trend toward integrating principles-based policies and behavioral economics in regulating consumer financial products, including aftermarket automotive financial products. For a framework, U.S. regulators need look no further than across the pond, say attorneys with BuckleySandler LLP and Eversheds LLP.