Insurance

  • July 27, 2015

    Insurer Can't Revive Negligence Claim For $11.5M Hotel Flood

    A Pennsylvania federal judge on Monday rejected Insurance Co. of Greater New York's bid to revive a professional negligence claim in its lawsuit over a flood at a Holiday Inn hotel that resulted in $11.5 million in damages, saying the company failed to support its attacks on defense deposition testimony.

  • July 27, 2015

    5th Circ. Burns Insured Vs. Insured Exclusion In Fire Row

    The Fifth Circuit ruled Monday that Kinsale Insurance Co. cannot escape Georgia-Pacific LLC's indemnity claim through a policy exclusion barring suits brought by one insured against another, reversing a decision that let Kinsale off the hook in a fire damage row.

  • July 27, 2015

    House Votes To Exempt Vets From ACA Employer Mandate

    The U.S. House of Representatives on Monday passed several bills related to military veterans, including measures to exempt vets from certain fees on U.S. Small Business Administration loans and to exempt them from calculations for the Affordable Care Act’s employer mandate.

  • July 27, 2015

    Aetna's $120M RICO Suit Against Texas Hospital Stays Alive

    A Houston-area hospital and CEO accused of bilking Aetna Life Insurance Co. out of as much as $120 million and offering kickbacks to physicians lost a bid to get rid of Aetna’s lawsuit Friday, though a Texas federal judge stayed the trial while other litigation between the parties proceeds.

  • July 27, 2015

    Military Hospitals Out $22M In 3rd-Party Insurance, DOD Says

    The U.S. military is out at least $21.7 million in outstanding outpatient claims from third-party health insurance plans, thanks to poor compliance measures at the six military hospitals reviewed, according to a U.S. Department of Defense Inspector General report released Friday.

  • July 27, 2015

    Consumers' Info Exposed In Health Care Fraud, Data Breach

    A non-profit New York health care provider said on Friday that the personal information — including names and health insurance information — of about 5,300 past and current members may have been breached during a criminal fraud scheme over a two-year period.

  • July 27, 2015

    Anthem Sued Again Over Gilead Hep C Drug Coverage

    Anthem Blue Cross is wrongfully withholding Gilead Sciences Inc.’s newly approved yet expensive treatment for hepatitis C by claiming policyholders aren’t sick enough to get it, a practice that violates ERISA law, according to a putative class action filed Friday in California federal court.

  • July 24, 2015

    White & Case Flexes Its M&A Muscle With Anthem-Cigna Deal

    With Friday’s blockbuster $52 billion proposal for Anthem Inc. to swallow fellow health insurer Cigna Corp., Anthem’s counsel White & Case LLP notched one of its biggest deals yet and solidified its status as a versatile deal-maker with a knack for health-related transactions.

  • July 24, 2015

    Anthem, Cigna Could Gain Pricing Power In Some Markets

    Anthem Inc.'s proposed $54 billion acquisition of fellow health insurance provider Cigna Corp. would create a juggernaut with the ability to drive up premiums for policyholders and force hospitals into charging lower prices, but only in the limited markets where the pair are already the dominant insurers, experts say.

  • July 24, 2015

    Equitable Subrogation Dispute Sent To Fla. Supreme Court

    A Florida appellate court on Friday asked the state's Supreme Court to review its decision that Allstate Insurance Co. and a policyholder who was found fully liable in an underlying personal injury action have the right to seek payment from a group of medical care providers who allegedly exacerbated those personal injuries.

  • July 24, 2015

    Health Insurance Mergers To Face Tough Antitrust Road

    With Anthem Inc.'s $54.2 billion deal for rival Cigna Corp. on Friday coming just weeks after Aetna Inc. agreed to pay $37 billion for Humana Inc., experts said the deals are sure to face a tough, extended, tandem antitrust review before the U.S. Department of Justice.

  • July 24, 2015

    Health Providers Say Lack Of Market Power Axes Antitrust Suit

    Bay Area Surgical Management LLC and other ambulatory surgical centers’ suit in California federal court against a variety of health care providers and insurers should be dismissed, as it fails to allege the existence of a conspiracy that could crush the plaintiffs' businesses, the providers said Thursday.

  • July 24, 2015

    Senate To Consider Ex-Im Bank Reauthorization, ACA Repeal

    Senate Majority Leader Mitch McConnell, R-Ky., proposed amendments Friday to repeal the Affordable Care Act and renew the Export-Import Bank’s charter, the latter drawing a blistering attack from Sen. Ted Cruz, R-Texas., as senators moved forward with debate on a six-year highway funding bill.

  • July 24, 2015

    11th Circ. Takes Up PIP Overbilling Suit Against HCA

    The Eleventh Circuit has taken up a suit alleging HCA Holdings Inc. overcharged patients' personal insurance protection at several HCA-run Florida hospitals, to review a lower court decision to strike the class allegations and dismiss all but one plaintiff.

  • July 24, 2015

    Beach Club Says $3.5M Sandy Cabana Collapse Covered

    A beach club battered by Hurricane Sandy asked a New Jersey federal court for partial summary judgment on Friday, saying that some of its cabanas that were pushed off their foundations clearly met an Evanston Insurance Co. policy definition of collapse.

  • July 24, 2015

    Superstorm Sandy Caused $23B Of Damage In NY, Study Finds

    A report released by the U.S. Geological Survey found that the total estimated aggregate losses in New York as a result of Superstorm Sandy totaled $23 billion and the storm produced the highest water levels on record in the state.

  • July 24, 2015

    7th Circ. Won’t Reopen Notre Dame’s Birth Control Waiver Suit

    The Seventh Circuit on Friday said it wouldn’t rehear the University of Notre Dame’s case against the Affordable Care Act’s contraception coverage mandate, leaving intact an earlier ruling that an accommodation created for employers with religious objections to the provision was not overly burdensome.

  • July 24, 2015

    Taxation With Representation: Cravath, Wachtell, Gibson Dunn

    In this week’s Taxation With Representation, a Cravath Swaine tax partner assists with a mega-merger in the health insurance industry while Lockheed Martin Corp. expands its holdings with help from Wachtell Lipton, and a gaming real estate investment trust picks up more assets.

  • July 24, 2015

    Identity Theft Victim Fights For Pharmacy Drug Fraud Claims

    A man whose identity was used to illegally obtain prescription drugs from Giant Eagle Inc. and CVS Caremark Corp. blasted a judge’s recommendation that his claims be dismissed, telling a Pennsylvania federal court Thursday that the companies should be held accountable for the identity thief’s actions.

  • July 24, 2015

    Japan's Meiji Yasuda To Pay $5B For US Insurer StanCorp

    Meiji Yasuda Life Insurance Co. on Friday said that it will drop $5 billion to buy U.S.-based StanCorp Financial Group Inc., as the Japanese insurer looks to bolster its profitability and diversify its overseas portfolio by making a bigger splash in the U.S.

Expert Analysis

  • When Workers' Comp Board Rulings Affect Excess Insurance

    Schiffer_Larry_SquirePatton.jpg

    If a workers' compensation claim brought by an employee against a self-insured employer is contested and resolved by a workers' compensation board, does a finding from that board decision bind an excess insurer in future litigation? asks Larry Schiffer at Squire Patton Boggs LLP.

  • NY Appeals Court Wrongly Denied Late-Notice Defense

    Lemley_Charles_WileyRein.jpeg

    For the second time in Estee Lauder Inc. v. OneBeacon Insurance Group, a New York state appeals court has wrongly held that an insurer waived a late-notice defense by failing to raise the defense in its initial disclaimer letter to the insured, based on a flawed application of New York insurance law that attempts to create a common law rule out of a statutory standard, says Charles Lemley at Wiley Rein LLP.

  • Watch What You Say To Your Insurance Broker

    Michael D. Lichtenstein

    Insurance brokers are often an important resource for policyholders when coverage disputes develop. However, the policyholder must be ever mindful that communication with its insurance broker, even if the policyholder’s coverage counsel is included in the communication, may not be legally privileged, say Michael Lichtenstein and Catherine Aiello at Lowenstein Sandler LLP.

  • REBUTTAL: The Problem With 3rd-Party Litigation Financing

    Lisa Rickard

    Manipulating gender disparity in the service of hawking a flawed investment product does nothing but trivialize a serious and important issue. The tortured logic in Burford Capital LLC’s recent plug for third-party litigation financing is nothing more than a marketing ploy to boost revenues, says Lisa Rickard, president of the U.S. Chamber Institute for Legal Reform.

  • Surviving The 2nd Wave Of Cybersecurity Litigation

    John C. Pitblado

    The first wave of cybersecurity coverage litigation tested the limits of policies that had been issued without specific underwriting of cybersecurity risks, and as the second wave of cybersecurity litigation hits, early returns suggest that future cases will re-run many familiar coverage issues. The second wave may be cresting, but there’s still plenty of time for the weather to start getting rough again, says John Pitblado at Car... (continued)

  • When Is An Employee A Seaman?

    David G. Meyer

    In Alexander v. Express Energy Services Operating, the Fifth Circuit once again addressed a critical issue facing businesses and their insurers whose operations have maritime connections, according to David Meyer of Blank Rome LLP.

  • Ex Ante Vs. Ex Post: Janis Joplin’s Yearbook Revisited

    Paul E. Godek

    Fisher and Romaine’s well-known article, “Janis Joplin’s Yearbook and the Theory of Damages,” argues that commercial damages should be measured as of the time the challenged act occurred, an approach that has generally been favored. However, their argument is somewhat contrived, says Paul Godek, principal at MiCRA and a former economic adviser at the Federal Trade Commission.

  • New Bill Clarifies Foreign Investment Insurance Exception

    Donald Carden

    A recently introduced senate bill seeks to clarify the largely undefined insurance company exception to the passive foreign investment company rules by requiring insurance companies to maintain minimum levels of insurance liabilities in order to qualify, say attorneys at Clifford Chance LLP.

  • Texas Legislature Reins In Public Adjuster Conduct

    Brett Wallingford

    Gov. Greg Abbott recently signed into law a bill reigning in the conduct of Texas public adjusters. Left unchecked, this conduct risked turning the legitimate public adjusting industry into nothing more than a vehicle for unscrupulous individuals to act as salesmen for construction companies or case runners for attorneys, say Brett Wallingford and John Maniscalco at Zelle Hofmann LLP.

  • COUNTERPOINT: Reverse Bad Faith Is A Necessary Weapon

    Charles E. Haddick

    The current reverse bad faith picture is far from a clear one, but to dismiss the doctrine as dead in its adolescence is premature. It is highly likely that reverse bad faith will continue to exist in several forms as a necessary weapon for insurers besieged with opportunistic, marginal and in some cases frivolous claims of insurer bad faith, says Charles Haddick at Dickie McCamey & Chilcote PC.