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Insurance
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May 15, 2013
Medicare Doesn't Trump State Workers' Comp Law: 5th Circ.
The Fifth Circuit ruled Tuesday that a Medicare statute cannot trump a Texas law that requires preauthorization for workers' compensation expenses because Medicare indicates that claimants should exhaust their state law remedies first.
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May 15, 2013
NFL Goes To NY Appeals Court For Concussion Suit Coverage
The National Football League recently took its sprawling insurance fight over former players' head injury suits to a New York appeals court, challenging a trial court's refusal to toss claims brought by a slew of insurance carriers.
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May 15, 2013
CMS Unveils $1B In ACA Grants For Innovative Care
The Centers for Medicare & Medicaid Services on Wednesday announced availability of $1 billion in Affordable Care Act grants to test new health care delivery models certain to be watched closely as policymakers study whether innovation can deliver higher quality and lower costs.
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May 15, 2013
Q&A With Patton Boggs' Eridania Perez
A possible solution to the insane and unnecessarily expensive discovery process in coverage arbitration is the adoption of rules that limit the scope of discovery requests, says Eridania Perez, a partner with Patton Boggs LLP specializing in insurance and reinsurance.
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May 15, 2013
Goldman Dodges Insurer's $63M MBS Suit In 2nd Circ.
The Second Circuit on Wednesday refused to revive a $62.5 million Liberty Mutual Insurance Co. suit alleging Goldman Sachs & Co. hid Fannie Mae’s exposure to toxic loans while underwriting the mortgage giant's securities deals in 2007, calling the case a "classic example of pleading fraud by hindsight."
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May 14, 2013
Fla.-Owned Insurer's Shutdown Of Ethics Office OK'd
Florida Chief Inspector General Melinda Miguel reported Tuesday that she did not find evidence of retaliation in state-owned insurer Citizens Property Insurance Corp.'s decision to disband its Office of Corporate Integrity shortly after it conducted investigations into misconduct at Citizens.
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May 14, 2013
9th Circ. OKs Revoking Medicare Part D Insurer's Contract
Federal regulators acted properly when they revoked the Medicare Part D contract of a prescription drug insurance provider for delaying patient access to medications for cancer, HIV and AIDS, the Ninth Circuit ruled Tuesday in the first such case to reach a federal appeals court.
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May 14, 2013
Hospital's $350M Bond Issuance Suit Falls In 5th Circ.
A Louisiana hospital operator on Tuesday lost its suit over bond insurer National Public Finance Guarantee Corp.'s delay in deciding to approve its plan to issue $350 million in additional bonds, when the Fifth Circuit ruled their agreement allowed National Public to withhold approval.
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May 14, 2013
Texas Sens. Pass Bill Limiting Insurers' 3rd-Party Recovery
The Texas Senate on Tuesday passed a bill clamping down on health insurers’ practice of aggressively collecting damages from third parties that caused injuries to insured patients by making them share in attorneys' fees, sending the measure to Gov. Rick Perry for approval.
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May 14, 2013
Lloyd's Wants Out Of LA Firm's Malpractice Coverage Suit
Lloyd's of London underwriters on Monday pushed for a quick victory in a fight with a Los Angeles law firm over defense coverage for malpractice claims stemming from a $7 million award against an alleged ex-client in a property dispute.
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May 14, 2013
Sen. Wants $440M In IRS ACA Funding Suspended
Sen. Dean Heller, R-Nev., urged the U.S. Department of Health and Human Services on Tuesday to help hold back nearly $440 million earmarked to fund the Internal Revenue Service's responsibilities under the Affordable Care Act, saying the IRS must first resolve concerns over its recent behavior.
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May 14, 2013
Goldman Dodges Insurer's $120M CDO Claims On Appeal
A New York state appeals court on Tuesday tossed ACA Financial Guaranty Corp.'s $120 million action targeting Goldman Sachs over a mortgage-backed securities transaction gone sour, finding Goldman never guaranteed that an outside hedge fund was taking an equity position favorable to ACA.
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May 14, 2013
Insurer Can Keep Premium For Sham $5M Policy: 1st Circ.
In a published decision, the First Circuit found Monday that a Phoenix Cos. Inc. life insurer could rescind a $5 million policy and still keep the premium it received from a policyholder who pretended to be a well-to-do real estate investor to score the insurance.
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May 14, 2013
Pain Patch Maker Wins Coverage Of False Ad Suit
An Illinois federal judge on Friday ruled Great American E&S Insurance Co. must defend JAR Laboratories LLC in a false advertising suit over its over-the-counter pain relief patch LidoPatch.
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May 14, 2013
10th Circ. Axes $1.2M Judgment In Lloyds Coverage Row
The Tenth Circuit ruled Monday that a lower court relied on an erroneous conclusion when it found Lloyds of London failed to sufficiently indemnify Brecek & Young Advisors Inc. in an arbitration alleging the firm's agents mismanaged investment accounts, reversing a $1.2 million judgment in BYA's favor.
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May 14, 2013
Q&A With Gardere's Rob Hoffman
Even when applying the best of good faith in performing e-discovery, if mistakes happen, innocent corporate clients can face sanctions. We litigators need to come up with a better system, says Rob Hoffman, a partner with Gardere Wynne Sewell LLP.
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May 13, 2013
Docs' Prior Blue Cross Deal May Kill Bid To Join Antitrust Suit
A Florida federal judge on Monday told three doctors suing Blue Cross and Blue Shield health plans that a previous settlement's release would be a “tough hurdle” to overcome in their efforts to join a putative antitrust class action against the insurer in Alabama.
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May 13, 2013
Texas Lawmakers Push Health-Data Modernization Bills
Texas lawmakers on Thursday gave final approval to legislation designed to modernize medical data management and are pushing another pair of measures that aim to make the insurance preapproval process for prescription drugs and other health care benefits easier on patients.
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May 13, 2013
Texas Judge Punts On Cement-Dust Coverage Suit
A Texas federal judge has declined to rule on an effort by Continental Insurance Co. to dodge payment of legal fees incurred by cement manufacturing companies fighting more than four dozen pollution lawsuits, finding that the dispute should be considered in California.
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May 13, 2013
Dewey Judge Delays $19M Deal Ruling Over Claims Dispute
A New York bankruptcy judge on Monday declined to rule on the $19.5 million settlement between Dewey & LeBoeuf LLP’s liquidation trust, the firm’s former chairman and primary insurer following arguments between attorneys over the extent to which the deal bars third-party claims.
Expert Analysis
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The Harry Potter Of Insurance: M&A Reps And Warranties
No less than two years ago, mergers and acquisitions reps and warranties insurance was hardly ever used to close deals — like Harry Potter, it was the poor stepchild often left in the closet. But today, it has become an important tool to close deals that may not otherwise get done and win bids in this challenging environment, say attorneys with Weil Gotshal & Manges LLP.
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Inside The Supreme Court Review Of Oxford Health
Oxford Health Plans LLC v. John Ivan Sutter may not be a case about deference after all, but more fundamentally about what parties can expect in arbitration under the Federal Arbitration Act. Arbitrator interpretations have never been impervious. And, as Stolt-Nielsen and Concepcion prove, the U.S. Supreme Court sees class arbitration as a different animal, say attorneys with Homer Bonner Jacobs.
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Bringing Japan Into TPP Talks Is An Important Opportunity
The U.S. recently backed Japan’s entry into the Trans-Pacific Partnership talks. Japan’s participation makes the trade agreement potentially much more lucrative for U.S. exporters — but only if the historic formal and informal barriers that have marred bilateral U.S.-Japan trade relations for decades can somehow actually be addressed, says Terence Stewart of the Law Offices of Stewart and Stewart.
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How A Product Liability Case May Impact Your Insurance
The recent $236 million jury verdict in New Hampshire over the use of the gasoline additive MTBE raises the question of whether litigation of product liability losses may adversely impact insurance coverage. More specifically, it reminds companies to be aware that factual evidence that can resolve insurance coverage issues may be available in the public domain, say attorneys with Carroll Burdick & McDonough LLP.
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A How-To Guide For Insurance Coverage Mediators
While the approach to the mediation of an insurance coverage and bad faith case is similar to mediations in other areas of law, insurance policies are, without question, the most difficult and least understood contracts in general use. Insurance coverage mediators should therefore review some important reminders of their duties as counsel, says Bruce Friedman of ADR Services Inc.
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Reports Of Death Of Fla. Economic Loss Rule Are Exaggerated
Depending on how you read it, the Florida Supreme Court’s Tiara Condominium opinion renouncing the contractual privity branch of the economic loss rule either threw open the courthouse doors to plaintiffs seeking to bolster purely contractual disputes with tort claims or simply renounced a relatively recent judge-made doctrine in favor of long-standing common law principles that do the same job under a different label. We believe a close reading better supports the latter conclusion, say attorneys with Hunton & Williams LLP.
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Don't Let Your Additional Insured Coverage Be A Mystery
When a company bargains for additional insured coverage in an entity's liability insurance policy, all too often, no one determines whether the coverage is what was promised until after a claim arises. Companies seeking such coverage should therefore obtain and closely analyze copies of the policies as part of a thorough legal, risk management and insurance program review, says Gregory May of Nelson Mullins Riley & Scarborough LLP.
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What’s In A (Tropical Storm's) Name?
The National Weather Service assigns an easily remembered name to tropical storms like Superstorm Sandy, which has risen several issues relating to first-party property insurance policies on “named storms.” One factor, among others, to consider is whether there have been notices regarding application of certain policy provisions tied to the named storm definition, says Taylor Davis of Robins Kaplan Miller & Ciresi LLP.
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Calif. Plumbs The Depths Of Water Damage Exclusions
The California Court of Appeal's recent decisions in Cardio Diagnostic Imaging Inc. v. Farmers Insurance Exchange and other cases demonstrate that the state stands ready to enforce water damage exclusions in property insurance policies according to their terms and is unlikely to entertain arguments seeking to render those provisions ambiguous, says Jose Umbert of Zelle Hofmann Voelbel & Mason LLP.
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The Road That Led To Standard Fire V. Knowles
In the years since the enactment of Class Action Fairness Act, the circuit courts have been split on whether a class-plaintiff may thwart federal review by merely stipulating to damages less than the jurisdictional threshold. The U.S. Supreme Court's unanimous decision in Standard Fire Insurance Co. v. Knowles recently settled this split, breathing strength into CAFA’s congressional intent, say attorneys with Day Pitney LLP.