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Insurance
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May 8, 2013
EEOC Vows To Clarify Wellness Program Standards
The U.S. Equal Employment Opportunity Commission on Wednesday acknowledged the need to issue guidance and standards for employer wellness programs to help companies navigate a complex web of anti-discrimination and health privacy statutes, noting that adding a separate scheme to the mix could add to the confusion.
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May 8, 2013
9th Circ. Chubb Ruling Bars Insurer's Superfund Suit, US Says
Citing the Ninth Circuit’s recent Chubb Custom decision, the federal government Tuesday asked a California federal judge to toss an insurer’s Superfund lawsuit seeking reimbursement for cleanup costs at a former munitions plant, saying it erred by suing before its policyholder sought payment from Uncle Sam.
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May 8, 2013
Policyholders Can Exit $5M Highmark Antitrust Settlement
A Pennsylvania federal judge on Tuesday allowed the plaintiffs in an antitrust class action against Highmark Inc. to step out of a proposed $4.8 million settlement amid claims that the insurer concealed pre-existing obligations that negated certain settlement concessions.
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May 8, 2013
Q&A With Nossaman's Joan Cotkin
The insurance industry as we knew it 30 years ago has substantially changed from service industry to one of financial services. Thus, being attuned to the “customer” needs sometimes fades away in favor of the better bottom line, says Joan Cotkin, co-chairwoman of Nossaman LLP's insurance practice group.
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May 7, 2013
Calif. To Shelve Coordinated Care Program Until 2014
California's health department said Monday that it will delay a large-scale pilot program to test care coordination among patients who are eligible for both Medicare and Medicaid, and will start in January 2014 at the earliest.
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May 7, 2013
Lack Of Clarity On Wellness Programs Puts Employers At Risk
As the U.S. Equal Employment Opportunity Commission gears up to consider employer wellness programs, attorneys say the lack of guidance on what constitutes a voluntary program has left companies at risk of violating anti-discrimination laws by inadvertently forcing employees to participate or to divulge private medical information.
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May 7, 2013
Marsh, Kroll Dodge Ex-Veep's Malicious Prosecution Suit
A New York federal judge on Tuesday granted bids by Marsh & McLennan Cos. Inc. and Kroll Associates Inc. to dismiss a suit brought by a former Marsh vice president alleging his ex-employer unfairly drew him into a bid-rigging and commission investigation that led to criminal charges.
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May 7, 2013
Chartis Avoids Covering $150M Health Plan Settlement
A Delaware state judge on Tuesday said that Chartis Specialty Insurance Co. doesn't need to cover a $150 million settlement between policyholder First Health Group Corp. and a coalition of health care providers accusing the medical service underwriter of illegally scrimping on payments.
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May 7, 2013
Top NY Court Rebuffs Appeal Of AXA’s $42M Art Swindle Win
New York's high court refused Tuesday to hear an appeal from a group of art investors protesting a ruling that freed an AXA SA subsidiary from covering heavy losses from a notorious gallery swindle involving $42 million worth of artwork.
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May 7, 2013
Ala. High Court Finds No Coverage For Faulty Work
Alabama's Supreme Court ruled Friday that American Resources Insurance Co. Inc. did not have a duty to defend a contractor against allegations of faulty work, deciding there had been no "occurrence" under the contractor's liability policy.
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May 7, 2013
Cigna Beats Class Action Over ACA Rebate Dodging
Cigna Corp. and a medical cost management firm on Tuesday escaped a putative class action accusing them of a conspiracy to help Cigna avoid paying Affordable Care Act-mandated rebates to patients, after a Florida federal judge ruled the plaintiff didn’t have standing to bring the suit.
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May 7, 2013
BofA Can't Shake AIG's $10.5B Countrywide RMBS Suit
A California federal judge on Monday said American International Group Inc. can move forward with its $10.5 billion lawsuit accusing Bank of America Corp.'s Countrywide Financial Corp. of lying about the quality of residential mortgage-backed securities it sold to the insurer, tossing Bank of America's jurisdictional challenge.
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May 7, 2013
FTC Warns Data Brokers To Heed Consumer Privacy Law
Ten data brokers have been warned by the Federal Trade Commission that a test-shopping experiment by the agency indicated they were willing to sell consumer information for use in employment, credit and insurance decisions without following Fair Credit Reporting Act requirements, the FTC said Tuesday.
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May 7, 2013
NY High Court Backs Insurer In Priest Sex Abuse Case
New York’s highest court ruled Tuesday that a Catholic priest’s abuse of a minor over more than five years could not be treated as a single occurrence under insurance policies issued to the Roman Catholic Diocese of Brooklyn, saying the diocese must pay deductibles for each policy it was covered under.
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May 7, 2013
CIFG Gets Fraud Claims Restored In $275M Goldman Suit
A New York state appeals court on Tuesday revived CIFG Assurance North America Inc.'s claims that Goldman Sachs & Co. and M&T Bank Corp. duped it into backing up a $275 million portfolio of bad home mortgages, reversing a trial court's finding that the bond insurer's due diligence precluded a fraudulent inducement claim.
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May 7, 2013
Senator Urges Fla. Gov. To Act On Heath Care Expansion
U.S. Sen. Bill Nelson, D-Fla., on Monday joined the Florida Senate Democratic Caucus' call for Gov. Rick Scott to reconvene the state legislature for a special session to reach a consensus on how to expand health care coverage for low-income Floridians.
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May 7, 2013
Kaufman Dolowich Picks Up Partner In NJ From Wilson Elser
Kaufman Dolowich Voluck LLP has snagged a former Wilson Elser Moskowitz Edelman & Dicker partner well seasoned in professional liability and insurance issues to join its Hackensack, N.J., office, the firm said Tuesday.
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May 7, 2013
Chartis Partly Escapes Suit Over Losses On $103M Hotel Loan
A New York state judge on Monday tossed part of a suit alleging that Chartis Specialty Insurance Co. failed to cover an investment firm for losses after a Mexican court ruled that bankrupt businesses didn’t have to make payments on a $103 million loan to hotel operators.
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May 7, 2013
Hospital Trade Group Wants Clarity On ACA Navigator Plan
The Federation of American Hospitals on Monday urged the Centers for Medicare and Medicaid Services to ensure hospitals can help patients explore their health coverage options under the Affordable Care Act’s “navigator” program, saying a proposed conflict-of-interest rule doesn’t explicitly allow them to do so.
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May 7, 2013
Q&A With Ober Kaler's Stephen Palley
Coverage disputes frequently turn on discrete questions of law or questions of fact relating to quantum of damages. Given this, it should be possible for lawyers and clients to craft more efficient and fairer dispute resolution processes, says Stephen Palley, a principal with Ober Kaler Grimes & Shriver PC specializing in insurance coverage litigation.
Expert Analysis
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UK Tax Advisers Are Beyond Legal Advice Privilege
A recent judgment from the U.K. Supreme Court in one of the most significant decisions on legal advice privilege for many years. Prudential PLC v. Special Commissioner of Income Tax, which dealt a blow to tax advisers and other nonlegally qualified service providers who provide legal advice to their clients, confirmed that — consistent with the position in the U.S. — legal advice privilege only protects communications to or from a qualified lawyer, say Richard Hornshaw and Daniel Cohen of Bingham McCutchen LLP.
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What 'Monty Python' Tells You About NJ's Insurance Law
As illustrated by a sketch from "Monty Python's Flying Circus," which captures an aspect of New Jersey's law on bad faith claim-handling, New Jersey needs to pass the bill that would give policyholders a statutory right to bring bad faith claims against their insurers because current law permits a carrier to handle claims poorly without any real threat of consequence, says Carl Salisbury of Kilpatrick Townsend & Stockton LLP.
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Dissecting FATCA: Oil And Gas Trader Edition
Under the U.S. Department of Treasury's Foreign Account Tax Compliance Act, foreign oil and gas traders must take steps now to ensure that they are on the correct path to compliance. On the other hand, the Treasury should issue additional guidance allowing withholding agents to apply for refunds on behalf of the recipients of withholdable payments. Otherwise, there may be too much administrative burden, creating a tax windfall for the Treasury, say attorneys with Bracewell & Giuliani LLP.
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How To Defend Your Co. From Gov't Health Care Claims
Federal enforcement of False Claims Act, Stark anti-kickback and Health Insurance Portability and Accountability Act claims against health care companies are rising rapidly. In order to defray the costs to defend a company from such government investigations, companies should review the tips to getting the most out of their directors and officers and errors and omissions policies, say attorneys with King & Spalding LLP.
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A Look At The Health Care M&A Horizon
Factors such as the Affordable Care Act’s payment reforms, downward pressure on costs, enhanced focus among payers on outcomes and quality, and expanded Medicaid roles will continue in 2013 to influence M&A activity across industry sectors, increase regulatory and compliance costs, and provide additional incentives to federal and state agencies to boost enforcement efforts, say attorneys with Skadden Arps Slate Meagher & Flom LLP.
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Don't Miss The Boat On Rescission Claims
While it is important for Superstorm Sandy insurers seeking relief from misrepresentations made by insureds to remember that rescission may be an appropriate remedy, insurers should note that under New York law, their time to bring a claim for rescission is limited, and they will not be permitted to sit on their rights, says Kristin Suga Heres of Zelle Hofmann Voelbel & Mason LLP.
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Expert Testimony Is Key In RMBS Liability
As residential mortgage-backed securities disputes between sophisticated insurers and financial entities intensify, expert testimony is emerging as a critical factor in determining whether insurers can avoid liability and recoup some of the losses already realized by the industry, say attorneys with Choate Hall & Stewart LLP.
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NY Cedents Enjoy More Protection And Authority
While some have stated that the New York Court of Appeals ruling in United States Fidelity & Guaranty Co. v. American Re-Insurance Co. was favorable to reinsurers, the decision actually provides further support for expanding the protections of the follow-the-settlement doctrine to post-settlement allocation decisions, say attorneys with Hunton & Williams LLP.
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Coming Soon To SCOTUS: Technicalities Of Saying 'I Do'
The U.S. Supreme Court’s decision to accept two cases addressing same-sex marriage, Windsor v. United States and Hollingsworth v. Perry, has raised questions about the potential consequences for employers, insurers, health care providers and others. The most significant impact of these decisions may be on employee benefits governed by the Employee Retirement Income Security Act, say attorneys with Faegre Baker Daniels LLP.
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6 Areas Often Underestimated In Law Firm Mergers
While mergers in other industries are driven by cost efficiencies or economies of scale, law firm mergers are typically focused on the potential to leverage clients and the overall quality of the attorney population, branding and market position. As a result, full disclosure of third-party vendor or support function operating costs can be a secondary concern until after the deal closes. Firms need to hit the ground running the moment the merger is inked, says Matthew Sunderman of HBR Consulting LLC.