Several doctors’ associations and doctors accusing WellPoint Inc. of conspiring to cap insurance reimbursements have told the high court that a Tenth Circuit decision barring them from pursuing claims in California because of an earlier Florida settlement creates a prospective waiver that flies in the face of antitrust law.
A Wisconsin federal judge ruled Friday that Travelers Property Casualty Co. of America had no duty to defend a law firm in litigation accusing it of violating a rival firm’s privacy through its advertising tactics, saying the litigation wasn’t covered because it sought only to stop the offending practice.
A Nevada federal judge on Thursday rejected Progressive Casualty Insurance Co.’s effort to toss counterclaims against it in a coverage dispute with a failed Las Vegas bank’s former top brass, who have been targeted by banking regulators over $18 million in bad real estate loans.
Follow-on cases to the U.S. Supreme Court's Hobby Lobby decision and Lanham Act standing questions after the court’s Lexmark ruling are among the percolating conflicts in lower courts that may rise again to the high court's attention, a panel of experts said Saturday.
A New Jersey intellectual property attorney on Friday was freed from a legal malpractice suit after a state appellate panel ruled a trial judge erred by converting the attorney's LLP into a general partnership based on an overzealous interpretation of court rules regarding liability insurance coverage.
A Louisiana federal judge on Wednesday rejected Hudson Specialty Insurance Co.’s bid to throw out claims that it ducked out on covering a health care benefit manager in a proposed class action, saying the insurer may have a duty to defend.
The D.C. Circuit on Friday rejected two Catholic organizations' claims that the religious exemption to the Affordable Care Act's contraception mandate is a substantial burden on their beliefs, saying the system requires “as little as possible” from the groups.
A D.C. federal judge on Thursday tossed a challenge to a fee levied on insurers by the District of Columbia to fund its Affordable Care Act insurance exchange, ruling the allegedly overbroad fee was not preempted by the ACA nor unconstitutional.
The plaintiffs in two Ohio lawsuits challenging the state’s ban on same-sex marriage on Friday asked the U.S. Supreme Court to hear their dispute after the Sixth Circuit split from other appellate courts by upholding the state’s marriage-restricting laws.
The Second Circuit begrudgingly upheld a New York district court finding that an employee welfare benefit fund couldn’t sue Gerber Life Insurance Co. for payment on claims tendered by beneficiaries of both plans, saying Friday that the relief sought was unavailable under the Employee Retirement Income Security Act.
He may have just helped bring the largest municipal bankruptcy in U.S. history to a close, but Jones Day’s David Heiman couldn’t celebrate the night after the city of Detroit won permission to exit Chapter 9 and begin the long and uncertain process of rebuilding.
If the federal government loses a high-profile U.S. Supreme Court case over Affordable Care Act subsidies, new legal battles will likely ensue to determine which insurance exchanges are affected and what states must do to keep subsidies flowing. Here are three pivotal questions that experts say will demand answers.
A Florida federal judge on Thursday found that Zurich American Insurance Co. needn’t defend the owner and operator of a spa from a negligence and premises liability suit filed after a customer was allegedly sexually assaulted during a massage, saying that a “health, spa or cosmetic” exclusion in its policy barred the claim.
A Zurich Insurance Co. unit on Thursday asked a New York appeals court to find that it need not defend now-defunct law firm Lee & Amtzis LLP from a malpractice suit stemming from multiple loan and real estate transactions, saying its policy doesn’t cover claims that arise from outside business dealings.
A New Jersey federal judge on Thursday threw out a yacht club’s suit seeking to recover for damage allegedly caused by Superstorm Sandy, saying it refused to let Atlantic Specialty Insurance Co. inspect the property and questioning whether the club and its counsel filed the suit "in bad faith."
JPMorgan Chase & Co.’s top investment banker testified on Thursday in the U.S. Court of Federal Claims that American International Group Inc. was a bad loan risk immediately prior to its 2008 federal bailout, effectively scaring off private investors, as a trial over allegedly onerous terms of the bailout deal continued.
Steve Parton, former general counsel for the Florida Office of Insurance Regulation, will be joining GrayRobinson PA as a shareholder in its Tallahasee, Florida, office, where he will set up a new insurance regulatory practice, the firm announced Thursday.
Senate Republicans on Thursday pressed the U.S. Equal Employment Opportunity Commission's general counsel on recent lawsuits over employer wellness programs and criticized the agency for pursuing litigation in cases where no employee has complained of discrimination.
Essex Insurance Co. reached a tentative settlement on Wednesday with the U.S. Department of Justice and other parties in a coverage dispute over $22 million that a defunct Washington scrap metal business allegedly owed the federal government for cleaning up an oil spill in the Columbia River.
The Seventh Circuit on Thursday determined that a title insurance company need defend against only claims covered in its policies, reversing an Illinois federal court opinion finding that Chicago Title Insurance Co. had to defend a real estate lender from a suit that included allegations of fraud.
In light of recent enforcement trends, health care stakeholders that work with government-sponsored health care programs should protect against even the appearance of irregularity in billing, coding and compensation by, among other things, seeking feedback on audits, tracking peer reviews and focusing on informed patient consent, say attorneys at Hogan Lovells US LLP.
While the Centers for Medicare & Medicaid Services has always used data mining tools to track millions of claims, prosecutors and regulators are now using such tools to identify health care practitioners that stand out based on high reimbursement claims under the theory that they are submitting fraudulent charges, say attorneys at Hogan Lovells US LLP.
Failing to identify and elicit suppressed biases hinders practitioners’ ability to de-select prospective jurors during jury selection. Five strategies can help mitigate the effects of prospective jurors’ tendency to “self-enhance,” says Joshua Dubin, principal of Dubin Research & Consulting.
Even without a filibuster-proof majority in the Senate, it is likely to be a very active session for the Republican Congress next year — especially if they take advantage of some key legislative tools available to a congressional majority, say former congressional counsel now with Venable LLP.
The U.S. Department of Justice's use of the Wartime Suspension of Limitations Act and its aggressive view of what constitutes fair market value under the Stark Law point to prosecutors expanding their investigatory reach with a host of aggressive, sometimes novel, interpretations of statutes and regulations, say attorneys at Hogan Lovells US LLP.
Oral arguments before the U.S. Supreme Court in Omnicare Inc. v. Laborers District Council suggest that justices on both sides of the political fence appear to be leaning toward applying the middle-ground “reasonable-basis” standard for Section 11 claims. Thus, it seems unlikely that the court will affirm the Sixth Circuit’s decision in the case, say Eric Scheiner and Jennifer Quinn Broda of Sedgwick LLP.
Although not an obvious national security risk, a Chinese insurance company's $1.95 billion purchase of Hilton Worldwide Holdings Inc.’s Waldorf Astoria New York hotel does raise issues that would merit Committee on Foreign Investment in the United States review of the transaction, say attorneys with Wiley Rein LLP.
In an effort to provide what many business owners may soon be seeking, a new type of coverage — Pandemic Disease Business Interruption Insurance — was recently introduced, however it is unclear whether insureds other than hospitals and health care facilities will be able to purchase the coverage and how much it might cost them, says Jennifer Gibbs of Zelle Hofmann Voelbel & Mason LLP.
When handling claims in foreign jurisdictions, insurers need to know the differences between common law and civil law systems given their impact on every phase of complex claims, from adjustment through the retention of experts and a final resolution, say Jose Umbert and Jason Reeves of Zelle Hofmann Voelbel & Mason LLP.
Litigation is a fluid and amorphous process, subject to shifts in strategy based on constant flows of information and events, not the least of which are the reactions of opponents and those who don the black robes. If a client feels informed and part of the process, he or she will feel satisfied with services received — even if the result is not a good one, says Mark Goodman, co-chairman of Capes Sokol Goodman & Sarachan PC's litig... (continued)