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Insurance

  • September 12, 2018

    Texas Hospital Aims To Nix Aetna Claims In Billing Suit

    A Houston-area medical center has asked a Texas federal judge to end Aetna’s claims in a suit accusing the insurer of underpaying on thousands of medical claims submitted under the Employee Retirement Income Security Act, arguing two court rulings in favor of the medical center point toward dismissal.

  • September 12, 2018

    Teacher Can't Fight Trump Birth Control Rules, Judge Says

    A Colorado schoolteacher doesn’t have standing to challenge Trump administration rules that exempt employers with moral or religious objections from providing birth control coverage under the Affordable Care Act since she didn’t demonstrate she was likely to be affected by them, a Colorado federal judge has ruled.

  • September 12, 2018

    Atty-Client Ruling A Threat To Discovery, Texas Justices Hear

    A lower appellate court's ruling that used the attorney-client privilege to shield from discovery documents reviewed by an expert witness cannot stand or it will not only eviscerate the rules of discovery, but result in impermissible collusion between attorneys and experts, the Texas Supreme Court heard in oral arguments Wednesday.

  • September 12, 2018

    1st Circ. Questions BioChemics Strategy In SEC Probe Case

    The First Circuit prodded BioChemics Inc. on what it felt was an inconsistent argument Wednesday as the pharmaceutical company tried to flip a district court order denying coverage by Axis Reinsurance Co. for defending against a U.S. Securities and Exchange Commission investigation and enforcement action.

  • September 12, 2018

    Wachtell, Simpson Thacher Pilot Carlyle's $6.7B Sedgwick Buy

    The Carlyle Group, with help from Wachtell Lipton Rosen & Katz, has agreed to buy Simpson Thacher & Bartlett LLP-advised Sedgwick Claims Management Services Inc., which provides technology-enabled insurance claim management services to consumers and businesses, in a deal valued at roughly $6.7 billion, the companies said Wednesday.

  • September 12, 2018

    MEPs Propose Undercover Investigation Powers For EIOPA

    Europe’s top insurance regulator could be permitted to investigate companies undercover and record conversations in a sweeping expansion of its powers, under new legislative proposals before the European Parliament.

  • September 11, 2018

    How A 'Lost Generation' Of Associates Bounced Back

    Caught in a whirlwind of firm dissolutions and layoffs, thousands of associates were thrust into one of the worst job markets in history a decade ago. While some have rebounded, others are still feeling the lingering effects of the financial crisis on their careers.

  • September 11, 2018

    Anthem Unit To Face Fiduciary Claims In Benefits Denial Suit

    An Anthem Inc. subsidiary must face allegations that it breached its fiduciary duties under the Employee Retirement Income Security Act with an exclusion for so-called wilderness therapy treatment, a New York federal judge ruled Tuesday, though the judge tossed the claims seeking to recover benefits from the insurer.

  • September 11, 2018

    Insurer Keeps Hidden-Camera Pic Coverage Suit In Fed. Court

    A West Virginia federal judge on Tuesday declined to dismiss an insurer’s suit seeking a judgment that it does not have to indemnify a university and a former women’s basketball coach sued in state court after the coach took photographs of players without their consent, finding it had jurisdiction over the case.

  • September 11, 2018

    No Quick Win For Insurer In Coverage Suit Over Contract Row

    An Oklahoma federal judge on Tuesday refused to let Federal Insurance Co. dodge a duty to cover a boiler maker in an underlying state court suit over its performance on a contract to build a water treatment system for the city of Altus, Oklahoma, saying conflicting evidence precludes a quick win.

  • September 11, 2018

    ERISA Industry Group Wants Delay Of ACA 'Cadillac Tax'

    The ERISA Industry Committee, an organization that represents large benefits plan sponsors, has urged lawmakers to pass a bill that will delay until 2023 the so-called "Cadillac tax," which imposes a 40 percent excise tax on high-cost, employer-sponsored health plans.

  • September 11, 2018

    Akerman Adds Ex-Federal Prosecutor In Fort Lauderdale

    Akerman LLP said Tuesday it has added a former special counsel to the U.S. attorney as a partner in its fraud and recovery practice group in Fort Lauderdale.

  • September 11, 2018

    3rd Circ. Creates Title Insurance Defense Duty Limits

    The Third Circuit has ruled that title insurers aren’t necessarily duty-bound to defend all claims that arise in a lawsuit targeting a policyholder, issuing a precedential decision in favor of Stewart Title Guaranty Co. in a mortgage company’s suit stemming from a defaulted loan.

  • September 11, 2018

    CNA Looks To End Long-Term Care Denial Suit With $5M Deal

    CNA Financial Corp. has agreed to pay up to $4.85 million to settle claims that it wrongly denied policyholders long-term care coverage and will alter its policies to cover assisted living facilities in certain states it had previously denied.

  • September 11, 2018

    Acquainted With Crash Victims, Judge Bows Out Of Case

    A Mississippi federal judge recused himself from an insurance dispute stemming from the crash of a private plane, saying he knows many of the six people who died on the plane or their families.

  • September 11, 2018

    Insurer Owes $1.2M Atty Fees In Construction Suit: 11th Circ.

    The Eleventh Circuit on Tuesday affirmed that Houston Specialty Insurance Co. will have to shell out $1.2 million in attorneys' fees to a construction firm and two of its employees after the insurer lost its coverage suit at trial over a contractor's injury.

  • September 11, 2018

    $250M State Farm Deal Could Spur More Campaign Cash Suits

    The eye-popping $250 million that State Farm will pay to settle claims it rigged an Illinois judicial election to overturn a $1 billion class action verdict likely will spur copycat suits over judicial campaign donations and the blurry lines of influence they yield, experts say.

  • September 11, 2018

    7th Circ. Says Insurer Doesn't Owe Plastics Co. $6.2M

    The Seventh Circuit on Monday declined to force an Illinois insurance company to come up with $6.2 million of the $7.2 million a plastics company was ordered to pay for a defective laminate covering that allegedly caused oil byproducts stored in containers to ignite, saying the plastics company never made the case that its product's failure and subsequent property damage hurt its customer's future profits.

  • September 11, 2018

    Travelers Flips $5M Award In Evidence Tampering Case

    Reversing a Nebraska federal court, the Eighth Circuit ruled Tuesday that a unit of The Travelers Cos. doesn't need to pay $5 million toward a default judgment against a Douglas County Sheriff's Office investigator who tampered with evidence in a murder case, finding the insurer's policy excludes indemnification for criminal acts.

  • September 11, 2018

    Marriott Fights Workers' Info Bid In COBRA Suit

    Marriott International Inc. asked a Florida federal court on Monday to throw out a bid for class information by former hotel workers suing over allegedly deficient notices about their rights to continued health care coverage under the Consolidated Omnibus Budget Reconciliation Act, arguing the motion is both premature and inaccurate.

Expert Analysis

  • Travel Act Gets Mileage In Health Care Cases

    Bradley Smyer

    In U.S. v. Beauchamp, a Texas surgeon recently agreed to plead guilty to federal conspiracy and violation of the Travel Act for his role in an alleged scheme involving millions of dollars in bribes and kickbacks for patient referrals. The case confirms that the Travel Act has officially come to health care enforcement, say Bradley Smyer and Mia Falzarano of Alston & Bird LLP.

  • Challenge Calif. Insurer Limits On Independent Counsel Rates

    Susan White

    When an insurer allows an insured to select its own defense counsel in California, it will often only agree to pay a very low hourly rate. However, an insured should not simply accept the insurer's say on this, as there are several ways to challenge an insurer's unilaterally imposed rates, says Susan White of Manatt Phelps & Phillips LLP.

  • NJ Ruling On Same-Sex Couple Could Reignite Old Claims

    Thomas Regan

    A New Jersey appeals court’s recent decision reviving the emotional distress claims of a same-sex partner has set a precedent that could reignite previously dismissed suits involving unmarried couples in the state. Insurance companies with clients in New Jersey, and self-insureds with New Jersey exposure, may want to adjust their reserves accordingly, says Thomas Regan of LeClairRyan LLP.

  • 4 Key Components To New Firm Partnership Agreements

    Russell Shinsky

    A well-drafted partnership agreement protects a law firm's founders, establishes a process for new and outgoing partners, and sets forth guidelines for navigating conflict along the way. Startup firms can begin with something less complex, but there are important elements that every agreement should include, says Russell Shinsky of Anchin Block & Anchin LLP.

  • Opinion

    Open The Federal Courthouses

    David Oscar Markus

    Forget about cameras, reporters in the Manafort trial were not even permitted in the courtroom with their phones, tablets or computers. That meant no live reporting on Twitter and no emails to the newsrooms with updates. In a world focused on information and news as it happens, this is unacceptable, says trial attorney David Oscar Markus.

  • Medicare Shared Savings Program May Get A Makeover

    Michael Lampert

    The Centers for Medicare & Medicaid Services recently proposed a rule that would overhaul the Medicare Shared Savings Program for accountable care organizations. The most significant change is the revision of the program's participation tracks and mandatory advancement to greater levels of two-sided risk, say attorneys with Ropes & Gray LLP.

  • Payors Share Some Responsibility For The Opioid Epidemic

    Joy Stephenson-Laws

    Recently, well-known commercial insurance companies and government health insurance programs like Medicare and Medicaid have come under scrutiny for their role in allegedly getting and keeping patients addicted to opioid painkillers while not doing enough to help curb the epidemic, says Joy Stephenson-Laws of Stephenson Acquisto and Colman.

  • Brexit: Bracing For A No-Deal Scenario

    Ross Denton

    Once considered the “cliff edge,” the possibility of the United Kingdom exiting from the European Union without agreeing on a trade deal has moved from unthinkable to increasingly likely. Both sides are ramping up preparations for a no-deal scenario, which would have significant implications for businesses in all sectors, say attorneys with Baker McKenzie LLP.

  • Could Diversity Pledge Lead To Unintended Consequences?

    Anthony Oncidi

    The CEO Action for Diversity & Inclusion Pledge is an initiative designed to promote diversity in the workplace. However, because its three main elements are extremely broad, the lack of specificity about what a company is committing to could be problematic in a litigation context, say Anthony Oncidi and Seth Victor of Proskauer Rose LLP.

  • States May Escheat IRAs But Who Gets The Tax Bill?

    Carol Tello

    The June IRS publication of a revenue ruling addressing the timing of federal income tax withholding and reporting treatment for funds escheated from traditional IRAs was timely. As a matter of substance, or of tax and unclaimed property administration, however, the ruling is already proving problematic, say attorneys at Eversheds Sutherland LLP.