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Insurance
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March 22, 2024
Kaiser's Ozempic Coverage Denial Is Discriminatory, Suit Says
Two Kaiser plans' refusal to cover new prescription weight loss drugs like Ozempic and Wegovy is "without any medical or scientific basis," a Washington state resident told a state court, alleging disability discrimination.
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March 22, 2024
Ind. Factory Adds To Historic $112M Bad Faith Coverage Win
A flooded factory building that was awarded $112 million in a historic bad faith win added to its victory Friday when an Indiana federal court denied its insurers' requests for a new trial and granted the factory more than $7 million in costs and interest.
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March 22, 2024
Ex-Ga. Insurance Head Cops To Healthcare Kickback Scheme
Former Georgia Insurance Commissioner John Oxendine pled guilty Friday to working with an Atlanta-area doctor to run a multimillion-dollar medical testing kickback scheme just weeks before he was set to face trial in federal court.
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March 22, 2024
5th Circ. Asked For Do-Over In Hurricane Coverage Feud
The owners of a New Orleans apartment complex urged the Fifth Circuit to rethink ordering them to arbitrate Hurricane Ida damage claims under New York law, arguing New York's choice-of-law clause would ordinarily be unenforceable under Louisiana law if it weren't couched within the arbitration provision.
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March 22, 2024
Colo. Mandates Multistate Online Insurance Tax Filing
Insurance companies in Colorado will be required to pay certain taxes through multistate third-party web-based application under legislation that Democratic Gov. Jared Polis signed into law Friday.
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March 22, 2024
Congress Spares Employee Benefits From $400M DOL Cut
A commitment from Congress to keep funding level for the U.S. Department of Labor's sub-agency that oversees employee benefits despite a $400 million agency-wide cut was one of the highlights for benefits attorneys in a new fiscal year 2024 spending deal. Here are three takeaways from attorneys on the funding agreement.
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March 22, 2024
5th Circ. Revives Coverage Row Over SXSW Ticket Refunds
Texas music festival South by Southwest's insurer must cover its defense in a class action by ticket holders who didn't receive refunds after the city of Austin canceled the March 2020 event because of the COVID-19 pandemic, the Fifth Circuit said, reviving the dispute.
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March 22, 2024
Ex-Drug Rep Won't Serve More Time After 1st Circ. Victory
The second sentencing of a former Aegerion Pharmaceuticals Inc. salesman did not add a day in prison to the roughly seven months he served before the First Circuit wiped away his initial conviction on charges he schemed to fraudulently sell the company's cholesterol treatment.
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March 22, 2024
Fox Rothschild Hires Lewis Brisbois Insurance Vet In Seattle
Fox Rothschild LLP has hired an insurance litigator in Seattle who focuses her practice on a range of commercial and liability disputes and joins the firm after working for a decade at Lewis Brisbois Bisgaard & Smith LLP, the firm has announced.
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March 21, 2024
Cigna Slams Suit's Claims Of Algorithm-Led Coverage Denials
Insurance giant Cigna Group wants a Connecticut federal court to toss a proposed class action alleging that an algorithm unlawfully rejected hundreds of thousands of claims en masse and without a proper review, arguing the suit is based on a "misleading" news article and shows a misunderstanding of the health insurer's claim denial process.
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March 21, 2024
Calif. Panel Revives Diner's COVID Sanitization Coverage Bid
A California state appeals court revived a diner's bid for property insurance coverage of COVID-19 losses after it determined the restaurant credibly alleged direct physical losses and that the policy's language covering losses attributable to a virus applied to COVID-19 sanitization efforts.
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March 21, 2024
VA May Have Acted In Bad Faith On $30M Debt Collection Deal
The U.S. Civilian Board of Contract Appeals refused to toss a $29.6 million appeal accusing the U.S. Department of Veterans Affairs of hampering a contractor's efforts to collect funds from outside insurers, saying the VA may have acted in bad faith.
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March 21, 2024
Anadarko Wants Defense Coverage In 2013 La. Kickback Case
Anadarko told a Houston federal court that an environmental remediation company should be required to defend it in a decade-old Louisiana kickback lawsuit that has already made its way through an appeals court twice.
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March 21, 2024
9th Circ. Backs Rescission Of Homeowner's Property Policies
Two Safeco insurers are entitled to rescind policies issued to a woman who misrepresented that her house wasn't used for business when in fact it was rented to short-term guests, the Ninth Circuit affirmed, saying there's no genuine issue of material fact as to the commercial use of the property.
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March 21, 2024
Plan Admin. Escapes Ex-Aerospace Execs' Death Benefits Suit
A third-party administrator isn't liable for misrepresentation and negligence claims from former aerospace company executives over death benefits, a Pennsylvania federal judge has ruled, saying the administrator isn't to blame for the plaintiffs' lack of understanding about the termination of a deferred compensation plan.
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March 21, 2024
EBSA Gets Level Funding Of $191.1M In Spending Deal
Spending leaders in the House and Senate agreed Thursday to provide $191.1 million in fiscal year 2024 for the U.S. Department of Labor's sub-agency overseeing employee benefits, a level that's identical to what lawmakers agreed to last fiscal year.
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March 20, 2024
7th Circ. Closes Door On Italian Hotel's Virus Coverage Bid
A luxury Italian hotel has no coverage for certain coronavirus-related losses, the Seventh Circuit affirmed on Wednesday, saying that the hotel's own filings contradicted its claim that it suffered a covered physical loss.
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March 20, 2024
Endo Plan To Trim $5B In Debt Confirmed By NY Judge
Drugmaker Endo International got a New York bankruptcy judge's approval for its Chapter 11 plan that aims to cut more than $5 billion in debt and hand over ownership to its lenders, roughly a month after it finalized a $465 million deal to resolve criminal and civil opioid claims.
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March 20, 2024
UK Pension Fraud Fund To Pay Out £416M To Victims By 2026
The U.K.'s pension lifeboat scheme said Wednesday it expects to pay up to £416.7 million ($530 million) in compensation to members of pension schemes that have been hit by scams.
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March 20, 2024
NY AG Scoffs At Trump's Claim Of 'Impossible' $465M Bond
The New York Attorney General's office on Wednesday disputed Donald Trump's claim that posting bond while he appeals a $465 million civil fraud judgment is a "practical impossibility," arguing the former president and his business empire haven't exhausted all avenues.
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March 20, 2024
Health And Safety Top Risk For Directors, Global Survey Says
Health and safety is the top risk for directors and officers worldwide, according to a survey published Wednesday, in a "surprise" result partly attributed to the lingering impact of the COVID-19 pandemic on businesses and increasing mental health considerations.
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March 20, 2024
Pa. Insurance Broker On Hook For Not Paying Real OT
A Pennsylvania-based insurance brokerage willfully violated federal wage law when it misrepresented overtime hours employees worked and otherwise dodged wage requirements, a federal judge ruled in a case brought by the U.S. Department of Labor.
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March 20, 2024
AI Misuse Will Drive Cyber Insurance Demand, Actuary Says
The use of artificial intelligence by criminals and other evolving threats will boost demand for cyber-insurance for at least the next decade, according to analysis published Wednesday by actuarial consultancy OAC.
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March 20, 2024
EU Insurers Warn Regulators Of Gaps In Greenwashing Rules
European insurers have urged the bloc's insurance and pensions watchdog to be consistent and clear with its greenwashing rules for investment products, pointing to discrepancies between jurisdictions and inconsistencies with other sustainability frameworks.
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March 20, 2024
How The Supreme Court Could Narrow Chevron
After hours of oral argument in a closely watched administrative law case, it appeared that some U.S. Supreme Court justices could be open to limiting the opportunities for lower courts to defer to federal agencies' legal interpretations in disputes over rulemaking — and legal experts said there are a number of ways they could do it.
Expert Analysis
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How New Lawyers Can Leverage Feedback For Growth
Embracing constructive criticism as a tool for success can help new lawyers accelerate their professional growth and law firms build a culture of continuous improvement, says Katie Aldrich at Fringe Professional Development.
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How Reps And Warranties Insurance Can Aid Sellers In M&A
Amid the current slowdown in the M&A climate, representation and warranty insurance offers sellers a number of advantages, including protection against fraud and possible leverage to insist on a no-seller-indemnity deal, say Alex Leibowitz and Eric Jesse at Lowenstein Sandler.
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Series
ESG Around The World: Australia
Clive Cachia and Cathy Ma at K&L Gates detail ESG-reporting policies in Australia and explain how the country is starting to introduce mandatory requirements as ESG performance is increasingly seen as a key investment and corporate differentiator in the fight for global capital.
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In Ga., Promptness Is Key To Setting Aside Default Judgments
The Georgia Court of Appeals' recent vacating of a lower court's decision to set aside a default judgment against Samsung Electronics America is a reminder of the processes and arguments provided by Georgia's statutes for challenging default judgments — including the importance of responding quickly, says Katy Robertson at Swift Currie.
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Twitter Legal Fees Suit Offers Crash Course In Billing Ethics
X Corp.'s suit alleging that Wachtell grossly inflated its fees in the final days of Elon Musk’s Twitter acquisition provides a case study in how firms should protect their reputations by hewing to ethical billing practices and the high standards for professional conduct that govern attorney-client relationships, says Lourdes Fuentes at Karta Legal.
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Ore. Warranty Ruling Complicates Insurance Classification
The Oregon Court of Appeals' recent TruNorth v. Department of Consumer and Business Services holding that a service contract — commonly referred to as an extended warranty — covering commercial property is subject to the state's consumer service contract laws raises regulatory questions for contract obligors, sellers and administrators, say attorneys at Locke Lord.
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ABA's Money-Laundering Resolution Is A Balancing Act
While the American Bar Association’s recently passed resolution recognizes a lawyer's duty to discontinue representation that could facilitate money laundering and other fraudulent activity, it preserves, at least for now, the delicate balance of judicial, state-based regulation of the legal profession and the sanctity of the attorney-client relationship, say attorneys at Ballard Spahr.
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1st Circ. Harvard Ruling Provides Primer On Policy Provisions
In its recent finding of no coverage for Harvard due to the school's failure to give Zurich American Insurance timely notice of its claim, the First Circuit provides a good analysis of the distinctions between occurrence and claims-made policies, including the rationale for differences in notice provisions, says Andrew Paliotta at Cozen O'Connor.
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A Festival Of Litigation Could Arise From 'Electric Zoo' Fiasco
Over Labor Day weekend, thousands of electronic dance music fans were displeased with the organization of the New York City-based Electric Zoo festival, which quickly elicited comparisons to the 2017 Fyre Festival — and three kinds of litigation could ensue from the debacle, say attorneys at Seiden Law.
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Law Firm Professional Development Steps To Thrive In AI Era
As generative artificial intelligence tools rapidly evolve, professional development leaders are instrumental in preparing law firms for the paradigm shifts ahead, and should consider three strategies to help empower legal talent with the skills required to succeed in an increasingly complex technological landscape, say Steve Gluckman and Anusia Gillespie at SkillBurst Interactive.
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Opinion
9th Circ.'s Latest UBH Ruling Ignores Case's Core Issue
The Ninth Circuit’s recent decision to vacate its earlier opinion in Wit v. United Behavioral Health frustratingly disregards the case’s key issue of benefits coverage for mental health treatment, and illogically elevates an insurer's discretionary authority over the medically necessary needs of patients, says Mark DeBofsky at DeBofsky Law.
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Nev. Insurance Law May Mean Turmoil In Liability Market
Nevada's new law prohibiting insurers from issuing or renewing defense-within-limits liability policies in the state could cause professional liability insurers to withdraw certain products or prohibitively increase premiums — and while an emergency regulation allows for exceptions, the situation remains fluid, says Joshua Leach at Atheria Law.
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SEC's New Rules Likely Will Affect Cyber, D&O Insurance
The U.S. Securities and Exchange Commission recently adopted cybersecurity incident disclosure rules that could create new challenges that affect how public companies assess the risk of securities, corporate governance and cyber-related lawsuits, which may implicate novel insurance coverage issues, say attorneys at Reed Smith.
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Potential Marijuana Status Change Would Shift Industry Risks
Cannabis companies and their insurers should pay close attention to how the U.S. Department of Health and Human Services' move toward marijuana reclassification plays out, and the potential for a shakeup in the landscape for cannabis regulation at the state and federal levels, says Ian Stewart at Wilson Elser.
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Key Provisions In Florida's New Insurer Accountability Act
Florida's recent bipartisan Insurer Accountability Act introduces a range of new obligations for insurance companies and regulatory bodies to strengthen consumer protection, and other states may follow suit should it prove successful at ensuring a reliable insurance market, say Jan Larson and Benjamin Malings at Jenner & Block.