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Insurance
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November 20, 2025
NC Hotel Owner Says Insurer Botched Tornado Damage Claim
An insurer failed to conduct a meaningful investigation of a North Carolina hotel's claim for tornado damage, the property owner alleged in a suit removed to federal court, saying the insurer issued a "puzzling" coverage denial referencing damage at a property 150 miles away and a workplace injury in Florida.
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November 20, 2025
BoFA Exec's Widow Sues Employer Plan, MetLife For Benefits
The widow of a former Bank of America executive brought a suit alleging the bank and Metropolitan Life Insurance Co. wrongly denied her claim for life insurance benefits after her husband's death.
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November 19, 2025
Colo. High Court Considers Insurers' Noncooperation Defense
Colorado Supreme Court justices on Wednesday questioned the scope and effects of a state law requiring insurers to meet certain requirements in requesting information from policyholders before bringing a failure-to-cooperate defense, in a case where a man was denied claims after not turning over medical records.
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November 19, 2025
Is 'Red Book' Best For Drug Pricing? Pa. Justices Ask
The Pennsylvania Supreme Court seemed skeptical Wednesday that the state workers' compensation authorities were using the best guide to calculate pharmacy reimbursements for injured workers' prescription drugs, with the justices questioning the fairness of the industry's long-used "red book" method.
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November 19, 2025
Contractor Not Covered In Pa. Hotel Construction Dispute
A pair of Zurich insurers have no duty to defend or indemnify a contractor accused of mismanaging the construction of a dual-brand hotel in Pennsylvania, a California federal court ruled, saying coverage for the alleged property damage is barred by a "course of construction" exclusion.
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November 19, 2025
Aetna Gets OK For $3.4M Deal In Cancer Treatment Denial Suit
A Florida federal judge has signed off on Aetna's $3.4 million settlement agreement resolving a class action that alleged the insurer unlawfully mischaracterized a proton beam cancer radiation treatment as experimental to deny dozens of claims.
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November 19, 2025
Insurer Says Broker Error Bars Claim For Chocolate Spoilage
Aspen American Insurance Co. hit a U.S. affiliate of French pastry retailer Laduree with a federal complaint seeking to void an insurance contract over a shipment of chocolate the company claimed was improperly refrigerated during overseas transit.
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November 19, 2025
Senate GOP Resists Extending Expanded ACA Tax Premiums
Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.
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November 19, 2025
Religious Org. Not Covered For Sex Abuse Suit, Insurer Says
A nonprofit insurer said a Christian ranch for "at-risk" boys isn't owed coverage for a lawsuit alleging physical and sexual abuse, telling a Missouri federal court that the ranch failed to adequately provide notice of the underlying claim.
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November 19, 2025
Tax Court Substance Ruling Offers Silver Lining For Taxpayers
Even though the U.S. Tax Court upheld stiff penalties under the economic substance doctrine against an eye doctor's microcaptive arrangements, the opinion generally favored taxpayers by clarifying that the IRS faces limits on when it can invoke the doctrine to audit transactions.
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November 19, 2025
Minn. Insurer Accused Of Not Paying For Boot-Up Time
A Minnesota health insurance provider failed to pay call center workers for the time they spent preparing their computers to be ready to receive calls, a current employee said in a proposed class and collective action filed in federal court.
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November 19, 2025
'Wrongly Decided' Case Backs Insurer Loss, Mich. Panel Says
An insurer is statutorily barred from suing an auto shop to recoup personal injury protection benefits it paid to policyholders injured in a crash, a Michigan state appeals court affirmed, though saying it is bound by a 1993 case it believes was "wrongly decided" and should be reviewed.
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November 18, 2025
Fla. Condo Says Insurers Handled Storm Claim In Bad Faith
A group of property insurers acted in bad faith by failing to properly, timely and fairly adjust a claim for damage caused by Hurricane Sally in 2020, the owner of a Pensacola condominium complex told a Florida federal court.
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November 18, 2025
Pa. Justice Spots 'Slippery Slope' In Trafficking Coverage Row
Justices on Pennsylvania's Supreme Court seemed wary Tuesday of creating a "slippery slope" where alleged violations of criminal law could be used by insurers to deny coverage under a "public policy exception," scrutinizing a suit in which insurers wanted out of defending a Philadelphia hotel accused of ignoring sex trafficking.
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November 18, 2025
4th Circ. Restores Trade Secrets Suit Against Insurance Execs
The Fourth Circuit on Tuesday revived insurer Sherbrooke Corp.'s claims of trade secrets theft against three former executives, disagreeing with a district judge who found that the company had not made enough of an effort to guard the software in question.
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November 18, 2025
NOLA Diocese Bondholders Can't Press Consolidation Bid
A Louisiana bankruptcy judge on Tuesday told bondholders they cannot argue for consolidating the bankruptcy cases of the Roman Catholic Archdiocese of New Orleans and its parishes at the ongoing confirmation hearing for the archdiocese's Chapter 11 plan.
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November 18, 2025
Ill. Justices Mull If Permits Override Pollution Exclusions
Counsel for a sterilization company and its former parent seeking defense costs for hundreds of lawsuits over ethylene oxide emissions at a suburban Chicago facility urged the Illinois Supreme Court on Tuesday to find a pollution exclusion in their insurance policy doesn't apply to emissions allowed under a state permit, insisting the policyholders are not polluters under Illinois law or "in the general sense of the word."
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November 18, 2025
Margolis Edelstein Says Insurer Can't Challenge Settlement
Insurance litigation firm Margolis Edelstein told a New Jersey state court that an insurer's legal malpractice suit against the firm should be tossed because its inability to challenge the value of an underlying settlement invalidates the entire matter.
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November 18, 2025
Sanctioned Atty Convinces Mo. Court Errors Not Caused By AI
A Missouri federal judge sanctioned former counsel for Liberty Mutual Personal Insurance Co. Monday for including citation errors in a motion this fall, finding that, although the attorney likely inserted the errors herself without the use of AI software, "such carelessness, exacerbated by a lack of internal guardrails, is entirely unacceptable."
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November 18, 2025
Insurer Needn't Cover LA Zoo Org. In City Contract Dispute
An insurer doesn't owe coverage to the Los Angeles Zoo's nonprofit arm in a contractual dispute brought by the city, a California federal court has ruled, finding that all claims are excluded under the association's nonprofit asset protection policy.
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November 18, 2025
Willkie, Appleby Lead Prismic's $1.3B Fundraise
Prismic Life Holding Company LP, led by Willkie Farr & Gallagher LLP and Appleby (Bermuda) Ltd., revealed Tuesday that it closed its third capital raise after securing $1.3 billion from investors, which will be used to grow the company's reinsurance platform.
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November 18, 2025
Geico Flouted Mass. Wage Laws For Adjusters, Suit Alleges
Geico required field claims adjusters to work up to 10 hours a day without overtime pay and improperly dinged them for "personal use" of company-issued vehicles, according to a proposed class action filed in Massachusetts state court.
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November 17, 2025
8th Circ. Affirms Ala. Apt. Owner's $27M Fire Coverage Win
A split Eighth Circuit affirmed Monday an apartment complex owner's $27 million jury award against a Travelers unit in a fire coverage dispute, saying sufficient evidence existed to support the verdict that the presence of microscopic soot constituted "direct physical loss or damage" to property as required by the policy.
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November 17, 2025
2 Execs Found Guilty In $233M ACA Fraud Scheme
A Florida federal jury returned a guilty verdict on Monday against a marketing company CEO and insurance brokerage executive who were accused of submitting fraudulent enrollments to fully subsidized Affordable Care Act insurance plans to get millions in commission payments from insurers.
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November 17, 2025
Colo. HOA, Insurer Settle Remaining Hail Damage Claims
A homeowners association and its insurer reached a settlement in Colorado federal court Friday in the homeowners association's breach of contract lawsuit where it claimed the insurer incorrectly issued roughly $1,600 for hail damage despite the association's $3.5 million damage estimate.
Expert Analysis
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Notable Developments At The NAIC Summer Meeting
Attorneys at Debevoise discuss their top takeaways from the National Association of Insurance Commissioners summer meeting last month, including developments on risk-based capital requirements and the evolving use of artificial intelligence in insurance practices.
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A Reminder Of The Limits Of The SEC's Crypto Thaw
As the U.S. Securities and Exchange Commission's regulatory thaw has opened up new possibilities for tokenization projects, the Ninth Circuit's recent decision in SEC v. Barry that certain fractional interests are investment contracts, and thus securities, illustrates that guardrails remain via the Howey test, say attorneys at Skadden.
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Series
Adapting To Private Practice: From Va. AUSA To Mid-Law
Returning to the firm where I began my career after seven years as an assistant U.S. attorney in Virginia has been complex, nuanced and rewarding, and I’ve learned that the pursuit of justice remains the constant, even as the mindset and client change, says Kristin Johnson at Woods Rogers.
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7 Document Review Concepts New Attorneys Need To Know
For new associates joining firms this fall, stepping into the world of e-discovery can feel like learning a new language, but understanding a handful of fundamentals — from coding layouts to metadata — can help attorneys become fluent in document review, says Ann Motl at Bowman and Brooke.
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Avoiding Unforced Evidentiary Errors At Trial
To avoid self-inflicted missteps at trial, lawyers must plan their evidentiary strategy as early as their claims and defenses, with an eye toward some of the more common pitfalls, says Nate Sabri at Perkins Coie.
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Agentic AI Puts A New Twist On Attorney Ethics Obligations
As lawyers increasingly use autonomous artificial intelligence agents, disciplinary authorities must decide whether attorney responsibility for an AI-caused legal ethics violation is personal or supervisory, and firms must enact strong policies regarding agentic AI use and supervision, says Grace Wynn at HWG.
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Resilience Planning Is New Key To Corporate Sustainability
While the current wave of deregulation may reduce government enforcement related to climate issues, businesses still need to evaluate how climate volatility may affect their operations and create new legal risks — making the apolitical concept of resilience increasingly important for companies, says J. Michael Showalter at ArentFox Schiff.
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When AI Denies, Insurance Bad Faith Claims May Follow
Two recent rulings from Minnesota and Kentucky federal courts signal that past statements about claims-handling practices may leave insurers using artificial intelligence programs in claims administration vulnerable to suits alleging bad faith and unfair trade practices, say attorneys at Cozen O'Connor.
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Health Insurance Kickback Cases Signal Greater Gov't Focus
A series of recent indictments by federal prosecutors in California suggests that the Eliminating Kickbacks in Recovery Act is gaining momentum as an enforcement tool against illegal inducement of patient referrals in the realm of commercial health insurance, say attorneys at BakerHostetler.
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Series
Being A Professional Wrestler Makes Me A Better Lawyer
Pursuing my childhood dream of being a professional wrestler has taught me important legal career lessons about communication, adaptability, oral advocacy and professionalism, says Christopher Freiberg at Midwest Disability.
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Series
Law School's Missed Lessons: Adapting To The Age Of AI
Though law school may not have specifically taught us how to use generative artificial intelligence to help with our daily legal tasks, it did provide us the mental building blocks necessary for adapting to this new technology — and the judgment to discern what shouldn’t be automated, says Pamela Dorian at Cozen O'Connor.
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Ch. 11 Ruling Voiding $2M Litigation Funding Sends A Warning
A recent Texas bankruptcy court decision that a postconfirmation litigation trust has no obligations to repay a completely drawn down $2 million litigation funding agreement serves as a warning for estate administrators and funders to properly disclose the intended financing, say attorneys at Kleinberg Kaplan.
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Insuring Against FCA Risk In Shifting Trade Landscape
In today's heightened trade enforcement environment, companies should proactively assess whether their insurance programs are positioned to respond to potential False Claims Act or customs-related claims, including reviewing directors and officers, professional liability, and representations and warranties policies for key terms, say attorneys at Pillsbury.
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Demystifying The Civil Procedure Rules Amendment Process
Every year, an advisory committee receives dozens of proposals to amend the Federal Rules of Civil Procedure, most of which are never adopted — but a few pointers can help maximize the likelihood that an amendment will be adopted, says Josh Gardner at DLA Piper.
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Key Insurance Coverage Considerations For AI Data Centers
The burgeoning artificial intelligence industry has sparked a surge in data center projects — a trend likely to be accelerated by the White House's AI Action Plan — but with these complex facilities come equally complex risks, engendering important insurance coverage considerations, say attorneys at Morgan Lewis.