More Insurance Coverage
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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
Aflac Legal Chief's Total Pay Rose To $4M In 2023
Aflac Inc. compensated its longtime top legal leader more than $4 million in 2023, marking the second year her pay increased since earning $3.6 million in 2021, according to the company's most recent securities filing.
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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
AI Presents Risk To Insurers And Policyholders, Panelists Say
The growing use of artificial intelligence presents a risk to both insurers and insureds, experts said during a webinar Thursday, advising policyholders and their attorneys on how to navigate novel issues arising from the use of AI in the insurance industry.
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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
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
2nd Circ. To Weigh 'Claim' Meaning In Family Share Dispute
The Second Circuit on Wednesday will hear arguments over whether a New York federal court erred in finding that a contract exclusion barred any duty a Liberty Mutual unit had to defend a propane company and two of its executives in a family shareholder dispute.
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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
Compensation For Cigna GC Dropped Slightly To $5.2M In '23
The top attorney for Connecticut-based health insurer Cigna Group saw her compensation package drop slightly in 2023 to $5.21 million from $5.23 million in 2022, according to a recent securities filing.
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March 21, 2024
Sanitizer Co. Faces Tough Ad Injury Coverage Bid In 2nd Circ.
A company accused of falsely advertising that its sanitizing products were effective in disinfecting surfaces faces an uphill battle, experts say, as the Second Circuit is poised to hear oral arguments Monday over whether the company is owed coverage under its commercial general liability policy for an underlying class action.
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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
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
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 19, 2024
Minn. BCBS Wants Toss Of DOL's $66.8M Tax Liability Suit
An insurance company is urging a Minnesota federal judge to toss a U.S. Department of Labor suit alleging the company improperly collected at least $66.8 million in state tax liability from plans it administered to pay in-network providers, arguing plans allowed the practice and participants weren't injured.
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March 19, 2024
Trade Court Says US Demand For Garlic Bond Came Too Late
The U.S. Court of International Trade backed an insurance company's contention that the U.S. government waited eight years too long to demand payments for Chinese garlic imports the company covered, saying the government was contractually obligated to make a demand sooner.
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March 18, 2024
Tribal Health Groups Say IHS Owes $4M In Support Funding
Two tribal health groups serving parts of Alaska are suing the U.S. Department of Health and Human Services for failing to pay nearly $4 million in contract support costs for their delivery of services paid for with third-party revenue they collected, the subject of a matter now pending before the U.S. Supreme Court.
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March 18, 2024
Trump Says He Can't Secure Bond For $465M Fraud Judgment
Former President Donald Trump told a New York appellate court Monday that posting bond while he appeals a $465 million judgment against him and his business empire for allegedly defrauding banks and insurers is a "practical impossibility."
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March 18, 2024
Insurer Settles Target Manager's Suit Over Disability Benefits
An insurance company reached a deal with a Target Corp. manager to end his lawsuit alleging the company unlawfully stopped the disability payments he was receiving to treat his post-traumatic stress disorder stemming from a George Floyd protest, a filing in Wisconsin federal court said.
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March 18, 2024
5th Circ. Revives Widows' Collections Suit Against Law Firm
The Fifth Circuit has revived a proposed class action against Louisiana law firm Shows Cali & Walsh LLP regarding its efforts to recoup grant funds awarded in connection with Hurricane Katrina, saying a reasonable jury could find the law firm violated the Fair Debt Collections Practices Act.
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March 18, 2024
Decline In EBSA Funding May Hurt Mental Health Parity Efforts
The U.S. Department of Labor's employee benefits arm warned Congress in its latest budget request that it may have to scale back its efforts to implement federal mental health parity laws and the No Surprises Act by 2025.
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March 18, 2024
4th Circ. Preview: Airport Mishap, Inmate Pay Launch March
The Fourth Circuit's spring session will task the court with refereeing a power struggle between Virginia regulators and the authority that runs Washington, D.C.'s airports — stemming from a workplace amputation — and delving into the "honest belief" doctrine's role in a Family Medical Leave Act case.
Expert Analysis
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Ch. 11 Ruling Stresses 5th Circ. Courts' Asset Sale Deference
A Texas federal court recently rejected a challenge to Fieldwood Energy’s Chapter 11 plan by several surety bond companies, serving as a reminder that courts within the Fifth Circuit give deference to the finality of asset sales where a stay of the applicable order has not been obtained, say Jonathan Lozano and Mark Dendinger at Bracewell.
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The Important Role Of Contra Proferentem In ERISA Cases
A Pennsylvania federal court's recent decision in Stein v. Paul Revere Life Insurance illustrates what happens when ERISA plan terms are unclear, and why the contra proferentem principle should be applied uniformly in all ERISA cases, says Mark DeBofsky at DeBofsky Law.
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No Surprises Act Gives Plan Sponsors Savings Opportunities
Under the No Surprises Act, the potential savings for an ERISA group health plan and its participants are significant, and sponsors should focus on the negotiation of third-party administrator service agreements to avoid exposure to breach of fiduciary claims for payment of excessive fees, say attorneys at Hall Benefits.
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HHS Advisory Opinion Serves As Free Drug Program Guide
A careful review of the U.S. Department of Health and Human Services' recent advisory opinion and track record on free drug programs provides a rubric for manufacturers to ensure that similar programs are viewed favorably under the Anti-Kickback Statute, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.
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ACA Anti-Discrimination Rules May Apply To 3rd-Party Admin
A Washington federal court's recent ruling in C.P. v. Blue Cross Blue Shield, where a third-party administrator applied plan rules that excluded gender-affirming care, potentially expands the scope of covered entities under the Affordable Care Act's anti-discrimination rule, say Kara Backus and Allison Jacobsen at Lane Powell.
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Courts Should Follow 8th Circ. On ERISA Procedure Rules
Other courts should take note of the Eighth Circuit's refusal to view Yates v. Symetra Life Insurance as an administrative law claim and join the growing effort to restore regular civil procedure to Employee Retirement Income Security Act cases, says Mark DeBofsky at DeBofsky Law.
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High Court Ax Of Atty-Client Privilege Case Deepens Split
The U.S. Supreme Court's recent dismissal of In re: Grand Jury as improvidently granted maintains a three-way circuit split on the application of attorney-client privilege to multipurpose communications, although the justices have at least shown a desire to address it, say Trey Bourn and Thomas DiStanislao at Butler Snow.
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Biden Admin.'s Anti-Merger Stance Is Leading To Bad Policies
A U.S. Department of Justice Antitrust Division speech reflects the Biden administration's goal to move enforcement in a markedly anti-merger direction, an approach that is leading to bad policies and enforcement decisions, says Cleary attorney David Gelfand, a former DOJ Antitrust Division official.
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9th Circ. Should Rethink Inadequate UBH Ruling
The Ninth Circuit should seriously consider rehearing Wit v. United Behavioral Health en banc because its recent claims reprocessing decision in the case raises troubling questions about the future of Employee Retirement Income Security Act's class actions, says Mark DeBofsky at DeBofsky Law.
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Hertz Ruling Could Help Debtors Avoid Make-Whole Premiums
A Delaware bankruptcy court’s recent ruling in Hertz, disallowing claims for make-whole premiums and post-petition interest at the contract rate, could be relied upon by debtors to sidestep those provisions, and potentially provide higher recoveries for equity holders, say Theresa Foudy and Alexander Severance at MoFo.
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Atty-Client Privilege Arguments Give Justices A Moving Target
Recent oral arguments before the U.S. Supreme Court in a case regarding the scope of the attorney-client privilege appeared to raise more questions about multipurpose counsel communications than they answered, as the parties presented shifting iterations of a predictable, easily applied test for evaluating the communications' purpose, say Trey Bourn and Thomas DiStanislao at Butler Snow.
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Predictions For The 2023 Drug Pricing Landscape
2022 was the year of legislative action around drug pricing, while 2023 is likely to serve up precedential judicial action — including active legal challenges with respect to the government's programs covering outpatient prescription drugs, accumulators and third-party funders, says Margaux Hall at Ropes & Gray.
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NY Adult Survivors Act Look-Back: What Orgs Must Know
With the look-back window for New York's Adult Survivors Act now open, survivors of past sexual abuse have a new opportunity to file civil claims — so organizations that could face litigation should take specific steps to ensure best practices both before and after lawsuits arise, say Michael Appelbaum and Christina Holdsworth at Goldberg Segalla.