More Insurance Coverage
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February 15, 2024
Wash. High Court Affirms Liberty Mutual's Bill Review System
The Washington State Supreme Court on Thursday said Liberty Mutual can use an industry database to cap payments to medical providers, rejecting a neurologist's argument that using computer-generated data to calculate medical bills violated consumer protection law because it didn't guarantee reasonable payment.
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February 15, 2024
1st Circ. Partially Revives Tufts U. Worker's Benefits Fight
The First Circuit has said a Massachusetts federal judge was right to release Tufts University from a suit by an employee alleging her insurance premiums were illegally increased but reinstated her claims against underwriter Prudential due to ambiguous contract language.
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February 15, 2024
Vaughan Baio Adds 3 Partners And 2 Offices In NY, NJ
Philadelphia-based midsized firm Vaughan Baio & Partners expanded its footprint and resources this month with the addition of three partners and the opening of two offices in New York and New Jersey.
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February 15, 2024
9th Circ. Backs Homeowners' Cert. In Allstate Overcharge Suit
Allstate will have to face a class action accusing it of artificially inflating home insurance premiums for thousands of California properties by double-counting built-in garage space, a Ninth Circuit panel ruled, affirming a lower court's decision.
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February 15, 2024
Insurance Group Of The Year: Simpson Thacher
Insurance attorneys at Simpson Thacher & Bartlett LLP helped Travelers score a win against CVS in a coverage fight over claims stemming from the opioid epidemic, securing the firm a spot on Law360's 2023 Insurance Groups of the Year.
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February 14, 2024
Prudential Inks $35M Deal Over Investor's Stock-Drop Suit
A Prudential Financial Inc. investor asked a New Jersey federal judge on Wednesday to sign off on a $35 million deal to settle allegations the insurer hid mortality trends and understated its life insurance reserves, causing its stock to trade at inflated prices.
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February 14, 2024
Insurer Needn't Defend Landlord From Antitrust MDL
A Washington state judge has ruled in favor of an insurer in a coverage dispute revolving around nearly 40 antitrust class action claims against landlords that have been combined into a multidistrict litigation case, finding that the insurer owes no defense coverage to an accused property manager.
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February 14, 2024
Insurance Group Of The Year: Covington
Covington & Burling LLP cemented an appellate court victory for Merck in a $1.2 billion dispute over the applicability of a war exclusion in the health giant's property policies this past year, topping a remarkable list of wins that earned the firm a spot as one of Law360's 2023 Insurance Groups of the Year.
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February 13, 2024
Insurance Co. Stock Fight Belongs In Del., NC Judge Rules
A former partner in an insurance brokerage who alleges the company gave him a lowball offer to buy back his shares after he was fired should have brought his complaint in Delaware, a North Carolina Business Court judge has ruled in granting the brokerage's motion to dismiss.
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February 13, 2024
LSD Trip Didn't Cause Quadriplegia, Houston Jury Told
An attorney for a former high school gymnast who became a quadriplegic after allegedly taking LSD compared the circumstances of the man's injuries to the hypothetical of a juror getting hit by a car on the way to the courthouse as he fought off a bid from an insurance company seeking to avoid paying a $1 million settlement connected to the man's injury.
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February 13, 2024
Cigna Patients Can't Get Class Cert. In Underpayment Suit
A California federal judge refused to grant class status to Cigna insurance plan participants who accused it of violating federal anti-corruption and benefits laws by colluding with its billing contractor to underpay their out-of-network claims for substance use disorder treatments.
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February 13, 2024
Lexitas Acquires Record Retrieval Co. MLR
Litigation services company Lexitas announced on Tuesday its first acquisition of the year, purchasing Philadelphia-based record retrieval company Medical Legal Reproductions.
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February 13, 2024
Catching Up With Delaware's Chancery Court
A pizza chain, an energy company, a medical-device maker and a Manila casino were all hit with book-and-record demands last week in Delaware's Court of Chancery. A shoe company also walked away from a shareholder suit, two cryptocurrency companies tallied the costs of a broken merger, and three cigarette giants argued over Florida settlement payments.
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February 13, 2024
Life Insurer Failed To Secure Data From Hack, Class Says
A life insurance provider and its parent company failed to protect sensitive customer information from a data breach, a proposed class action told an Indiana federal court, saying the parent company was hacked via a SIM swapping scheme targeting a senior employee.
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February 13, 2024
Ex-Wilson Elser Atty Can't Get Benefits For Chronic Fatigue
A former Wilson Elser Moskowitz Edelman & Dicker LLP partner is not entitled to long-term disability benefits, as he did not prove that his chronic fatigue syndrome kept him from doing his job, a Nevada federal judge has ruled.
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February 13, 2024
Michelman & Robinson Adds Locke Lord Regulatory Ace In SF
Michelman & Robinson LLP has boosted its regulatory and administrative law practice with a partner in the Golden State who had been with Locke Lord LLP for more than a decade prior to her departure, the firm said Tuesday.
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February 13, 2024
Insurance Group Of The Year: Cohen Ziffer
Cohen Ziffer Frenchman & McKenna's attorneys won a rare, pro-policyholder reversal in COVID-19 insurance litigation and secured an even rarer reversal of a jury verdict in a dispute over coverage for a settlement of Medicaid fraud claims, landing the firm a spot among Law360's 2023 Insurance Groups of the Year.
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February 13, 2024
DOL's Benefits Arm Reports $1.4B In Recoveries In 2023
The U.S. Department of Labor's Employee Benefits Security Administration announced Tuesday that it recovered more than $1.4 billion in payments to plans, beneficiaries and participants in fiscal year 2023, an amount that is essentially level with the agency's total recoveries from the previous year.
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February 12, 2024
Ex-CEO Of Health Co. Found Guilty Of Fraud After $195M Loss
An Illinois federal jury on Monday found the former chief executive officer of a healthcare company guilty on all 13 criminal charges brought by the federal government alleging his company tricked consumers into purchasing health insurance that didn't cover what the company promised.
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February 12, 2024
NJ Lands $6.4M Deal Over 'Bogus' Medicare Billing Claims
New Jersey Attorney General Matthew Platkin announced Monday that his office and the Garden State's insurance fraud prosecutor have obtained a $6.4 million consent judgment against the late owner of a mental health clinic chain accused of defrauding Medicaid with "an elaborate bogus-billing scheme."
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February 12, 2024
NC High Court Snapshot: Philip Morris Fights Tax Credit Limit
North Carolina's top court will return in February from an extended hiatus to weigh whether a home healthcare company was correctly ejected from the state's Medicaid program, and if regulators were right to limit state export tax credits for tobacco giant Philip Morris.
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February 12, 2024
Barry McTiernan Signs Battery Park Plaza Lease
Commercial real estate company Rudin said Monday that Barry McTiernan & Moore LLC will move its headquarters to the tower at One Battery Park Plaza in a deal that involved broker Cushman & Wakefield.
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February 12, 2024
Insurance Group Of The Year: Carlton Fields
After a year of achieving precedential wins defending the travel insurance industry in COVID-19-related class actions and other complex litigation, Carlton Fields has secured its first Law360 Practice Group of the Year award.
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February 09, 2024
Pot Patients Say NM Insurance Case Triggers CAFA Exception
A medical cannabis company doing business in New Mexico and several patients say a proposed class action over insurance coverage for medical cannabis belongs in state court partly because the case triggers a Class Action Fairness Act exception depriving federal jurisdiction that would otherwise be offered.
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February 09, 2024
What To Know About 'Novel' Johnson & Johnson ERISA Suit
A new lawsuit from a Johnson & Johnson worker claims the company violated federal law by letting pharmacy benefit manager Express Scripts overcharge health plan participants for drugs, potentially signaling that fee litigation under the Employee Retirement Income Security Act is shifting focus from retirement savings to health benefits, attorneys say.
Expert Analysis
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Why Courts Are Rejecting Agencies' Merger Challenges
Recent losses for the U.S. Department of Justice and the Federal Trade Commission show how difficult it is for the agencies to challenge transactions based on certain theories — and that merging parties can close difficult transactions if they are willing to fight regulators in court, say attorneys at McDermott.
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2nd Circ. Securities Ruling May Encourage Fraud
The Second Circuit's recent decision in Menora v. Frutarom, intended to clarify when defrauded purchasers have standing under securities laws, is inconsistent with well-settled law and creates wide-reaching uncertainty that will likely incentivize fraud, say attorneys at Labaton Sucharow.
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Lessons From 3 Antitrust Agency Losses In Merger Trials
The government lost three antitrust agency merger trials last month, underscoring the need for companies considering strategic deals to first weigh a number of factors, including the viability of litigating before an impartial judge, say Gorav Jindal and Brian Rafkin at Akin Gump.
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Boy Scouts Ch. 11 Case Highlights Third-Party Release Split
The Delaware bankruptcy court's recent approval of major parts of the Boy Scouts’ Chapter 11 plan showcases a split among federal district courts as to whether bankruptcy courts have the constitutional authority to approve third-party releases on a final basis, bringing unpredictability and ambiguity to settlements and dealmaking, say attorneys at V&E.
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4th Circ. Ruling Won't Safeguard Life Insurance Under ERISA
The Fourth Circuit's recent decision in Bellon v. PPG Employee Life, finding that life insurance benefits had vested for certain employees, is a limited exception to a strong trend of courts reading the Employee Retirement Income Security Act to generally countenance the elimination of life insurance coverage for retirees, says Elizabeth Hopkins at Kantor & Kantor.
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9th Circ. Accidental Death Ruling Raises Critical ERISA Issue
The Ninth Circuit’s recent ruling in Wolf v. Life Insurance Co. of North America helps clarify whether accidental death insurance covers reckless conduct, and raises an important Employee Retirement Income Security Act principle about claim denial that will likely affect future cases, says Mark DeBofsky at DeBofsky Law.
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Expect Fundraising Market To Grow More Competitive
Though the fundraising market's momentum was slowed by inflation and geopolitical unrest earlier this year, rapid deployment of capital is now driving a strong resurgence that will push smaller and middle-market firms to square off against more established managers, say attorneys at Debevoise.
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ERISA Ruling Rightly Addresses Civil Procedure Hurdle
The Eleventh Circuit’s recent opinion in Harris v. Lincoln National Life Insurance demonstrates why courts should treat Employee Retirement Income Security Act cases the same as breach of contract suits by permitting the parties to utilize the full panoply of rights afforded by the Federal Rules of Civil Procedure, says Mark DeBofsky at DeBofsky Law.
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Justices' EPA Ruling Didn't Move Needle On Chevron Doctrine
Though some suggest the U.S. Supreme Court’s recent decision in West Virginia v. U.S. Environmental Protection Agency marked the end of a doctrine requiring judicial deference to federal regulators, the ruling merely articulated well-developed precedent on the limits of agency authority, say Dan Wolff and Eryn Howington at Crowell & Moring.
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Dobbs, Workers' Comp. Brief Hint At Biden's Cannabis Stance
The U.S. Supreme Court’s recent Dobbs v. Jackson Women’s Health decision, combined with the solicitor general’s brief in a workers’ compensation case that the high court recently declined to review, reveals three notable possibilities about the Biden administration’s position on cannabis, say Whitt Steineker and Claire Hodge at Bradley Arant.
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Questions To Consider In High Court FCA Dismissals Case
Next term, when the U.S. Supreme Court reviews whether the government has authority to dismiss a False Claims Act suit after initially declining to proceed with the action in Polansky v. Executive Health Resources, it will likely require the government to intervene before seeking dismissal, says Christina Lehm at Nelson Mullins.
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High Court Will Eventually Need To Resolve Cannabis Issues
The U.S. Supreme Court's refusal to resolve whether federal law protects employers who do not comply with state requirements for medical marijuana reimbursements is a blow to the cannabis industry, but ongoing conflicts between state and federal cannabis laws mean the court will likely eventually need to get involved, says David Standa at Greenspoon Marder.
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2nd Circ. Ruling Highlights ERISA Determination Deadlines
As seen in the Second Circuit’s recent McQuillin v. Hartford decision, the deadlines for deciding Employee Retirement Income Security Act claims and appeals have teeth, and there are consequences when a plan administrator fails to comply, says Mark DeBofsky at DeBofsky Sherman.