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Insurance
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April 08, 2026
Fla. Insurer, Ex-Parent To Pay $135M Over ACA Fraud Scheme
A Florida insurer and its former parent, which is a Delaware-based national partnership of insurance brokers, have agreed to pay $135 million collectively to resolve allegations of a scheme to enroll ineligible consumers into subsidized Affordable Care Act plans and of defrauding the federal government of more than $140 million.
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April 08, 2026
No Surprises Act Bars Provider's Award Enforcement Bid
A Pennsylvania federal court declined to force an insurer to pay over $300,000 in alleged outstanding payments from an out-of-network billing dispute with a provider, finding it lacked authority to do so under the No Surprises Act.
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April 08, 2026
Prudential Can't Enforce 'Illusory' Policy, Beneficiaries Say
The beneficiaries of two pilots who died in a plane crash said a Prudential insurer can't escape their suit seeking accidental death and dismemberment benefits under an aviation company's life insurance plan, telling a Washington federal court that the policy departs from the industry standard because it is "illusory."
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April 08, 2026
ERISA Recap: 6 Noteworthy Decisions From March
JPMorgan Chase & Co. narrowed but couldn't escape a suit from workers who said their health plan paid too much for prescription drugs, Genworth Financial Inc. unwound a class at the Fourth Circuit, and the Sixth Circuit breathed new life into proposed class actions against FedEx and Kellogg. Here, Law360 looks at these and three other notable decisions from March in ERISA cases.
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April 08, 2026
$37M Award For Whistleblowers Nixed In Medicaid Fraud Row
A Texas state appeals court did away with an order awarding three whistleblowers a $37 million share of the state's settlement resolving Medicaid fraud allegations against Xerox, finding their respective cases over the alleged scheme were based on publicly available information.
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April 08, 2026
FedEx Says NY Attys And Medical Providers Staged Crashes
FedEx accused a network of lawyers, medical providers and clinics of orchestrating an insurance scam in which they staged motor vehicle accidents in order to defraud the delivery giant through sham lawsuits and inflated medical bills, according to a suit filed in New York federal court.
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April 08, 2026
Insurer Says NC Law Firm's $130K Forgery Loss Isn't Covered
Law firm Narron and Holdford PA isn't owed close to $130,000 in coverage for a forged cashier's check and wire transfer because the incident doesn't trigger coverage under the insurance policy it has with a pair of insurance companies, the insurers have told a North Carolina federal court.
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April 08, 2026
HIV, AIDS Patients End Disability Bias Suit With CVS
CVS Pharmacy Inc. and a group of HIV and AIDS patients have agreed to wrap up a suit claiming the company made it harder for them to get their medication in violation of disability discrimination law, according to a California federal court filing.
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April 07, 2026
Calif. Dialysis Bill Violates 1st Amendment, 9th Circ. Says
The Ninth Circuit on Tuesday struck down provisions of a California law that aims to restrict dialysis providers' ability to profit from patients receiving health insurance premium assistance from nonprofit charities, ruling in a published opinion that the provisions violated nonprofit American Kidney Fund's and dialysis providers' First Amendment rights.
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April 07, 2026
Federal Court To Decide If Faulty Pumps Caused Detroit Flood
A Michigan federal judge on Tuesday heard arguments on whether to dismiss American Select Insurance Co.'s suit alleging faulty Great Lakes Water Authority pumps were responsible for extreme flooding in Detroit and surrounding cities during heavy rainfall in June 2021.
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April 07, 2026
Pa. Hospitals Accuse Aetna Of Underpaying Medicare Claims
Two Pennsylvania hospital operators have sued Aetna Health Inc. in federal court, alleging the insurer has been improperly denying Medicare Advantage claims for inpatient services, or underpaying, under a new policy.
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April 07, 2026
Insurer Premera Accuses Clinic Of Misusing No Surprises Act
Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.
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April 07, 2026
Wash. Panel Nixes Insurer's Gordon Rees Malpractice Claims
A Washington Court of Appeals panel said a Great American insurance unit can't inherit an equipment manufacturer's legal malpractice claims against Gordon Rees Scully Mansukhani LLP and Sinars Slowikowski LLC because of "potential conflict" between the insurer and manufacturer in the underlying dispute over a climber's fall.
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April 07, 2026
Timeshare Exit Co.'s Insurer Can't Appeal To 9th Circ. Yet
A Washington federal judge rejected an insurer's request to reconsider a summary judgment ruling that the carrier breached its duty to defend a now-defunct timeshare exit company, stating that the carrier failed to prove an indisputable error in the ruling.
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April 07, 2026
8th Circ. Backs Insurer Win In ND Pollution Exclusion Row
An Eighth Circuit panel on Tuesday backed an insurer's win in a coverage dispute over a man's alleged injuries from carbon monoxide exposure, finding it did not need a North Dakota high court's input to determine that a policy's pollution exclusion barred coverage.
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April 07, 2026
Auto Insurance Co. Escapes Retirement Fund Suit
An auto insurance company defeated a proposed class action claiming its employee retirement plan was unlawfully overinvested in a conservative default investment option, with a Michigan federal judge saying Tuesday that the suit lacked information about participants who voluntarily put money in the fund.
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April 07, 2026
Hormel Foods Faces Class Cert. Bid In Retirement Fund Suit
An ex-worker for Hormel Foods Corp. asked a Minnesota federal judge to certify a class in his federal benefits lawsuit alleging the company failed to remove high-cost investment options with poor return rates from its $1.2 billion in employee retirement plans.
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April 07, 2026
Tobacco Co. Says Insurers Can't Void $75M Tornado Coverage
Insurers have no basis to rescind a $75 million policy issued to a tobacco company alleging it was wrongly denied coverage for $89 million worth of aging tobacco inventory that was destroyed in a tornado, the company told a Tennessee federal court.
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April 06, 2026
Florida Insurance Co. To Plead Guilty In $102.7M ACA Fraud
A Florida insurance company will plead guilty to defrauding the federal government out of more than $100 million in federal subsidies by targeting unhoused and other vulnerable people for enrollment in Affordable Care Act plans they did not qualify for, according to a notice filed Monday in Florida federal court.
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April 06, 2026
State Farm Auto Insureds Seek To Triple $38M Win At Trial
Two certified classes of State Farm auto insurance policyholders kicked off a bench trial Monday on the question of damages owed after a Washington federal judge found the insurer had shortchanged policyholders on payouts for totaled vehicles, arguing the $38.3 million previously awarded for State Farm's consumer protection violation should be tripled.
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April 06, 2026
9th Circ. Panel Finds Insurer Owed Defense To Wash. Provider
An Allied World unit unreasonably declined to defend a Washington behavioral health network in a lawsuit alleging sexual misconduct by an employee, a Ninth Circuit panel held Monday, partially reversing a summary judgment win for the insurer.
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April 06, 2026
Anthem Owes $2.1M For No Surprises Act Awards, Court Told
Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.
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April 06, 2026
Clyde & Co. Adds Kennedys Insurance Expert To LA Office
Clyde & Co. LLP has announced the continued upscaling of its U.S. operations with the addition of insurance litigation expert Shain Wasser from Kennedys as partner in its Los Angeles office, helping the firm strengthen its North American insurance and complex litigation capabilities.
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April 06, 2026
Reinsurers Say Arbitrator DQ Bid Should Stay In Federal Court
Reinsurers are urging a New York federal court not to heed a Farmers unit's request to remand its suit seeking disqualification of an arbitrator from an asbestos coverage fight, arguing the insurer wrongly framed the dispute as an attorney ethics matter.
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April 06, 2026
Atty Convicted Of Staging Truck Crashes Seeks New Trial
A disbarred New Orleans attorney has asked a federal judge in Louisiana for a new insurance fraud trial, arguing a suite of issues from her federal trial last month caused her to receive what she described in a filing as a "miscarriage of justice."
Expert Analysis
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Human Diligence Crucial As AI Raises Real Estate Fraud Risks
A recent title fraud warning from Florida officials demonstrates that artificial intelligence has lowered the barrier to committing complex property scams, forcing real estate industry stakeholders and attorneys to prioritize contextual review in transactions, says Neil Cohen at Barsh and Cohen.
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How Cos. Should Prepare For NY RAISE Act Compliance
With the New York Responsible AI Safety and Education Act taking effect March 19, state regulators will expect subject artificial intelligence governance policies to understand whether appropriate safeguards and protocols are in place to prevent or mitigate discriminatory or adverse outcomes by frontier models, says Michael Paulino at Gordon Rees.
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The Benefits Of Choosing A Niche Practice In The AI Age
As artificial intelligence becomes increasingly accessible, lawyers with a niche practice may stand out as clients seek specialized judgment that automation cannot replicate, but it is important to choose a niche that is durable, engaging and a good personal fit, says Daniel Borneman at Lowenstein Sandler.
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Trial Advocacy Lessons From 3 Oscar-Nominated Films
Several films up for best picture at this weekend’s Academy Awards provide useful tips for trial lawyers, from the power of a dramatic opening to the importance of pivoting when the unexpected happens, say attorneys at Robins Kaplan.
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Series
Podcasting Makes Me A Better Lawyer
Podcasting has changed how I ask questions and connect with people, sharpening my ability to listen without interrupting or prejudging, and bringing me closer to what law is meant to be: a human profession grounded in understanding, judgment and trust, says Donna DiMaggio Berger at Becker.
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Can Trump's AI Order Override State Insurance Rules?
Although a December executive order charts a course to potentially dismantle state artificial intelligence regulations applicable to virtually any industry, the effect on the insurance industry deserves special attention because under federal law, the regulation of the business of insurance is largely delegated to the states, say attorneys at Eversheds Sutherland.
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Calif. Case Could Lead To A Redefined Pollution Exclusion
In recently agreeing to hear Montrose Chemical v. Superior Court, the California Supreme Court will decide whether a court should consider extrinsic evidence offered by a party to prove its interpretation of the insurance policy language, opening the door to a different definition of "sudden" in insurance policies' pollution exclusions, say attorneys at Pillsbury.
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Series
Volunteering With Scouts Makes Me A Better Lawyer
Serving as an assistant scoutmaster for my son’s troop reaffirmed several skills and principles crucial to lawyering — from the importance of disconnecting to the value of morality, says Michael Warren at McManis Faulkner.
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Series
Law School's Missed Lessons: In Court, It's About Storytelling
Law school provides doctrine, cases and hypotheticals, but when lawyers step into the courtroom, they must learn the importance of clarity, credibility, memorability and preparation — in other words, how to tell simple, effective stories, say Nicholas Steverson and Danielle Trujillo at Wheeler Trigg, and Lisa DeCaro at Courtroom Performance.
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Aligning Microsoft Tools With NYC Bar AI Recording Guidance
The New York City Bar Association’s recently issued formal opinion, providing ethical guidance on artificial intelligence-assisted recording, transcription and summarization, raises immediate questions about data governance and e-discovery for companies that use Microsoft 365 and Copilot, say Staci Kaliner, Martin Tully and John Collins at Redgrave.
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Class Actions At The Circuit Courts: March Lessons
In this month's review of class action appeals, Mitchell Engel at Shook Hardy discusses four recent rulings from January and identifies practice tips from cases involving allegations of violations of consumer fraud regulations, the Fair Credit Reporting Act, employment law and breach of contract statutes.
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5 Different AI Systems Raise Distinct Privilege Issues
A New York federal court’s recent U.S. v. Heppner decision, holding that a defendant’s use of Claude was not privileged, only addressed one narrow artificial intelligence system, but lawyers must recognize that the spectrum of AI tools raises different confidentiality and privilege questions, says Heidi Nadel at HP.
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Opinion
AI-Assisted Arbitration Needs Safeguards To Ensure Fairness
As tribunals and arbitral institutions increasingly use artificial intelligence tools in their decision-making processes, clear disclosure standards and procedural safeguards are necessary to ensure that efficiency gains do not erode the fairness principles on which arbitration depends, says Alexander Lima at Wesco International.
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Series
Playing Piano Makes Me A Better Lawyer
Playing piano and practicing law share many parallels relating to managing complexity: Just as hearing an entire musical passage in my head allows me to reliably deliver the message, thinking about the audience's impression helps me create a legal narrative that keeps the reader engaged, says Michael Shepherd at Fish & Richardson.
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How To Counter 7 Logical Fallacies In Legal Arguments
Many legal arguments are riddled with reasoning flaws that can effectively distract or persuade the fact-finder, but these tactics lose much of their power when attorneys recognize and strategically shine a light on them, says Allison Rocker at Baker McKenzie.