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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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New Mass. 'Junk Fee' Regs Will Be Felt Across Industries
The reach of a newly effective regulation prohibiting so-called junk fees and deceptive pricing in Massachusetts will be widespread across industries, which should prompt businesses to take note of new advertising, pricing information and negative option requirements, say attorneys at Hinshaw.
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SDNY OpenAI Order Clarifies Preservation Standards For AI
The Southern District of New York’s recent order in the OpenAI copyright infringement litigation, denying discovery of The New York Times' artificial intelligence technology use, clarifies that traditional preservation benchmarks apply to AI content, relieving organizations from using a “keep everything” approach, says Philip Favro at Favro Law.
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11th Circ. Geico Ruling Underscores Bad Faith Test
A recent ruling by the Eleventh Circuit highlighted that negligence is not the standard for a finding of bad faith and that the insurer can overcome a bad faith suit by being diligent in its investigation and settlement efforts, emphasizing the totality of the circumstances test, says Juan Garrido at Cozen O'Connor.
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Opinion
High Court, Not A Single Justice, Should Decide On Recusal
As public trust in the U.S. Supreme Court continues to decline, the court should adopt a collegial framework in which all justices decide questions of recusal together — a reform that respects both judicial independence and due process for litigants, say Michael Broyde at Emory University and Hayden Hall at the U.S. Bankruptcy Court for the District of Delaware.
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Series
Traveling Solo Makes Me A Better Lawyer
Traveling by myself has taught me to assess risk, understand tone and stay calm in high-pressure situations, which are not only useful life skills, but the foundation of how I support my clients, says Lacey Gutierrez at Group Five Legal.
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Opinion
DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable
In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.
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Series
Law School's Missed Lessons: Client Service
Law school teaches you how to interpret the law, but it doesn't teach you some of the key ways to keeping clients satisfied, lessons that I've learned in the most unexpected of places: a book on how to be a butler, says Gregory Ramos at Armstrong Teasdale.
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How Financial Cos. Can Prep As NYDFS Cyber Changes Loom
Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.
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Series
Adapting To Private Practice: 3 Tips On Finding The Right Job
After 23 years as a state and federal prosecutor, when I contemplated moving to a law firm, practicing solo or going in-house, I found there's a critical first step — deep self-reflection on what you truly want to do and where your strengths lie, says Rachael Jones at McKool Smith.
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What 2 Recent Rulings Mean For Trafficking Liability Coverage
Two recent federal district court decisions add to a growing number of courts concluding that Trafficking Victims Protection Reauthorization Act claims may trigger coverage under commercial general liability policies, rejecting insurer arguments regarding public policy and exclusion defenses, says Joe Cole at Shumaker.
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Civil Maritime Nuclear Sector Poised For Growth, Challenges
The maritime industry now stands on the verge of a nuclear-powered renaissance, with the need for clean energy, resilient power generation and decarbonized logistics driving demand for commercial maritime nuclear technology — but these developments will raise significant new legal, regulatory and technical questions, say attorneys at Holland & Knight.
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Series
Painting Makes Me A Better Lawyer
Painting trains me to see both the fine detail and the whole composition at once, enabling me to identify friction points while keeping sight of a client's bigger vision, but the most significant lesson I've brought to my legal work has been the value of originality, says Jana Gouchev at Gouchev Law.
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Understanding And Managing Jurors' Hindsight Bias
Hindsight bias — wherein events seem more predictable after the fact than they were beforehand — presents a persistent cognitive distortion in jury decision-making, but attorneys can mitigate its effects at trial through awareness, repetition and framing, say consultants at Courtroom Sciences.
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Hybrid Claims In Antitrust Disputes Spark Coverage Battles
Antitrust litigation increasingly includes claims for breach of warranty, product liability or state consumer protection violations, complicating insurers' reliance on exclusions as courts analyze whether these are antitrust claims in disguise, says Jameson Pasek at Caldwell Law.
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Better Crypto Insurance Is Attainable Amid Regulatory Shifts
With regulatory clarity improving and insurance carriers taking an increasingly constructive approach, crypto industry participants can improve their insurance coverage and pricing if finance, legal and compliance teams take specific steps, say Walker Newell and Jacob Sawyer at Woodruff-Sawyer.