More Insurance Coverage
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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.
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March 15, 2024
Insurance Mogul Hit With $500K Judgment For Website Co.
The legal woes of embattled North Carolina insurance mogul Greg Lindberg were compounded when a federal judge ordered him and one of his companies to pay nearly half a million dollars, including interest and attorney fees, to an internet marketing company for a payment he missed following his sentencing on federal bribery charges.
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March 15, 2024
9th Circ. Pauses Benefits Case Awaiting UBH Challenge
The Ninth Circuit has told a trial court to halt what United Behavioral Health has called an improper revival of a proposed class action alleging the insurance company illegally denied coverage for mental health and substance abuse treatment.
Expert Analysis
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ALI, Bar Groups Need More Defense Engagement For Balance
The American Law Institute and state bar committees have a special role in the development of the law — but if they do not do a better job of including attorneys from the defense bar, they will come to be viewed as special interest advocacy groups, says Mark Behrens at Shook Hardy.
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FCA Liability Lessons From HHS Psychotherapy Audit
The U.S. Department of Health and Human Services' recent finding of improper Medicare payments for psychotherapy services provided in 2020-2021 might inspire whistleblowers to pursue allegations under the federal False Claims Act, but there are reasons to be skeptical of converting these audit results into expansive FCA liability, say attorneys at Sidley.
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What's Next For 5th Circ.'s ACA Preventive Care Suit
The Fifth Circuit's high-profile Braidwood v. Becerra case has significant ramifications for Affordable Care Act coverage requirements, and there is precedent to suggest that it could be ultimately decided by the U.S. Supreme Court, says Nicholas DiCarlo at Zuckerman Spaeder.
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2nd Circ. Reinsurance Ruling Misconstrues English Law
The Second Circuit's finding in Insurance Company of the State of Pennsylvania v. Equitas Insurance, that London-based reinsurer Equitas owed coverage for losses outside the policy period, stems from that court's misinterpretation of English law on reinsurance policy construction, says Christopher Foster at Holman Fenwick.
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Firm Tips For Helping New Lawyers Succeed Post-Pandemic
Ten steps can help firms significantly enhance the experience of attorneys who started their careers in the coronavirus pandemic era, including facilitating opportunities for cross-firm connection, which can ultimately help build momentum for business development, says Lana Manganiello at Equinox Strategy Partners.
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6th Circ. Judge Correctly ID'd ERISA Civil Procedure Conflict
While the Sixth Circuit in Tranbarger v. Lincoln Life & Annuity recently affirmed a ruling that denied the plaintiff's disability benefits, one judge's concurrence should be commended for arguing that adjudication of such Employee Retirement Income Security Act cases fundamentally contradicts the Federal Rules of Civil Procedure, says Mark DeBofsky at DeBofsky Law.
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Prepping Your Business Ahead Of Affirmative Action Ruling
The U.S. Supreme Court's upcoming ruling on whether race should play a role in college admissions could potentially end affirmative action, and companies will need a considered approach to these circumstances that protects their brand power and future profits, and be prepared to answer tough questions, say Nadine Blackburn at United Minds and Eric Blankenbaker at Weber Shandwick.
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What Banks Can Glean From FSB Climate Risk Report
Although a recent Financial Stability Board report doesn't aim to provide specific guidance to financial institutions on how to incorporate climate-related metrics into their frameworks, it may nonetheless be valuable given the general lack of comparative data on evolving climate-related compensation practices elsewhere, say attorneys at Sullivan & Cromwell.
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Cannabis Supercenters: Key Benefits And Legal Issues
Barstow, California’s novel plan to convert an abandoned mall into a cannabis supercenter could offer a potential blueprint for cannabis companies to thrive in a saturated market and for communities to repurpose underutilized retail spaces — but certain financing, zoning and leasing issues will need to be assessed, says Christopher Gordon at Fox Rothschild.
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Challenging Standing In Antitrust Class Actions: Injury-In-Fact
As demonstrated in recent cases, the classic injury-in-fact requirement for Article III standing claimed in most antitrust suits is economic harm — and while concrete harm satisfies the requirement, litigants may still be able to challenge whether economic injury has occurred, say Michael Hamburger and Holly Tao at White & Case.
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What ACA Preventive Care Ruling Means For Employers
Though a Texas federal court's recent ruling in Braidwood v. Becerra paves the way for employers to reimpose cost-sharing requirements on preventive care, companies considering making these changes to their group health and welfare plans should first analyze the financial and social impacts, says Rachel Shim at Holland & Knight.
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Seeking IRS Accountability For Faulty Microcaptive Notice
Like the taxpayers in Standard Insurances v. U.S. seeking to expand earlier wins in microcaptive insurance cases that limit IRS use of improperly obtained information, others should consider ways to hold the agency accountable and provide incentive for it to follow the law going forward, says Joshua Smeltzer at Gray Reed.
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AmEx Ruling Proves A Double-Edged Sword In Labor Antitrust
Though the U.S. Supreme Court's 2018 decision in Ohio v. American Express was a defense victory, both the plaintiff and defense bars have learned to use the case's holdings to their advantage, with particularly uncertain implications for labor antitrust cases, say Lauren Weinstein and Robert Chen at MoloLamken.