More Insurance Coverage
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March 27, 2024
Farm Data Co. Wants To Bar Carlton Fields Atty From IP Suit
Lawyers for an agricultural industry data software outfit want a Carlton Fields lawyer banned from participating in a patent dispute with a rival startup because of her in-house involvement at the rival and work on an older trade secrets suit involving the same technology.
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March 27, 2024
6th Circ. Backs Allstate In Worker's Religious Bias Appeal
The Sixth Circuit declined Wednesday to reinstate a former Allstate employee's lawsuit alleging he was fired for expressing faith-based anti-LGBTQ views, saying he failed to rebut the company's argument that he was cut loose for his lackluster performance.
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March 27, 2024
2nd Circ. Weighs Broadening 'Claim' In Shareholder Dispute
The Second Circuit questioned Wednesday whether it should use a New York state appeals court ruling to broaden the meaning of "claim" in a propane company's directors and officers policy with a Liberty Mutual unit, including not just an entire underlying lawsuit but the individual causes of action within.
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March 27, 2024
Justices Grapple With Complex $3M Estate Tax Dispute
The U.S. Supreme Court confronted a complicated dispute Wednesday over whether the estate of a deceased building supply company owner should be taxed on $3 million in life insurance proceeds the company used to buy his shares after his death, with two justices seeming to take opposing sides.
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March 27, 2024
Feds Say Murdaugh Lied, Broke Plea Deal Over $9M Fraud
Alex Murdaugh, the South Carolina attorney serving a life sentence for killing his wife and son, was dishonest with the government and should potentially face a harsher prison sentence than the one proposed in a plea agreement on federal charges of stealing at least $9 million from clients, prosecutors said.
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March 27, 2024
Insurer Ducks Coverage Of Florida Law Firm Dispute
A personal injury law firm involved in a joint venture dispute has no insurance coverage for the litigation, a Florida federal judge has ruled, finding its policy only provided professional services liability, not anything else.
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March 27, 2024
Advice-Of-Counsel Defense Curbed From NC Tax Fraud Trial
Two St. Louis attorneys and a North Carolina insurance agent can't fall back on advice-of-counsel defenses during their upcoming tax fraud trial after a federal judge found that they had failed to follow court orders requiring them to hand over information about the advice they sought.
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March 27, 2024
Embattled Law Firm Can't Escape Hurricane Ad Suit
A Texas federal judge has agreed with a magistrate judge's recommendation in refusing to toss a suit seeking class damages over a troubled Houston law firm's allegedly illegal efforts to solicit clients in hurricane-related property damage cases.
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March 27, 2024
BCBS Can't Escape Therapy Coverage Suit
A North Carolina federal judge refused to throw out a proposed class action accusing Blue Cross Blue Shield of unlawfully refusing to cover proton beam therapy to treat prostate cancer, saying the case could remain in court if a state worker health plan is added as a defendant.
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March 26, 2024
Alcoa Retirees Score Partial Win In Life Insurance Fight
Alcoa USA Corp. violated its collectively bargained obligations when it unilaterally cut off company-provided life insurance benefits, but was within its rights to pay retirees to waive their claims to benefits, an Indiana federal judge ruled.
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March 26, 2024
Insurance Mogul's Ex-Political Consultant Wants Own Retrial
A former political consultant charged alongside embattled insurance mogul Greg Lindberg wants their criminal retrial on wire fraud and bribery charges severed, telling a federal court that Lindberg's potential plan to throw him under the bus will destroy any defenses against the government's accusations.
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March 26, 2024
Geico Alleges $5.6M Billing Scam Targeted NY Insurance Cos.
The insurance giant Geico has sued a New Jersey man and three medical imaging companies in New York federal court, accusing them of a $5.6 million scheme to submit fraudulent bills for unnecessary or otherwise useless tests on auto accident victims.
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March 26, 2024
$4.5M Microcaptive Insurance Deduction Nixed By Tax Court
An eye doctor can't deduct more than $4.5 million in insurance premiums that he paid to two microcaptive companies because the payments don't qualify as valid insurance purchases for federal income tax purposes, the U.S. Tax Court ruled Tuesday.
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March 26, 2024
Gender Pay Bias Claims Against MetLife Allowed To Proceed
A New York federal judge in Manhattan trimmed hostile work environment and biased firing claims Tuesday from a gender discrimination lawsuit a fired female executive brought against insurance company MetLife, but said there was enough evidence the insurance giant paid her less than her male co-workers and denied her promotions.
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March 26, 2024
Meet The Calif. Atty Taking On Health Insurers' Use Of AI
With the health insurance industry under scrutiny over its use of algorithms and artificial intelligence in the patient coverage review process, California appellate attorney Glenn Danas saw an opening for litigation with what he calls a "high outrage factor."
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March 25, 2024
Judge Probes If $54M Deal Will Affect Tehum Care Ch. 11 Plan
A Texas bankruptcy judge Monday mulled if approving a settlement for prison health care company Tehum Care Services Inc. will lock in releases for a future Chapter 11 plan at the third day of a trial asking him to confirm the deal or toss the "Texas two-step" bankruptcy.
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March 25, 2024
Berkshire Hathaway Unit's Patent Must Undergo 3 PGRs
The Patent Trial and Appeal Board has instituted three post-grant reviews challenging a single Columbia Insurance Co. fire wall hanger patent, following petitions from Simpson Strong-Tie Company Inc.
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March 25, 2024
Creditor Says Fruit Grower Can't Cover Ch. 11 Expenses
A creditor of fruit producer Prima Wawona is asking a Delaware bankruptcy court to reject the company's Chapter 11 plan, saying it does not provide for the payment of nearly $5.3 million in workers' compensation expenses and other post-bankruptcy debts.
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March 25, 2024
Ex-Root Exec Gets 51 Months In Prison For $10.2M Theft
The former chief marketing officer for Columbus, Ohio-based car insurer Root Inc. has been sentenced to 51 months in prison followed by five years of supervised release for embezzling more than $10.2 million from his employer and spending it on plastic surgery, a yacht, a plane, and other personal expenses.
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March 25, 2024
Trump Gets Late Reprieve After Failing To Post $465M Bond
A New York appellate panel said Monday that Donald Trump can pause enforcement of the state attorney general's $465 million civil fraud judgment by posting just $175 million while he appeals, after the former president complained that he was unable to secure a bond for the entire amount.
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March 22, 2024
Kaiser's Ozempic Coverage Denial Is Discriminatory, Suit Says
Two Kaiser plans' refusal to cover new prescription weight loss drugs like Ozempic and Wegovy is "without any medical or scientific basis," a Washington state resident told a state court, alleging disability discrimination.
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March 22, 2024
Ind. Factory Adds To Historic $112M Bad Faith Coverage Win
A flooded factory building that was awarded $112 million in a historic bad faith win added to its victory Friday when an Indiana federal court denied its insurers' requests for a new trial and granted the factory more than $7 million in costs and interest.
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March 22, 2024
Ex-Ga. Insurance Head Cops To Healthcare Kickback Scheme
Former Georgia Insurance Commissioner John Oxendine pled guilty Friday to working with an Atlanta-area doctor to run a multimillion-dollar medical testing kickback scheme just weeks before he was set to face trial in federal court.
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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.
Expert Analysis
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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.
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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.