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Recent Increase in IRS Enforcement of ACA Reporting Penalties
Hanson Bridgett LLP, September 2019

Recently, the IRS has intensified enforcement of information reporting compliance under the Affordable Care Act (ACA). Information reporting penalties apply in addition to any penalties assessed for failures to meet the employer shared responsibility provisions, known as the employer mandate...

Insurers Beware: California’s Notice-Prejudice Rule Is a “Fundamental Public Policy”
Hanson Bridgett LLP, September 2019

For those insurers that seek to circumvent California’s notice-prejudice rule, the California Supreme Court has just made that more difficult. In Pitzer College v. Indian Harbor Insurance Company, 845 F.3d 993 (9th Cir. 2017), the Ninth Circuit certified questions to the California Supreme Court, including: “Is California's common law notice-prejudice rule a fundamental public policy for the purpose of choice-of-law analysis?” (Pitzer College, 845 F.3d at 994...

Employers May Offer Two New Types of Health Reimbursement Arrangements in 2020
Hanson Bridgett LLP, July 2019

Under final rules issued last month, employers can offer two new types of health reimbursement arrangements or HRAs: individual coverage HRAs ("ICHRAs") and excepted benefit HRAs ("EBHRAs"). HRAs are self-funded, account based plans that reimburse employees for qualified medical expenses on a tax-free basis. The final rules apply for plan years beginning on or after January 1, 2020. While the rules are complex, the new ICHRAs and EBHRAs offer new planning opportunities for employers...

Ninth Circuit Rules ERISA Pension Plan Must Pay Survivor Benefits to Registered Domestic Partner
Hanson Bridgett LLP, June 2019

In a short, unpublished opinion, the Ninth Circuit Court of Appeals ruled that an ERISA pension plan administrator should have treated a deceased participant's registered domestic partner as a surviving spouse and granted his claim for survivor benefits...

California Appellate Court Affirms Large Punitive Damages Award Against Insurer
Hanson Bridgett LLP, June 2019

Last month, a California appellate court rejected an insurer's arguments and affirmed a large punitive damages award against the insurer, providing a fresh roadmap for policyholders to obtain such relief when insurers engage in certain bad-faith practices. Mazik v. GEICO General Insurance Company (2019) 35 Cal.App.5th 455 involved a policyholder's claim for the $50,000 limits under his underinsured motorist policy...

Beware: Violations Of State Safety Requirements Bring Penalties For Both State Fund and Self-Insured Employers
Dinsmore & Shohl LLP, April 2019

Recently, Dinsmore has noticed an uptake in claimant allegations that an employer has caused an accident due to violation of a specific safety requirement (VSSR). A VSSR award is an additional award paid to the employee by the Bureau of Workers’ Compensation (BWC) billed directly to state fund employers or paid directly by a self-insured employer...

New Administrative Fines Imposed by the UAE Insurance Authority
Afridi & Angell, March 2019

On 6 January 2019, UAE Cabinet Resolution No. 7 of 2019 Concerning the Administrative Fines Imposed by the Insurance Authority was published in the UAE Official Gazette, which lists a total of 204 items that are considered to be violations by the Insurance Authority and their corresponding penalties...

All Stop: Ruling on the Applicability of Exclusion to BIPA Claims Delayed
Dykema, March 2019

The fallout from the Illinois Supreme Court’s January 25, 2019, opinion in Rosenbach v. Six Flags Entertainment Corp., 19 IL 12316, continues.Rosenbach settled the dispute of who qualifies as an “aggrieved person” under the Illinois Biometric Information Privacy Act (“BIPA”), and in doing so opened the floodgates for this litigation to proliferate...

Ohio Enacts New Cybersecurity Requirements for Insurers
Dinsmore & Shohl LLP, February 2019

Senate Bill 273 goes into effect on March 20, 2019, and creates new requirements for Ohio insurance companies, including health insurance plans, to develop and implement specific information security programs to safeguard nonpublic business and personal information. Senate Bill 273 is based upon the National Association of Insurance Commissioners’ Insurance Data Security Model Law (also referred to as "MDL-668")...

Recent Changes to EPA Coal Ash Regulations - Regulatory and Insurance Coverage Implications
Haynes and Boone, LLP, January 2019

A new rule promulgated by the U.S. Environmental Protection Agency (“EPA”) governing the disposal of coal combustion residuals, also known as CCR or coal ash, raises the risk for civil claims and the need for insurance to cover them.1  The rule, which takes effect Aug. 29, 2018, revises regulations issued in 2015 and has the stated intent of providing utilities and states “more flexibility in how CCR is managed...

Securing Indemnification and Additional Insurance Coverage Requires Careful Drafting
Lowenstein Sandler LLP, January 2019

Insurance plays a prominent role in all real estate transactions. Stakeholders generally understand that insurance policies must be secured for the leasehold to address property damage and liability claims. However, stakeholders often do not pay attention to the precise contract language used to establish the insurance requirements and address how the waterfall of available insurance coverage will flow...

Discretionary Dismissal of Insurer's Declaratory Judgment Action on Coverage Upheld
Dinsmore & Shohl LLP, January 2019

The U.S. Court of Appeals for the Sixth Circuit, in Massachusetts Bay Insurance Company v. Christian Funeral Directors, Inc., No. 18-5267 (6th Cir. Dec. 26, 2018), recently upheld a district court’s declination of jurisdiction over an insurer’s declaratory judgment action on coverage...

Federal District Court Rules HHS Cuts to 340B Reimbursement 'Exceeded' Authority
Dinsmore & Shohl LLP, January 2019

In a recent opinion out of the U.S. District Court for the District of Columbia, U.S. District Court Judge Rudolph Contreras held that the U.S. Department of Health and Human Services (HHS) exceeded its authority when it substantially reduced the amount Medicare pays for 340B-acquired medications...

Discretionary Dismissal of Insurer’s Declaratory Judgment Action on Coverage Upheld
Dinsmore & Shohl LLP, January 2019

The U.S. Court of Appeals for the Sixth Circuit, in Massachusetts Bay Insurance Company v. Christian Funeral Directors, Inc., No. 18-5267 (6th Cir. Dec. 26, 2018), recently upheld a district court’s declination of jurisdiction over an insurer’s declaratory judgment action on coverage...

Year in Review: Top Insurance Cases of 2018
Hunton Andrews Kurth LLP, January 2019

2018 was a busy year for courts deciding insurance coverage disputes. Many of those decisions will shape the coverage landscape for years to come. Policyholders enjoyed their fair share of the wins, including substantial victories in areas involving social engineering to disgorgement of corporate gain. We take this opportunity to reflect on some of the year’s most notable coverage decisions...

PBM Contracting Transparency: Pennsylvania Auditor General Releases PBM Report
Dinsmore & Shohl LLP, December 2018

On December 11, 2018, Pennsylvania Auditor General Eugene A. Depasquale released a long-awaited report discussing the role of pharmacy benefit managers (PBMs) in Pennsylvania’s health care system...

Top 10 Insurance Tips for Year End Transactions
Haynes and Boone, LLP, December 2018

The end is near. 2018 is fast coming to a close, and it is that time of year when corporate lawyers are counting—not the number of shopping days left until Christmas, but the number weeks, days and hours left before the end of the fiscal year. Admittedly, in the scramble to close deals, insurance requirements and indemnity provisions may not be at the top of the list of critical deal points for clients and counsel...

How to Prepare for the 2019 Nursing Home Compliance Program Mandate
Dinsmore & Shohl LLP, November 2018

The deadline for meeting the previously issued nursing home compliance mandate is approaching. The Centers for Medicare & Medicaid Services (CMS) issued the mandate in 2016 and gave facilities three years to become compliant. On November 28, 2019, skilled nursing facilities (SNF) and nursing homes will be required to adopt and implement a compliance program as a condition for participation in Medicare and Medicaid...

Department of Education Proposes New Title IX Regulations
Dinsmore & Shohl LLP, November 2018

Educational institutions (“recipient” or “recipient institutions”) have been waiting for the Department of Education to issue formal Title IX regulations after it issued interim guidance in September 2017.  This interim guidance rescinded previous Obama-era guidance that called for strict enforcement of Title IX and indicated that new formal guidance would be forthcoming...

CMS Announces Section 1115 Waiver Allowing Medicaid Payments for Inpatient Mental Health Treatment
Dinsmore & Shohl LLP, November 2018

In a letter to state Medicaid directors on Nov.13, 2018, the Secretary of the U.S. Department of Health and Human Services, Alexander Azar, announced a new demonstration opportunity that will allow states to provide improved care for adults with a serious mental illness (SMI) and children with serious emotional disturbance (SED)...

OIG Ramping Up Enforcement Actions Against Dental Practices
Dinsmore & Shohl LLP, November 2018

In the last quarter of 2018, the Office of the Inspector General (OIG) announced that ImmediaDent of Indiana, LLC (ImmediaDent), which operates nine dental care practices, and Samson Dental Partners, LLC (SDP), which provides administrative support to Immediadent, have agreed to pay the United States and the state of Indiana $5.1 million to resolve allegations that they improperly billed Indiana’s Medicaid program...

How is Project Insurance Coverage Affected by a Sub-Contractor Having its Own Insurance Coverage?
Deacons, October 2018

In Haberdashers’ Aske’s Federation Trust Ltd v Lakehouse Contracts Ltd [2018] EWHC 558 (TCC), England’s Technology and Construction Court had to decide on the extent of coverage (or inclusion) of a project insurance policy for a construction project and how that coverage was affected by a sub-contractor having its own insurance cover...

Insurance Conduct and Culture - A New Regulatory Focus
MinterEllisonRuddWatts, October 2018

Australian Royal Commission and New Zealand review Insurers and insurance intermediaries in New Zealand are under intense scrutiny by regulators, the media and customers as the Australian Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry unfolds...

Ohio Supreme Court: Faulty Work by a Subcontractor is not an "Occurrence" Requiring Coverage Under a Commercial General Liability Insurance Policy
Dinsmore & Shohl LLP, October 2018

The Ohio Supreme Court yesterday reversed the decision of a lower court of appeals and held that a general contractor is not entitled to insurance coverage for property damage arising out of its subcontractor’s faulty work, even when the general contractor purchased a CGL insurance policy with a rider pertaining to coverage related to a subcontractor’s faulty work...

Ohio Supreme Court: Faulty Work by a Subcontractor is not an “Occurrence” Requiring Coverage Under a Commercial General Liability Insurance Policy
Dinsmore & Shohl LLP, October 2018

The Ohio Supreme Court yesterday reversed the decision of a lower court of appeals and held that a general contractor is not entitled to insurance coverage for property damage arising out of its subcontractor’s faulty work, even when the general contractor purchased a CGL insurance policy with a rider pertaining to coverage related to a subcontractor’s faulty work...

Insuring Instability: Is There Coverage for the Cost of the Trade War?
Haynes and Boone, LLP, October 2018

A new round of U.S. tariffs on $200 billion in Chinese imports became effective on September 24, 2018.1The 10 percent tax on Chinese consumer products is only the latest escalation in an ever-widening trade war between the United States and its global trading partners. While it appears that, subject to Congressional approval, trade disputes between the U.S...

Insuring Instability: Is There Coverage for the Cost of the Trade War?
Haynes and Boone, LLP, October 2018

A new round of U.S. tariffs on $200 billion in Chinese imports became effective on September 24, 2018.1 The 10 percent tax on Chinese consumer products is only the latest escalation in an ever-widening trade war between the United States and its global trading partners. While it appears that, subject to Congressional approval, trade disputes between the U.S...

How Insurance Might Cover Losses Incurred in Connection with Hurricane Lane
Haynes and Boone, LLP, September 2018

Although Hurricane Lane’s substantial weakening from a Category 5 storm as it approached land likely spared Hawaii a disaster, the storm still caused much harm. Areas of the Big Island got inundated with well over three feet of rain, causing landslides and major road closures, and high winds stoked brush fires on Maui, burning 2,300 acres of land, damaging multiple homes, and forcing hundreds of evacuations...

Consultation on a Proposed Model to Extend Unfair Contract Terms (UCT) Protections to Insurance Contracts - Australia
MinterEllison, July 2018

Earlier this year, the government released a proposal paper: Extending Unfair Contract Terms Protections to Insurance Contracts outlining a model to extend unfair contract term (UCT) provisions to insurance contracts regulated under the Insurance Contracts Act 1984 (Cth) (IC Act) for consultation. The consultation period closes on 27 July. A high level summary of the proposed model is below...

Maximizing Insurance Coverage for Cyber Losses: Two New Decisions Highlight Potential Recovery Sources
Lowenstein Sandler LLP, July 2018

Businesses prudently and increasingly purchase stand-alone cyber insurance policies to manage the risk of cyber breaches and attacks. Two decisions from separate U.S. Courts of Appeals in the past two weeks highlight the fact that in-house counsel and risk managers should look to their organizations’ traditional insurance policies as a source of potential coverage for cyber-related losses. Spec’s Fam. Partners, Ltd. v. Hanover Ins. Co...

Increased Risk: The Importance of Questions to Policyholders
Lavery Lawyers, June 2018

Earlier this year, Marcelin Fortier (hereinafter the “applicant”) sued his insurer in a case. The Superior Court rendered a decision1  whereby it reiterates the principles applicable to the notion of increased risk in insurance. The case also insisted on the importance of the questions asked by insurers at the time an insurance contract is purchased.  On 8 January 2015, the applicant’s home was seriously damaged by fire...

Texas Supreme Court Confirms No Independent Injury Needed to Recover Under Texas Bad Faith Statute
Haynes and Boone, LLP, June 2018

For years, corporate policyholders lacked a clear path to recovery against their insurance companies under the Texas bad faith statute. The reason for this uncertainty was that some courts required a showing of an injury independent from the loss of policy benefits as a means of recovery under the bad faith statute...

CBO Releases Highly Anticipated Report on Trump's ObamaCare Repeal Bill; 23 Million Americans Projected to Lose Insurance by 2026
Waller, May 2018

Earlier this year, the Congressional Budget Office (CBO) released its report on the direct spending and revenue effect of H.R. 1628, the American Health Care Act of 2017 (AHCA), as passed by the House of Representatives. CBO made this estimate in conjunction with the Joint Committee on Taxation...

Haynes and Boones Insurance Recovery Group Expands to East Coast
Haynes and Boone, LLP, May 2018

Barry Buchman, Adrian Azer and Greg Van Houten have joined Haynes and Boone, LLP’s Washington, D.C. office in the Insurance Recovery Practice, expanding the group’s presence coast-to-coast. Partner Barry Buchman brings more than 20 years of experience and looks forward to helping the practice flourish in Washington, D.C., and the East Coast...

Cyber Insurance for Financial Institutions
Fredrikson & Byron, P.A., May 2018

Many financial institutions already realize the importance of cyber insurance coverage, but a joint statement issued by the Federal Financial Institutions Examination Council (FFIEC) last month further emphasizes the need for inclusion of cyber insurance in your risk management program. Current regulations do not require banks to have cyber insurance coverage, but it can prove to be a critical policy as the number and sophistication of cyber incidents increase...

Kidnap Ransom Insurance: Unlocking Coverage for Ransomware Attacks
Haynes and Boone, LLP, March 2018

By one account, “the cost of global ransomware attacks will exceed $11.5 billion annually by 2019, up from $5 billion last year and $325 million in 2015” – a 35X increase in just four years.1Relative to other cyber crime, ransomware is an equal opportunity enterprise—striking individuals as well as businesses of all kinds...

Kidnap Ransom Insurance: Unlocking Coverage for Ransomware Attacks
Haynes and Boone, LLP, March 2018

By one account, “the cost of global ransomware attacks will exceed $11.5 billion annually by 2019, up from $5 billion last year and $325 million in 2015” – a 35X increase in just four years.1Relative to other cyber crime, ransomware is an equal opportunity enterprise—striking individuals as well as businesses of all kinds...

New ERISA Disability Benefit Claims and Appeals Rules Take Effect April 2, 2018
Hanson Bridgett LLP, March 2018

New rules will apply to disability benefit claims and appeals under certain plans that are subject to the Employee Retirement Income Security Act of 1974 (ERISA), effective for claims made after April 1, 2018.  According to the Department of Labor (DOL), the new rules are intended to provide greater protection to claimants, and are modeled on the enhanced claims and appeals procedures that apply to health benefit claims under the Affordable Care Act (ACA)...

Insurance, Reinsurance & Pension Funds
Veirano Advogados, February 2018

Legal entities that contract insurance to protect their own assets qualify as consumers within the meaning of the consumer code, says the brazilian Superior Court of Justice (STJ) "[...] the legal entity that takes out insurance seeking to protect its own assets shall be end user of insurance services, thus calling for the application in its favor of the rules provided for in the Consumer Code...

On Shaky Ground: How Can Policyholders Prepare for the Predicted Increase of Earthquakes in 2018?
Haynes and Boone, LLP, January 2018

This year has already been a busy one for seismic activity. In the first weeks of 2018 alone, there have been reports of a 7.9 magnitude quake off the shores of Kodiak, Alaska, a 6.2 magnitude temblor in Japan, and a series of tremors in California. And, few will forget the catastrophic earthquakes that struck Mexico City and the Iraq-Iran border last year...

How to Survive a Late Notice Challenge in an Environmental Insurance Coverage Action
Lowenstein Sandler LLP, January 2018

Since the mid-1980’s, environmental insurance coverage claims have been the most complex of insurance coverage claims. Insurance companies usually will not voluntarily provide coverage for gradually-occurring environmental claims without a fight, which typically takes the form of insurance coverage litigation that can be costly and time-consuming. A policyholder must overcome many hurdles to obtain coverage for an environmental claim...

What is the Fair Insurance Code?
MinterEllisonRuddWatts, December 2017

The Fair Insurance Code is a voluntary code of conduct agreed to by members of ICNZ.  It applies to those members who provide general insurance to individual consumers and small businesses with 20 employees or less.  The Code outlines the relationship between insurers and consumers and sets minimum service standards in areas including customer on-boarding , claims management and handling. It also sets out disclosure requirements and dispute resolution processes...

Three Things Employers Should Know When Seeking EPLI Coverage For Sexual Harassment Claims
Haynes and Boone, LLP, December 2017

At a time when tolerance seems to be an increasingly precious commodity, society can celebrate an awakening intolerance for sexual harassment. For all of the scandal and salacious detail dominating the media in recent months, there is the hope that victims of depravity can find empowerment and healing, if not justice, too...

Uganda Insurance Regulatory Authority clarifies new bancassurance guidelines
ENSafrica, November 2017

The Ugandan Insurance Regulatory Authority (“IRA”) has released clarification on its recently published bancassurance guidelines. Following the publication of the Insurance (Bancassurance) Regulations, 2017, the IRA published guidelines on the licensing of financial institutions as bancassurance agents...

Three Mistakes to Avoid in Handling a New Workers’ Compensation Claim
Dinsmore & Shohl LLP, November 2017

Employers should recognize three common mistakes in determining a valid workers’ compensation claim and in preparing to defend an invalid claim: 1. Failure to Investigate Thoroughly An initial thorough investigation of a workers’ compensation claim can be the key to determining a valid claim or a successful defense to an invalid claim at hearing. Early investigation allows for comprehensive documents-gathering and discovery...

A Checklist for Victims of Napa/Sonoma Fires: Recovering from Your Insurance
Haynes and Boone, LLP, October 2017

The purpose of this alert is to provide victims of the Napa/Sonoma fires a checklist to use when seeking recovery from their insurance companies. Property Insurance policies may provide coverage for damage to both your property and your business. Business losses can result from a variety of causes, all of which may be covered under a property policy...

POTUS Trump Looks to Halt CSR Payments
Waller, October 2017

President Donald Trump announced that the federal government will halt payments known as cost share reduction (CSR) payments. The CSR payments amounted to approximately $7 billion this year, and served as a subsidy to enable lower-income Americans to afford health insurance coverage...

Surviving the Loss of Your Home
Hanson Bridgett LLP, October 2017

I lost my home in the 1991 Oakland Firestorm. As such, my heart goes out to the residents of Napa, Mendocino and Sonoma counties whose homes were damaged or destroyed, to the firefighters and first responders who have risked and are risking their lives, as well as to the community, which will also experience the aftermath of such devastating fires...

Escobar's Effect on False Claims Act Qui Tam Actions
Dinsmore & Shohl LLP, October 2017

As seen in Law Journal Newsletters The False Claims Act (FCA or Act) can be a real punch in the gut for businesses on the wrong side of an FCA claim. The Act, codified at 31 U.S.C. §§ 3729-3733, is designed to prevent private companies contracting with the government from knowingly submitting false or fraudulent claims for their services...

Title Insurance in India: An Opportunity Awaits
Kochhar & Co. Advocates & Legal Consultants, September 2017

Under RERA, the promoter of a real estate project is obliged to obtain the requisite insurance policies required to secure the development of project and insurances as may be notified by the government. The lack of transparency and uniformity in the Indian real estate market has done little to entice insurance companies from tapping into lucrative land deals and developing insurance products for the real estate sector...

 

 

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