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Robinson+Cole Construction Law Zone

For Whom Additional Insured Coverage Applies in New York

Simply including a requirement in a contract to add certain parties as additional insureds under a commercial general liability insurance (CGL) policy may not be enough to ensure such coverage is provided in New York. In New...more

Holland & Knight LLP

Regulation of AI in Healthcare Utilization Management and Prior Authorization Increases

Holland & Knight LLP on

Over the past two years, federal and state government agencies have moved to regulate the deployment of artificial intelligence (AI) in the healthcare setting, including in the utilization management (UM) and prior...more

Pillsbury - Policyholder Pulse blog

Fifth Circuit Reminds Policyholders to Be “Not Less Than” Careful When Drafting Master Service Agreements

Just as the oilfield fuels the modern economy, master service agreements (MSAs) fuel the modern oilfield. But while almost every MSA contains indemnity and insurance clauses, experienced oilfield lawyers will advise their...more

Searcy Denney Scarola Barnhart & Shipley

Tailgating: How to Prove That a Vehicle Was Following Too Closely

Aggressive drivers often act like they are more important than everyone else on the road. One tactic they use is to follow so closely that the driver in front feels obligated to speed up. Other times, drivers tailgate to get...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Affordable Care Act Proposed Rule Would Broaden Access to Over-the-Counter Contraception Without Cost Sharing

Employer-sponsored health plans would be required to cover over-the-counter contraception, including condoms and emergency contraception, without a prescription and without cost sharing under newly proposed Affordable Care...more

Downey Brand LLP

Hello Again from NAFSMA

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If you don’t recall, NAFSMA is the National Association of Flood and Stormwater Management Agencies, and I am attending NAFSMA’s 46th annual conference in Colorado Springs, Colorado....more

Marshall Dennehey

Asked and Answered: Retail Insurance Agent Meets Standard of Care by Requesting Coverage Sought, Even If Insurer Declines to...

Marshall Dennehey on

Weaver Warehouse, LLC v. Gottschalk, et al., 2024 WL 1326499 (Pa. Super. Mar. 28, 2024) - Weaver Warehouse sought $3 million in builder’s risk insurance and $2.6 million in existing structure coverage for property...more

Marshall Dennehey

Fourth District Court of Appeal Reversed and Remanded a Final Judgment in Favor of the Insureds Where Prompt Notice Was Not...

Marshall Dennehey on

Security First Insurance Company v. Linda Visca and Silvio Visca, No. 4D2023-0961, June 5, 2024 - On February 20, 2020, the defendant was notified of the plaintiffs’ September 10, 2017, Hurricane Irma claim. The policy stated...more

Manatt, Phelps & Phillips, LLP

Administration Proposes Rules on OTC Contraception and Utilization Management in Preventive Care

On October 21, the Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) issued a proposed rule on permissible utilization management techniques for preventive services and the required...more

Manatt, Phelps & Phillips, LLP

Accelerating the Adoption of Value‑Based Care: The Role of Current Procedural Terminology (CPT®)

Executive summary - The shift towards value-based care (VBC) has led to a reimagining of the traditional definition of health care delivery—including what types of services are delivered, how those services are delivered,...more

Weber Gallagher Simpson Stapleton Fires &...

Understanding Senate Bill 1232: Streamlining Workers’ Comp Wage Payments with Direct Deposit in Pennsylvania

In an effort to streamline payment of Pennsylvania workers’ compensation wage loss benefits, Governor Shapiro signed Senate Bill 1232 into law on October 29, 2024. Senate Bill 1232 amends Section 308 of the Pennsylvania...more

King & Spalding

OIG Issues Report Finding that Medicare Advantage Insurers Received Billions for Diagnoses Reported Only on Health Risk...

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A recent OIG report found that diagnoses reported in 2022 Medicare Advantage (MA) encounter data based only on health risk assessments (HRA) and HRA-linked chart reviews resulted in CMS making additional risk-adjusted...more

Arnall Golden Gregory LLP

New Federal Parity Rules: A Step Forward for Equitable Mental Health and Substance Use Disorder Coverage

In September 2024, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) released final rules to strengthen the enforcement of the Paul Wellstone and Pete Domenici Mental...more

Goldberg Segalla

Defending HIMP-1 Claims: Top Things to Know

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In New York State, the Health Insurance Matching Program – widely known as HIMP – provides means for a claimant’s private health insurer to seek reimbursement for treatment they believe a workers’ compensation carrier or...more

Woodruff Sawyer

Clawbacks Can’t Touch This: Executives, Protect Your Pay with Clawback Insurance

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It’s been a year since the SEC’s compensation clawback rules took effect. Since then, US-listed public companies have implemented compliant compensation clawback policies that require executive officers to pay back...more

BCLP

Mental Health Parity Final Rule Imposes Year-end Action Items on Group Health Plan Sponsors

BCLP on

On September 9th, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the “Departments”) issued the much anticipated final rule under the Mental Health...more

Skadden, Arps, Slate, Meagher & Flom LLP

The Standard Formula: A Guide to Solvency II – Chapter 12: Undertakings in Difficulty

Undertakings in difficulty, in the context of Solvency II, refers to insurers that are either failing or likely to fail to meet their solvency capital requirement (SCR) or their minimum capital requirement (MCR) (together,...more

Bradley Arant Boult Cummings LLP

Navigating Claims-Made Policies: Five Lessons from Match Group LLC v. Beazley Underwriting Ltd.

As many policyholders are acutely aware, the insurance landscape is complex, with numerous insurers offering a wide range of available insurance programs. While some coverage forms are standard, many are unique to specific...more

Marshall Dennehey

Court Rules that Liability Insurance Does Not Cover Claims for Civil Liability Under the Antiterrorism Act 18 U.S.C. 2333(a)

Marshall Dennehey on

Travelers Prop. & Cas. Corp. v. Chiquita Brands Internatl., Inc., 2024-Ohio-1775 - Several insurers sought a declaration that they were not obligated to indemnify the defendant when it resolved underlying claims alleging...more

Marshall Dennehey

Professional Services Exclusion in GL Policy Issued to Property Inspector Barred Claims for Injuries Resulting from Inspector’s...

Marshall Dennehey on

Yarborough v. Erie Inspection Servs., Inc., 2024-Ohio-1712 - The plaintiff was a real estate agent who was injured when she fell through an open inspection panel in the floor of a bathroom at a house that she had listed. She...more

White and Williams LLP

Following Precedent Forces Alabama Court to Follow Outdated Law

White and Williams LLP on

In Myers v. Alfa Mut. Ins. Co., No. CL-2024-0010, 2024 Ala. Civ. App. LEXIS 119, the Court of Civil Appeals of Alabama (Appeals Court) issued a per curium opinion addressing whether the trial court properly awarded damages...more

Adams and Reese LLP

Florida Courts Disagree on Contractor’s License Requirements for Disaster Recovery Tasks

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On the heels of a record-breaking three hurricanes making landfall in Florida in 2024 – Debby, Helene, and Milton – disaster recovery is obviously a hot topic as residents and business owners work to recover from the...more

Manatt, Phelps & Phillips, LLP

HHS OIG Scrutinizes Medicare Advantage Use of Health Risk Assessments

On October 24, the HHS Office of Inspector General (OIG) released a report titled “Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions.” In evaluating 2022 MA...more

Presley & Presley

Buffet of Bad Faith Issues

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Standards for extra-contractual recovery vary from state to state to some extent. While the standard for recovery may differ, evidentiary, discovery and interpretation issues overlap and arise in many bad faith cases...more

BCLP

Key Concepts In Privacy Law for Insurance Carriers: Part 1 - GLBA

BCLP on

This article is the first in a series that will address privacy concerns for insurance carriers, agents and brokers. The insurance industry is uniquely situated at the confluence of multiple data privacy regimes....more

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