The Insurance & Reinsurance Report
Your Timely Insurance and Reinsurance Analysis of Legal and Regulatory Developments and News.
Cases provided courtesy of LexisNexis.
90-Day Rule – 45 CFR Parts 144, 146, and 147
4815 Dev. Corp. v. Harleysville Ins. Co.
Atl. Cas. Ins. Co. v. Cheyenne Country
Barlee v. First Horizon Nat’l Corp.
Chubb Custom Ins. Co. v. Space SystemsLoral, Inc.
City of New York v. Nova Cas. Co.
Dodd v. Am. Family Mut. Ins. Co.
Encore Receivables Mgmt. v. Ace Prop. & Cas. Ins. Co.
Gear Auto. v. Acceptance Indem. Ins. Co.…
Continue ReadingRay Haluch Gravel Co., et al., v. Cent. Pension Fund of the Int’l Union of Oper. Eng’rs & Participating Emp’rs, et al., case No. 12-992
Petition Granted June 17, 2013
According to the petition, “[t]he question presented in this case, on which there is an acknowledged conflict among nine circuits, is whether a district court’s decision on the merits that leaves unresolved a request for contractual attorney’s fees is a “final decision” under 28 U.S.C. § 1291.”
The U.S. Supreme Court agreed to hear …
Continue ReadingOxford Health Plans v. Sutter
(United States Supreme Court, June 10, 2013)
This action arises from an arbitrator’s decision on whether a contract authorizes class arbitration and whether the arbitrator’s decision survives the judicial review allowed by §10(a)(4) of the Federal Arbitration Act (FAA).
Specifically, a physician entered into a contract with the insurer and agreed to provide medical care to members of the insurer’s network. The physician, on behalf of himself and a proposed class, sued the insurer, alleging that the insurer had failed …
Continue ReadingPHL Variable Ins. Co. v. P. Bowie 2008 Irrevocable Trust
(1st Cir. (R.I.) May 13, 2013)
The First Circuit recently held that an insurer may retain life insurance premiums following a policy rescission to offset the loss it has suffered. The ruling is notable because courts typically require an insurer to refund an insured’s policy premium where a rescission is effected.
In PHL, an insurance broker submitted an application for life insurance for Peter Bowie. Bowie’s application represented that he was a self-employed …
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If you would like to receive future editions of CaseWatch: Insurance directly by email, please contact Sarah Delaney at [email protected].…
Continue ReadingCases provided courtesy of LexisNexis.
AB Green Gansevoort, LLC v. Peter Scalamandre & Sons, Inc.
Atl. Cas. Ins. Co. v. Cheyenne Country
Bank of America, N.A. v. Superior Court
Boston Gas Co. v. Century Indemnity Co.
Colby v. Union Security Insurance Co.
Collective Brands, Inc. v. Nat’l Union Fire Ins. Co.
Conestoga Wood Specialists Corp. v. U.S. Dept. of H.H.S.
Entitle Ins. Co. v. Darwin Select Ins. Co.
First Tenn. Bank Nat’l Association v. St. Paul …
Continue ReadingLife, Health, Disability, and ERISA – a summary of decisions from across the country concerning life, health, and disability policies, including those governed by ERISA. For a free copy of this edition, click here..
Following your review of Life, Health, Disability, and ERISA kindly feel free to contact attorneys and co-editors with any comments you may have, or with any topics you would like to see in upcoming newsletters. Editors: Daniel Gerber, Sarah Delaney, Matthew C. Van Vessem…
Continue ReadingIt is somewhat rare for a trial and appellate court to disagree and, upon appeal to the United States Supreme Court, find out they were both wrong. It is even rarer for both parties in this action to win and lose simultaneously in a decision. And yet, on Tuesday, April 16, 2013, the scenario described above happened in US Airways v. McCutchen. The ruling from Justice Elena Kagan was a mixed bag. On one hand, the court ruled that clear …
Continue ReadingUnited States v. Gutschlag, GM-Southwest, Inc. U.S. Dist. Ct., W.D.Va. April 8, 2013
Third Party Administrator GM – Southwest, Inc. (TPA), and its former owner John Paul Gutschlag, Sr. contracted with Virginia Tech from 2003-2011 to provide health insurance to the school’s undergraduate and graduate students. The premiums for the health insurance were paid directly to the TPA, who accounted for the premiums received, deducted its commission, and then delivered the balance to the carriers.
Each year the TPA was responsible for compiling and reporting …
Continue ReadingUnited States of America v. Rick A. Kulhman No. 11-15959 (11th Cir. 2013)
Dr. Rick Kuhlman, a chiropractor who operated in Atlanta, GA, and Nashville, TN, pled guilty to running a five-year, $3 million health care fraud scheme. He appeared to be the perfect defendant because of his efforts to make things right and a willingness to educate others on the criminal nature of his actions. Therefore, the district court ruled out a jail sentence. However, the 11th Circuit reversed the relatively light sentence …