Industry Updates

For calendar-year plans, the 2025 plan year is right around the corner. And even for non-calendar-year plans, January 1, 2025, is a key implementation date for certain plan features. This is the ideal time for plan sponsors to review plan documents and policies, consider plan design changes, and ensure that plan operations comply with evolving legislative and regulatory requirements. While this checklist only scratches the surface of what is required, it highlights some of the primary changes...By: McDermott Will & Emery

Is your cyber insurance policy sufficient to protect your company? As criminals leverage AI and other emerging technologies to exploit vulnerabilities in cybersecurity defenses, it’s critical to assess your company’s capacity to withstand a breach. Ralph Pasquariello, a Senior Partner and cyber liability specialist at The Tech Collective with more than 15 years of experience in the field, joins host Juliana Neelbauer for the first half of a two-part discussion about cyber liability...By: Fox Rothschild LLP

When a policyholder is at fault, their insurer is often faced with multiple claims. These claims add up quickly and can easily surpass policy limits. With clear fault and insufficient policy limits, what is an insurer to do? While insurers are required to act in good faith and in the best interest of their insureds, states have taken different approaches on how to satisfy the good faith standard when facing multiple claimants for insufficient funds. This article briefly discusses the approaches...By: Faegre Drinker Biddle & Reath LLP

The Massachusetts Senate proposed an amendment on Monday December 2, 2024, that would delay implementation and enforcement of the 2021 Patients First Act addressing health care cost transparency. Section 31 of the amendment would replace the current implementation date of January 1, 2025, with January 1, 2027, providing an additional two years for providers to prepare for the additional notice requirements accompanying the law....By: Foley & Lardner LLP

In California, if someone else was at least partially at fault for a car accident that you were involved in, you can receive compensation for lost wages. The reason for this is because lost wages are included in the economic damages that may be recovered....By: Maison Law

Key Insurance Types for Construction - Construction projects often involve numerous risks, but various insurance policies are designed to mitigate these....By: Mandelbaum Barrett PC

In Charles Dickens’ classic “A Christmas Carol,” the final act is brought by the spectral Ghost of Christmas Future who shows the miserly Ebenezer Scrooge the vision of those he mistreated in life celebrating his death after he is gone. This Christmas, that part of the seasonal story might be hitting health insurance executives a little too close to home......By: Holland & Hart - Your Trial Message

The New York State Department of Financial Services (NYDFS) and the Attorney General’s office have recently imposed significant fines totalling $11.3 million on Geico and Travelers for data breaches that compromised the driver’s license numbers and other sensitive personal data of approximately 120,000 individuals....By: Barnea Jaffa Lande & Co.

The United States District Court for the District of New Hampshire, applying California law, considered several exclusions under a directors and officers liability policy as applied to a violation of the California Franchise Investment Law (“CFIL”). The claim involved an insured franchisor’s violation of the CFIL for failing to disclose prior fraud cases against the company’s founder when entering into a new franchise agreement....By: Wiley Rein LLP

A recent decision by a federal court in the Eastern District of New York illustrates how directors and officers (“D&O”) policies can provide valuable insurance coverage for defense costs and potential liabilities arising from False Claims Act (“FCA”) litigation. In Northern Metropolitan Foundation for Healthcare, Inc. v. RSUI Indemnity Company, Case No. 20-CV-2224 (EK) (JAM) (E.D.N.Y. Sept. 24, 2024), the insured—an owner and operator of adult healthcare centers in Brooklyn, New York—sought...By: McGuireWoods LLP

On November 25, NYDFS announced settlements with two auto insurance companies for inadequate data security that compromised the personal information of over 120,000 New York consumers and secured $11.3 million in total penalties. According to NYDFS, hackers exploited vulnerabilities in the companies’ online insurance applications to steal personal information, including driver’s license numbers, which were then used for fraudulent unemployment claims during the Covid-19 pandemic. Investigations...By: Orrick, Herrington & Sutcliffe LLP

Bermuda is a British Overseas Territory. The modern legal system of Bermuda is established by the Bermuda Constitution Order 1968, an Order in Council of the United Kingdom that established the Supreme Court as the primary court of first instance and the Court of Appeal as the court with jurisdiction to hear appeals from judgments of the Supreme Court....By: Carey Olsen

Welcome to the Fall 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and compliance tips. We bring you the most recent and significant insights in an accessible format, concluding with our main takeaways — aka “And the Fox Says…” — on what you need to know....By: ArentFox Schiff

Cyber breach costs are skyrocketing, and staying on top of incident response is crucial for both insureds and insurers. Learn how to manage unpredictable costs and work more efficiently with vendors in our on-demand webinar by Integreon and Intelligent Insurer....By: Integreon

This month’s Friday Five explores recent decisions including the impact of a COVID furlough on eligibility for LTD benefits, what constitutes a breach of an employer’s fiduciary duty, what defines total proof of disability or is viewed as a severe procedural violation, and the appropriate weight given to a treating physician’s conclusions....By: Saul Ewing LLP

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-09 (the “Opinion”) to a municipal corporation (the “Requestor” or the “EMS Provider”) that provides emergency medical services (“EMS”) to county residents. In the Opinion, OIG analyzes the EMS Provider’s proposal to bill patients’ insurance plans (but waive patients’ cost-sharing amounts) when it provides EMS without an associated ambulance...By: Arnall Golden Gregory LLP

Cyber breach costs are skyrocketing, and it is crucial for both insureds and insurers to stay on top of cyber incident response. ?? Ensure your incident response plan is robust ?? Avoid the volatile costs of dealing with large data sets ?? Address the challenges of a data breach, including data mining and notification. In this on-demand webinar by Integreon and Intelligent Insurer, learn how to manage unpredictable costs and work more efficiently with vendors....By: Integreon

The California Department of Public Health’s (CDPH) September 6, 2024, All Facilities Letter (AFL) reaffirms the independent practice authority of Certified Registered Nurse Anesthetists (CRNAs). Despite this reaffirmation, misinterpretations of nurse anesthesiology scope of practice continue to disrupt anesthesia services in general acute care hospitals throughout California....By: Fennemore

The Net-Zero Asset Owner Alliance (the Alliance), an influential coalition of pension funds and insurance companies holding a combined $9.5 trillion in assets, released a report on Wednesday calling on regulators worldwide to mandate and standardize corporate disclosures of Scope 3 emissions, as regulations on these emissions are evolving worldwide....By: Fenwick & West LLP

In Farage v. Associated Ins. Mgt. Corp., 2024 N.Y. Slip Op. 05875 (Nov. 26, 2024) (here), the New York Court of Appeals examined the enforceability of an insurance contract’s two-year suit limitation period. In a 4-3 decision, written by Judge Madeline Singas, the Court held that the contract provision in the parties’ insurance agreement shortening the statute of limitations barred plaintiff from receiving payment for the restoration of her property that the fire had damaged....By: Freiberger Haber LLP

Launched in July 2024, Death Clock is an application that uses artificial intelligence (AI) to predict when its users will die. Death Clock trained its AI model using over 1,200 life expectancy studies. It then uses the answers from a questionnaire about the user’s physical health, like diet and exercise, to calculate each user’s date of death. While users of the free version will only receive this date, users of the paid version will receive lifestyle recommendations to help them live longer....By: Robinson+Cole Data Privacy + Security Insider

In Fehr v Sun Life Assurance Company of Canada, 2024 ONCA 847 (Fehr), the Ontario Court of Appeal dismissed the representative plaintiffs’ appeal seeking post-certification leave to amend their statement of claim and to certify an additional common issue. The Court concluded that the proposed common issue arose out of a previously unpleaded cause of action, triggering limitations considerations, including for the entire class....By: Bennett Jones LLP

Santa is not the only person who should be making a list and checking it twice this December. All sponsors of self-insured medical plans should also make sure that they double-check their year end to do lists....By: Bricker Graydon LLP

Internationally active insurance groups (IAIGs) should take note of a critical new group capital standard adopted by a global insurance standard-setting body. This could have an effect on capital requirements for these large insurance businesses in one or more jurisdictions across the world....By: Kramer Levin Naftalis & Frankel LLP

As a part of our Quarterly Practice Group Update, we are pleased to produce yet another installment with examples of our continued success in the area of fraud litigation....By: Goldberg Segalla

Decisions, decisions, decisions. The Centers for Medicare & Medicaid Services (CMS) under the Trump Administration will have its hands full making decisions about Center for Medicare and Medicaid Innovation (CMMI) models throughout 2025 and into 2026....By: McDermott+

A California federal district court recently compelled arbitration of a reinsurance dispute, finding that it “had little difficulty concluding that this case falls within the parties’ arbitration agreement.” Truck Insurance Exchange v. Certain Underwriters at Lloyd’s London et al., 24-CV-08157-SB-JC, C.D. Cal. (Nov. 15, 2024)....By: Husch Blackwell LLP

Under a long anticipated Centers for Medicare & Medicaid Services (CMS) final rule that took effect in October, casualty insurers face risks of incurring Civil Money Penalties (CMPs) if they fit the Section 111 definition of a Responsible Reporting Entity (RRE) but then fail to timely report to CMS certain payments to Medicare beneficiaries. To mitigate these risks, insurers should take a second look at the reporting requirements CMS has put in place for “Non-Group Health Plans” (NGHPs), that is...By: Wiley Rein LLP

Representation & Warranty Insurance (“RWI”) is specialty insurance coverage purchased for M&A deals which provides third-party insurance coverage for certain breaches of the Seller’s representations and warranties in the definitive purchase agreement. Historically, RWI was used only for M&A deals involving purchase prices of $100 million or more....By: Whiteford

Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as Medicare, Medicaid and TRICARE....By: McAfee & Taft