Industry Updates

  • Further Clarity Regarding Coverage for Funds Transfer Fraud
    by Zelle LLP on April 2, 2025 at 9:10 pm

    At this point, your IT department has almost certainly warned you to approach your e-mail inbox with skepticism--for good reason. Cybercriminals regularly and effectively impersonate our legitimate contacts for illegitimate gain. They may be targeting your servers and systems—through attacks like malware, ransomware, viruses, and hacking—or they may just be targeting you to authorize transmission of your company’s data and money without ever infiltrating your computer......By: Zelle LLP

  • Getting Ready to Appeal
    by Chartwell Law on April 2, 2025 at 6:53 pm

    I had the opportunity to spend two weeks in early March as appellate counsel at a hotly contested wrongful death trial. Seated next to lead trial counsel, I had a ringside seat where I could observe the jury minute by minute, while also ensuring that the errors - and there were many - were properly preserved for appeal. After nine days of trial, I had accumulated well over a hundred pages of notes, with my preferred assignments of error for appeal already identified. As we waited for the jury to...By: Chartwell Law

  • First Rulings on Pension Risk Transfer — ERISA Class Actions Reach Opposite Conclusions on Article III Standing
    by Seyfarth Shaw LLP on April 2, 2025 at 6:43 pm

    The first two district court opinions deciding whether plaintiffs have Article III standing to challenge pension risk transfers have reached opposite conclusions. One case will proceed to discovery, and the other has been dismissed without leave to amend. Many other motions to dismiss are pending in other courts and it is too early to tell which view will prevail; more rulings are expected soon....By: Seyfarth Shaw LLP

  • Coverage for Defective Workmanship Not Restored by Ensuing Loss Provision
    by Cozen O'Connor on April 2, 2025 at 3:08 pm

    In Bob Robison Commercial Flooring Inc. v. RLI Insurance Company (2025 WL 852889 (8th Cir. 2025), the United States Court of Appeals for the Eighth Circuit determined that an ensuing loss provision of a builder’s risk insurance policy did not restore coverage resulting from defective workmanship where the insured failed to identify a separate covered peril....By: Cozen O'Connor

  • A Matter of Circumstance: New York Court Finds Circumstantial Evidence Enough
    by White and Williams LLP on April 2, 2025 at 2:28 pm

    In State Farm Fire & Cas. Co. a/s/o Miriam Perez v. Pentair Flow Techs., LLC No. 7:21-CV-6679, 2025 U.S. Dist. LEXIS 36875, the United States District Court for the Southern District of New York (District Court) reconsidered whether the plaintiff established sufficient circumstantial evidence to move forward with its product liability claim against the defendant. The District Court, again, denied the defendant’s motion for summary judgment, finding that the circumstantial evidence presented by...By: White and Williams LLP

  • Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review
    by J.S. Held on April 2, 2025 at 1:07 pm

    In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround their business – particularly when it comes to quality and reimbursement. Whether it’s navigating a billing dispute or malpractice litigation, responding to regulatory investigations or assessing medical necessity for services, healthcare providers, payers, and life science...By: J.S. Held

  • Policyholder Files Suit for Cyber Attack and Argues Endorsement is Not Part of Policy
    by Morris, Manning & Martin, LLP on April 2, 2025 at 12:28 am

    In Conesys, Inc., et al. v. Palomar Excess and Surplus Ins. Co. a policyholder filed a lawsuit alleging breach of contract and bad faith, among others, based on an insurer's application of an “Extortion Threat Sublimit Endorsement” to a cyber attack....By: Morris, Manning & Martin, LLP

  • A Regulatory Assessment of AI Performance Guarantees
    by Holland & Knight LLP on April 1, 2025 at 8:49 pm

    With the warranty industry evolving in the U.S., companies seeking to modernize conventional warranties by leveraging advanced technologies such as artificial intelligence (AI) are faced with unique regulatory questions and risks....By: Holland & Knight LLP

  • “Other Insurance” Issues with Additional Insureds and Indemnity
    by Maynard Nexsen on April 1, 2025 at 6:15 pm

    Excess insurance policies are generally written to be just that; they—through their “other insurance” provisions—purport apply in excess of other insurance available to the insured. In many jurisdictions, courts will commonly enforce “other insurance” provisions that are consistent and disregard “other insurance clauses” that are “mutually repugnant.” See, e.g., Safeco Ins. Co. of Illinois v. Harleysville Ins. Co., 580 F. Supp. 3d 1079, 1084 (M.D. Ala. 2022). This doctrine allows, with...By: Maynard Nexsen

  • RWI Retention Dropdowns: How They Work and Why They Matter
    by Woodruff Sawyer on April 1, 2025 at 6:13 pm

    As a transactional liability brokerage, we place policies including reps and warranties insurance (RWI), tax liability policies, and contingent liability policies. We also oversee claims for these policies. As someone who handles both, I recently had a client pose a claim question that can be confusing to many people: What is an RWI retention dropdown and how does it work? This question highlights a topic that often requires clarification in the realm of policy and claim management....By: Woodruff Sawyer

  • The SEC Effectively Ends Climate Disclosure Requirements Under Trump Administration
    by Womble Bond Dickinson on April 1, 2025 at 5:47 pm

    On Thursday, March 27, 2025, the U.S. Securities and Exchange Commission announced via letter to the U.S. Court of Appeals for the Eighth Circuit that SEC attorneys would no longer defend its climate change disclosure rules....By: Womble Bond Dickinson

  • Decisions Expand Scope of Business Owners’ Policy Exclusion
    by Maynard Nexsen on April 1, 2025 at 4:42 pm

    In the age where cling wrap doesn’t cling and “shrinkflation” is a necessary portmanteau, it’s rare to get more. This is especially true for insurers, whose policies are construed against them when ambiguous, and particularly when such ambiguity excludes coverage. But in recent months, two courts have opted to give insurers more, holding that Abuse or Molestation Exclusions include not just negligent employment and supervision allegations, but also claims for negligent training....By: Maynard Nexsen

  • Effective Risk Management for Nursing Facilities: Insurance Insights on Retaliation Claims
    by Bradley Arant Boult Cummings LLP on April 1, 2025 at 4:30 pm

    This is the first in a series of articles addressing critical issues in risk management and insurance for skilled nursing facilities. Owners and operators of skilled nursing facilities know that a claim or lawsuit against their facility is not a matter of if, but when. Procuring the proper insurance is critical to effectively managing and mitigating these risks. A professional liability insurance policy should provide coverage for the facility and its directors, administrators, and employees...By: Bradley Arant Boult Cummings LLP

  • United States Court of Appeals Enforces Arbitration Agreement Against Third-Party Non-Signatories
    by Miller Canfield on April 1, 2025 at 4:13 pm

    Arbitration agreements often seem straightforward—until they unexpectedly bind parties who never signed them. The United States Court of Appeals for the Eleventh Circuit’s recent decision in Various Insurers v. General Electric International, Inc., ___ F.4th ___ (11th Cir. 2025), underscores the reach of arbitration clauses and the courts’ willingness to enforce them against third parties....By: Miller Canfield

  • Non-Creditor was Entitled to Actual Notice of A Chapter 11 Plan’s Injunction Barring Suits Against Insurance Carriers
    by Patterson Belknap Webb & Tyler LLP on April 1, 2025 at 3:34 pm

    A federal district judge recently affirmed a bankruptcy judge’s ruling that a non-creditor was entitled to actual notice of an injunction that would bar the non-creditor from suing the debtors’ insurance carriers. In re Boy Scouts of America and Delaware BSA LLC, No. 24-382, 2025 WL 893001 (D. Del. Mar. 24, 2025). The trustee had argued that the non-creditor was entitled to constructive notice, not actual notice....By: Patterson Belknap Webb & Tyler LLP

  • Pennsylvania Federal Court Holds Notice of Intent to File Third-Party Complaint Constitutes a “Claim”
    by Wiley Rein LLP on April 1, 2025 at 3:00 pm

    The United States District Court for the Eastern District of Pennsylvania, applying Pennsylvania law, has held that a letter notifying the insured of the sender’s intent to file a joinder complaint, i.e., a third-party claim, against it constituted a Claim under the insured’s claims-made professional liability insurance policy....By: Wiley Rein LLP

  • Multi-Party Construction Mediations and How to Address Them
    by Miles Mediation & Arbitration on April 1, 2025 at 2:27 pm

    Multiparty construction mediations are often complicated due to the number of liability, causation, and damages issues. Whether the mediation occurs prior to litigation or after litigation is initiated, there are several tasks the mediator, or neutral, must perform to help the parties reach resolution. Originally published in Missouri In-House Counsel March 2025....By: Miles Mediation & Arbitration

  • FEMA Order Provides Debris Removal Benefits to Certain Commercial Businesses Damaged By LA Wildfires, But Window to Obtain Benefits Closes April 15, 2025
    by Buchalter on April 1, 2025 at 2:15 pm

    The Buchalter LA Wildfire Taskforce is happy to report some good news for certain commercial property owners impacted by the LA Wildfires. On March 28, 2025, the Federal Emergency Management Administration (FEMA) agreed to expand the scope of its wildfire cleanup effort. Specifically, FEMA has agreed that certain commercial real properties, residential apartments, condominiums and mobile homes will be included in the US Army Corps of Engineers (USACE) debris removal program....By: Buchalter

  • Medicare Drug Price Negotiation: Saving Money for Medicare, but What About Patients?
    by DLA Piper on April 1, 2025 at 4:07 am

    Evaluating current formulary access for the 25 drugs selected for Drug Price Negotiation in Medicare Part D shows several selected drugs have higher co-pays in 2025 relative to 2024 - Introduction - The Inflation Reduction Act (IRA) is anticipated to result in changes to Medicare beneficiaries' ability to affordably access their medications in the Medicare drug benefit....By: DLA Piper

  • A Deadly Encounter: Court Clarifies Use of Force in Police Shooting of Mentally Ill Individual
    by Marshall Dennehey on April 1, 2025 at 3:34 am

    Key Points: Use of Deadly Force: The court upheld the police officers’ use of deadly force, which is relevant for insurance coverage in similar incidents. Municipal Liability: No liability for the defendant as there was no constitutional violation, impacting municipal coverage decisions....By: Marshall Dennehey

  • Gold Dome Report - Legislative Day 37 - March 2025
    by Nelson Mullins Riley & Scarborough LLP on April 1, 2025 at 3:34 am

    As the end of the 2025 Legislative Session draws near, those who still harbor hope for the legislative process look ahead to next year — with study committees. Everyone’s favorite way to see lawmakers and lobbyists in business casual during the offseason, study committees provide a venue to promote ideas and issues that occasionally make their way into actual legislation....By: Nelson Mullins Riley & Scarborough LLP

  • Reimbursement of Pennsylvania Department of Human Services Lien Is Found Not Automatic by Pennsylvania Commonwealth Court
    by Marshall Dennehey on April 1, 2025 at 3:29 am

    Key Points: No formal liability for payment of work-related medical expenses is triggered on the part of the employer/insurer until such expenses are properly submitted in accordance with the terms and provisions of the Pennsylvania Workers’ Compensation Act and the Medical Cost Containment Regulations....By: Marshall Dennehey

  • A Double Take: Workers’ Compensation Liens Render UIM Non-Duplication Clauses Unenforceable
    by Marshall Dennehey on April 1, 2025 at 3:03 am

    Key Points: Delaware Superior Court permits injured plaintiffs-employees to board medical bills and lost wages already paid by the workers’ compensation carrier in subsequent UIM claim related to the same incident, despite a non-duplication clause in UIM policy....By: Marshall Dennehey

  • Adequate Notice Requires More Than the Delivery of a Policy
    by Marshall Dennehey on March 31, 2025 at 10:22 pm

    Key Points: Supreme Court of Idaho on December 31, 2024, reversed and remanded district court’s grant of summary judgment in favor of builder who asserted negligence claims against its insurance company and sought damages for the insurance agent’s failure to include the real property at issue in renewal of insurance policy....By: Marshall Dennehey

  • Notice Prejudice Rule Applies to Claim Not Reported “As Soon As Practicable” But Within Policy Period
    by Wiley Rein LLP on March 31, 2025 at 5:10 pm

    The United States District Court for the District of Kansas, applying Kansas law, has held that an insurer must show prejudice to deny coverage when an insured provided notice of a claim within the policy’s three-year policy period, but not “as soon as practicable” as required by the policy’s notice provision....By: Wiley Rein LLP

  • UK Consumer Duty rule review: FCA sets out ‘targeted steps’ to simplify requirements for firms
    by Hogan Lovells on March 31, 2025 at 5:08 pm

    Following feedback to its July 2024 Call for Input (CfI) on placing greater reliance on the Consumer Duty instead of specific rules and guidance, the FCA won’t be carrying out a wholesale Handbook review. It has instead identified ‘targeted steps’ to amend or simplify discrete areas of its rules. Where possible, it will take advantage of current work to make the changes – a number of which are still subject to future industry engagement....By: Hogan Lovells

  • Seoul Medical Group and Renaissance Imaging Medical Associates Settle Medicare Risk Adjustment Fraud Case for $62 Million
    by Bass, Berry & Sims PLC on March 31, 2025 at 2:22 pm

    The Department of Justice announced this week that California-based primary care provider Seoul Medical Group, Inc. (SMG), SMG’s former president and majority owner, and California-based radiology group Renaissance Imaging Medical Associates Inc. (Renaissance) will pay a combined $62.85 million to resolve allegations of False Claims Act violations related to the submission of unsupported diagnosis codes to Medicare Advantage Organizations in order to increase reimbursement from the government....By: Bass, Berry & Sims PLC

  • Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court
    by ArentFox Schiff on March 31, 2025 at 2:14 pm

    The US District Court for the Eastern District of New York in Manalapan Surgery Ctr., et al. v. 1199 SEIU National Benefit Fund, No. 23-CV-03525 (EDNY March 12, 2025), recently granted a motion to dismiss a complaint filed by four out-of-network ambulatory surgery centers against 1199 SEIU National Benefit Fund....By: ArentFox Schiff

  • Brasília em Pauta – Edição Nº 192
    by Mayer Brown on March 29, 2025 at 4:01 am

    PAUTAS: STF – CONTROLE CONCENTRADO E REPERCUSSÃO GERAL | STJ – REPETITIVOS | TCU – PLENÁRIO | CÂMARA DOS DEPUTADOS | SENADO FEDERAL - Prezados e prezadas, O “Brasília em Pauta” é um boletim semanal preparado pela equipe de Contencioso de Brasília, contendo os principais casos a serem julgados pelo Supremo Tribunal Federal (STF), Superior Tribunal de Justiça (STJ) e Tribunal de Contas da União (TCU), bem como importantes questões a serem votadas pela Câmara dos Deputados e Senado Federal....By: Mayer Brown

  • A Carrier May Have No Duty to Defend an Intentional Injury Claim Against an Employer Arising from a New Jersey Workers’ Compensation Case
    by Marshall Dennehey on March 29, 2025 at 3:49 am

    Key Points: A workers’ compensation insurance carrier normally does not have a duty to pay benefits for an intentional injury claim....By: Marshall Dennehey