Industry Updates

On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party billing agent, manipulated the federal No Surprises Act’s (NSA) independent dispute resolution (IDR) process....By: ArentFox Schiff

On May 21, 2025, CMS announced that it plans to increase its auditing efforts for Medicare Advantage (MA) plans. Effective immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits, and it will increase resources to complete audits for payment years 2018 through 2024 given that CMS is several years behind in completing these audits....By: King & Spalding

The Pensions Regulator (TPR) has published guidance for trustees on new models and options for DB and hybrid pension schemes. While some of these are endgame options, the guidance also covers options for improving financial outcomes, scheme governance and security for members while the scheme is ongoing....By: Mayer Brown

Welcome to the latest edition of the Conyers Bermuda Insurance Bulletin. It is hard to believe that the second quarter of the year is well underway! The Bermuda (re)insurance sector has had a strong start to 2025 following a busy 2024. During the course of last year, 75 new insurers and intermediaries were registered on the island, compared with a total of 67 registrations in 2023....By: Conyers

In connection with the increase in the number of incidents and attacks, the scope and impact of the incidents and attacks are also growing. With the rise in frequency and impact of cybersecurity incidents and cybercrimes, many companies are left wondering when (not if) they will be targeted and how large of a cost it will be....By: Ward and Smith, P.A.

The recent New York Court of Appeals decision in Matter of Schulze v. City of Newburgh Fire Department (April 10) has significant implications for municipal employers and workers’ compensation insurance carriers in New York, particularly regarding reimbursement rights for disability benefits paid to firefighters under General Municipal Law (GML) § 207-a. Below is a concise......By: Goldberg Segalla

Louisiana’s Direct Action Statute was recently amended to remove the right of an injured person or, if deceased, the statutory beneficiaries, to bring a direct action claim against a tortfeasor’s insurer, except in certain, narrow exceptions, as set forth in the statute.1 Since the amendment became effective on August 1, 2024, significant litigation has ensued regarding whether the amendment can be applied retroactively when a plaintiff has filed suit before the amendment’s effective date....By: McGlinchey Stafford

Indiana recently enacted significant new legislation that will impact how pharmacy benefit management services are provided in Indiana. Senate Bill 140 (SB 140), signed into law during the 2025 legislative session, imposes wide-ranging reforms on pharmacy benefit managers (PBMs)....By: Quarles & Brady LLP

The Departments of Labor, Treasury, and Health and Human Services (the “Departments”) recently announced a nonenforcement policy with respect to the 2024 Mental Health Parity and Addiction Equity Act (“MHPAEA”) regulations or otherwise pursue enforcement actions based on a failure to comply, at least temporarily. The Departments appear to have taken this approach to be consistent with a pending lawsuit challenging the 2024 regulations......By: Holland & Hart - The Benefits Dial

This blog discusses the regulatory requirements that apply to risk-bearing entities in Massachusetts, including recent updates introduced by Chapter 343 of the Massachusetts Acts of 2024 (the Act). This blog is part of Foley & Lardner’s RBE series (see our Introduction posted November 18, 2024, and our post on New York and New Jersey’s Requirements posted February 24, 2025)....By: Foley & Lardner LLP

In Tokio Marine & Nichido Fire Insurance v Honda Canada, 2025 ONSC 2856, the Ontario Superior Court upheld an arbitral panel's conclusion that an umbrella insurance policy covered settled class counsel fees, but not settlement administration costs related to an enhanced recall. The underlying class action alleged airbag defects and the settlement provided certain benefits to reimburse class members. The decision reminds defendants that insurance may not cover a recall program within a settlement...By: Bennett Jones LLP

When people see a car flipped over in an accident, they often react with a shudder and assume it’s pretty serious. Similarly, if you consider what happens when two cars hit head-on, you might assume it would result in a serious accident and that the people involved could be hurt very badly....By: Searcy Denney Scarola Barnhart & Shipley

Once in a while, there is an insurance case that addresses numerous “common” issues and reaffirms the parties’ respective duties in supporting and adjusting claims, promptly making repairs, and mitigating loss. The recent Fifth Circuit opinion in Matter of New York Inn, Inc., No. 24-10338, 2025 WL 999084, at *1 (5th Cir. Apr. 3, 2025) is such a case and provides parties and lower courts in Texas with legal guidance on a number of issues surrounding property damage claims....By: Zelle LLP

In an opinion issued on May 8, 2025, the Second Circuit Court of Appeals addressed two cases: Certain Underwriters at Lloyd’s London v. 3131 Veterans Blvd LLC and Certain Underwriters at Lloyd’s London v. MPIRE Properties LLC. At issue in both cases was an insurance policy issued by surplus lines insurers that included a mandatory arbitration clause covering “all matters in difference between the Insured and the [Insurers] … in relation to this insurance” and directing that the arbitration take...By: Carlton Fields

In a recent important decision, the Supreme Court of Appeals of West Virginia formally recognized that a third party can sue an employer for negligent supervision of an employee, even if the employee’s intentional or reckless conduct is the basis for the claim....By: Steptoe & Johnson PLLC

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care providers....By: Jones Day

Pennsylvania House Bill 183 (HB 183) introduces substantial amendments to Section 306(c)(22) of the Pennsylvania Workers’ Compensation Act. If enacted, the proposed changes will have significant implications for injured workers, employers, and insurers by expanding the scope and duration of disfigurement claims and altering the payment structure for benefits....By: Goldberg Segalla

For ultra-high-net-worth individuals (UHNWIs) whose estates far exceed the 2025 federal lifetime exemption of $13.99 million per person, the stakes for estate and asset protection planning have never been higher-or more urgent. With the current exemption set to plummet at the end of 2025, and a flat 40% federal estate tax rate looming over every dollar above that threshold, families who postpone planning risk devastating financial consequences. The complexity of these estates, often comprising...By: Mandelbaum Barrett PC

Latney v. Fernandez, 2025 WL 457693, No. HHD-CV-23-6168441S (Sup. Ct Hartford, Feb. 6, 2025) - The Superior Court of Connecticut denied a motion for summary judgment to dismiss a claim for uninsured motorist benefits because they found that the defendant failed to prove that the plaintiff had not exhausted the underlying limits of the alleged tortfeasor....By: Marshall Dennehey

Key Takeaways: A Florida-based Health Maintenance Organization (HMO) was fined for contracting with a Third Party Administrator (TPA) that was not licensed in Florida, violating its statutory obligation to ensure competent administration under Florida law....By: Polsinelli

Georgia Governor Brian Kemp signed sweeping tort reform legislation into law on April 21, 2025. Senate Bills 68 and 69, which narrowly passed the House after receiving unanimous support in the Georgia Senate, were identified as a legislative priority by both Governor Kemp and members of the General Assembly earlier this year....By: Morris, Manning & Martin, LLP

School Board of Marion County v. State Farm Mutual Automobile Insurance Company, 397 So. 3d 248 (Fla. 5th DCA Nov. 21, 2024) - An insurance carrier sought reimbursement for PIP benefits paid following a school bus accident, arguing that legislative statutes waiving sovereign immunity applied to the case....By: Marshall Dennehey

When you get injured in a car accident, your legal rights are determined by Florida law. Due to some unique aspects of Florida law, understanding your legal rights is often easier said than done. With that said, understanding your legal rights is also extremely important—and this is one of many reasons why it is important to have an experienced Florida accident lawyer on your side....By: Searcy Denney Scarola Barnhart & Shipley

This chapter of the Encyclopaedia of Prudential Solvency focuses on the prudential solvency regime of the Cayman Islands, a prominent (re)insurance hub. The Cayman Islands initially rose to prominence in the insurance industry in the late 1970s with the creation of an internationally recognised legal framework. Since then, the territory has grown into a global centre for international insurance business. It is the second largest jurisdiction for captives, and is the number one destination for...By: Skadden, Arps, Slate, Meagher & Flom LLP

Welcome to our fifth issue of The Site Report for 2025! In this edition, we address North Carolina's insurers' duties, the increases and decreases in construction for renewable energies, construction and tariffs, and the increase in construction for certain states....By: Spilman Thomas & Battle, PLLC

On May 1, Pennsylvania Governor Josh Shapiro announced a new centralized consumer protection hotline, website, and email address, providing residents with streamlined access to state agencies for reporting scams, financial misconduct, and insurance-related disputes. The rollout is part of a broader push by Pennsylvania to expand state-level enforcement amid a shift in federal priorities....By: Sheppard Mullin Richter & Hampton LLP

The increasing volume of litigation involving Poly- and Perfluoroalkyl Substances (PFAS) presents substantial financial and operational uncertainties for the insurance sector. Due to their environmental persistence and toxicological composition, PFAS-related claims alleging bodily injury, property damage, and ecological contamination have escalated. This article analyzes comprehensive strategies insurers can implement to limit liability exposure and mitigate environmental coverage claims....By: McGlinchey Stafford

On April 30, the Federal Bureau of Investigation (FBI) released a Public Service Announcement warning consumers about fraudulent discount medical scams. These scams typically involve deceptive offers for health insurance plans that, in reality, provide little to no legitimate coverage. Scammers are contacting people through text messages, phone calls, or emails falsely claiming to represent well-known insurance providers, or using high-pressure tactics to convince individuals to sign up quickly...By: Rivkin Radler LLP

On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion bills, Senate Bill 322 and House Bill 1460, as an opportunity to prioritize patients over profits....By: Goodwin

With the SPAC market heating up, we are seeing a huge uptick in activity on the SPAC IPO side. All these new SPACs will be searching for great deals in no time, so in this edition of the SPAC Notebook we dive into what is currently happening—or about to happen—with de-SPAC transactions. To delve into this topic, I am joined by two rising stars and partners from Doug Ellenoff's team at Ellenoff Grossman & Schole....By: Woodruff Sawyer