Recent Publications


Circuit Court Rejects FMLA Interference Claim Against Secondary Employer
November 30, 2013 | Insurance Coverage | Appeals

Keppel Amfels L.L.C., which builds and repairs offshore drilling platforms and marine vessels at the Port of Brownsville, Texas, relies on lease-labor and temporary staffing agencies, including Perma-Temp Personnel Services, Inc., to staff about half of its local work assignments. Although these agencies fill “temporary” positions, some placements last for several years.

Keppel Amfels and

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Agency Misunderstood Effect of Exclusion, Circuit Rules in Affirming Decision in Favor of Insurer
November 30, 2013 | Insurance Coverage

The U.S. Court of Appeals for the Sixth Circuit has affirmed a district court’s decision in favor of an insurance company, ruling that an errors and omissions policy did not cover alleged intentional misconduct and that the insured had “misunderst[ood]” the effect of a provision in the policy’s “Exclusions” section. 

The Case

One insurance agency

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Policy Excluded Coverage Even if Insured’s Voluntary Intoxication Affected His Intent, Court Rules
November 30, 2013 | Insurance Coverage

A federal district court in Georgia has ruled that a homeowner’s insurance policy excluded coverage for claims that the insured had assaulted his daughter-in-law even if the insured’s voluntary intoxication had affected his intent. 

The Case

A woman sued her father-in-law, alleging that, after they had left a bar, he was intoxicated, placed her in

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Reinsurer’s Denial Letters Doom Insurer’s “Equitable Estoppel” Argument for Coverage
November 30, 2013 | Insurance Coverage

A federal district court in Florida has rejected an insurance company’s argument for coverage under a reinsurance treaty on the basis of equitable estoppel.

The Case

A contractor entered into a contract with a city in Florida to relocate utilities within the right-of-way along Florida State Road 50. At the completion of the project, the

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Court Says There May Be No Coverage Even If Pedestrian Acted Intentionally in Collision with Vehicle
November 30, 2013 | Insurance Coverage

A federal district court in Michigan has refused to dismiss an insurer’s declaratory judgment action, ruling that an alleged collision between a pedestrian and a vehicle might not have been an “accident” for purposes of the insureds’ no-fault insurance policy if the pedestrian’s intentional acts had led to the collision.

The Case

An insurer sought

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Policy’s Intentional Acts Exclusion Bars Coverage Even Where Insured May Have Lacked Mental Capacity to Govern His Conduct
November 30, 2013 | Insurance Coverage

A federal district court in Pennsylvania has ruled that an intentional acts exclusion in a homeowner’s insurance policy barred coverage of claims arising from an assault even where the defendant may have lacked the mental capacity to govern his conduct.

The Case

The administrator of the estate of a deceased man sued a couple and

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Public Health and Health Planning Council Releases Ambulatory Care Services Report
November 30, 2013 | Health Services

The New York State Public Health and Health Planning Council (the “Council”) recently released a draft report on ambulatory care services, including most notably a discussion of retail clinics, urgent care centers, and freestanding emergency departments. The report was reviewed at a full meeting of the Council on December 12th, and is slated to be

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Measuring Compliance Risk in Health Care Transactions
November 30, 2013 | Health Services

Health care compliance attorneys are frequently asked to “rate” the risks around various existing or proposed business arrangements involving medical professionals.  Could a given arrangement be viewed as a violation of the Stark Self-Referral Law (“Stark”) or Anti-Kickback Statute (“AKS”)?  Are there compelling, or at least plausible, arguments for why the arrangement should instead be

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Program of All-Inclusive Care for the Elderly (“PACE”)
November 30, 2013 | Health Services

I.  Introduction and Background of PACE

The Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive long term services and support to Medicaid and Medicare enrollees.  A multi-disciplinary team of health professionals provides individuals with coordinated care.  For most participants, the comprehensive service package enables them to receive care at home rather than receive

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Fool’s Gold: How To Avoid Suspect Business Arrangements in Diagnostic Testing Ventures
November 30, 2013 | Health Services

The lure of easy money can draw some radiologists to engage in conduct reflecting what is, at best, an alarming lack of awareness and, at worst, a deliberate disregard of the serious criminalliability1 risks entailed in entering into certain suspect business arrangements  with diagnostic testing ventures. Radiologists must understand these liability risks in order to

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Telehealth and Newly Approved CPT Codes
November 30, 2013 | Health Services

Medicare’s 2014 Physician Fee Schedule includes several new Telehealth services and service regions that will be reimbursed under the Medicare Program beginning in 2014. 

The new Fee Schedule will expand the geographic areas Medicare will cover Telehealth, expanding into the “fringes of metropolitan areas.”  The American Telemedicine Association has stated this will enable providers to

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Medicaid Redesign Team Releases Draft RFQ for Health and Recovery Program
November 30, 2013 | Health Services

On December 9th, the Department of Health (“DOH”), the Office of Mental Health (“OMH”), and the Office of Alcoholism and Substance Abuse Services (“OASAS”) released a Request for Information (“RFI”) and a draft Request for Qualifications (“RFQ”) for Health and Recovery Programs (“HARPs”) as part of the efforts of the Behavioral Health Workgroup of the

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New York Court holds that parents may assert legal malpractice as a defense to fee claims arising from attorneys’ representation of their children.
November 30, 2013 | Insurance Coverage | Directors & Officers Liability | Complex Torts & Product Liability | Professional Liability

Traditionally in New York, law guardians appointed in custody disputes were often viewed as taking on a role similar to that of a guardian ad litem, advocating for what they believed to be the best interests of the child, rather than advocating for the outcome desired by the child. Because these law guardians were often

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The Case for Allowing Insurers to Recover Attorneys’ Fees in Fraud Suits
November 1, 2013 | Appeals | Insurance Coverage

AMERICAN BAR ASSOCIATION – MASS TORTS & DEVELOPMENTS

After an employee of Glasbern Inc. was injured, the company’s Workers’ Compensation insurer, Zenith Insurance Company, began paying Workers’ Compensation benefits to him. Thereafter, Zenith sued Glasbern, Glasbern’s owner, Albert Granger, and its insurance broker, alleging that it only had issued and renewed the policy as a

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New York Insurance Coverage Law Update
November 1, 2013 | Insurance Coverage

New York’s Top Court Answers Two Certified Questions About “Vandalism”

The walls and foundation of the insured’s building allegedly cracked as a result of the acts of an allegedly irresponsible excavator working on neighboring property. In response to two questions certified by the Second Circuit, the New York Court of Appeals ruled that (1) a

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