The Oregon Supreme Court has overruled a 1973 decision and concluded that a covenant not to execute obtained in exchange for an assignment of rights did not, by itself, extinguish an insured’s or its insurer’s liability.

The Case

The Brownstone Homes Condominium Association alleged that it discovered various defects in the construction of its condominium complex.  

A federal district court in Massachusetts has ruled that an insurance company did not have a duty to defend its policyholders in a lawsuit against them alleging the commission of three intentional wrongs arising from a dispute among neighbors.

The Case

Kenneth and Donna Kaplan, residents of Hull, Massachusetts, were sued in a Massachusetts state

West Virginia’s highest court, the Supreme Court of Appeals of West Virginia, has reversed an $8 million judgment against an insurance company, ruling that the late notice provided by the insured precluded coverage under the policies – and that the insured’s loss of its own insurance policies did not excuse its duty to provide timely

Named Insured’s Negligence Was Not Needed To Trigger Additional Insured Coverage, Northern District Rules

An electrician working for a subcontractor on a construction project sued the general contractor for bodily injury, alleging that he had fallen from a ladder.  The general contractor sought to be defended and indemnified as an additional insured under the subcontractor’s

Sixth Circuit Rules that SPD’s Subrogation Provision Was Enforceable, Even in Absence of a Separate Written Plan

A beneficiary of the health benefits plan established under the Employee Retirement Income Security Act of 1974 (ERISA) by a trust agreement entered into by participating elevator companies and the Board of Trustees of the National Elevator Industry

Health Republic Insurance of New York (“Health Republic”) has announced that it will not offer coverage after November 30, 2015 leaving over 200,000 of its customers scrambling to find new health insurance. Health Republic is one of twenty-three non-profit insurance plans that were created under the Affordable Care Act to increase competition in the insurance

The Department of Health and Human Services, Office of Inspector General (“OIG”) has recently released its Work Plan for Fiscal Year 2016 (“Plan”). The Plan summarizes new and ongoing audits, investigations and evaluations that OIG will prioritize in the upcoming year.

While many of the areas of focus addressed in the Plan are similar to

Reports have surfaced that the federal government is preparing to announce settlements under the False Claims Act with hundreds of hospitals as part of a nationwide enforcement initiative into the suspected overuse of implantable cardiac devices, referred to as Implantable Cardioverter Defibrillators (“ICDs”).[1]  There reportedly are more than 500 hospitals under investigation, many if not

One of the hallmarks of a claims-made and reported policy historically has been the two-pronged requirement that (1) the claim against the insured must be first made during the policy period, and (2) the claim had to be reported to the insurer, if not strictly within the policy period, at least no later than a

As this column regularly observes, insurance companies frequently use civil litigation as a tool to fight insurance fraud,1 including fraud involving life insurance policies.2 Insurance fraud, of course, also is a crime,3 and prosecutors often bring criminal actions against those who commit insurance fraud.

Generally speaking, a person convicted of insurance fraud faces a potential

On October 30, 2015 the Centers for Medicare and Medicaid Services (“CMS”) released a final rule that makes significant changes to the Medicare Physician Fee Schedule as well as other payment policies for 2016. Below is a summary of the major policy changes reflected by the rule, specifically provisions regarding the physician self-referral law, payment

Medical, health home, mental health, and other providers licensed by the New York State Department of Health, Office of Mental Health or other governmental agency, and any providers ordering, providing, billing or claiming at least $500,000 from Medicaid in a consecutive twelve month period, are required to have an effective compliance program. Those providers must

In a case closely followed by all advertisers in general and the dietary supplement/natural products industry in particular, United States v. Bayer Corp., the United States District Court for New Jersey rebuffed an attempt by the Federal Trade Commission (FTC) to greatly increase the level of proof required for an advertiser to substantiate health related

An appellate court in Illinois, affirming a trial court’s decision, has ruled that a policy exclusion precluded coverage for claims against an insured for violation of the federal Telephone Consumer Protection Act of 1991 (TCPA), conversion, and violations of the Illinois Consumer Fraud and Deceptive Business Practices Act (the “Illinois Act”).

The Case

Wellington Homes,

The Vermont Supreme Court, affirming a trial court’s decision, has ruled that an insured had breached his insurance policy’s cooperation clause and that, as a result, his insurance carrier had no obligation to defend or indemnify him in connection with an underlying personal injury claim.

The Case

Charles Chandler asserted that his then-girlfriend, now-wife, Faye