News & Analysis as of

Insurance Industry Claim Procedures

Zelle  LLP

When Are Insurance Code Chapter 542 Penalties Not Owed?

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There are a litany of deadlines an insurer must be mindful of, and this is especially true in Texas, which imposes a number of statutorily prescribed deadlines during the claim adjustment process. The Texas Prompt Payment of...more

Wiley Rein LLP

Court Requires Insurer Show Prejudice for Coverage Denial Where Notice of Claim Given After Reporting Window but Within Policy...

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The United States District Court for the Eastern District of Oklahoma, applying Oklahoma law, granted an insured’s motion for summary judgment, finding that a claim was sufficiently made and reported during the policy period....more

Eversheds Sutherland (US) LLP

DOL hears an ERISA claimant on access to audio recordings

In a June 14, 2021 information letter, the US Department of Labor (DOL) opined that a claimant appealing an adverse benefit determination under a plan covered by the Employee Retirement Income Security Act of 1974, as amended...more

Robinson+Cole ERISA Claim Defense Blog

Disability Claims Regulations and the COVID-19 Pandemic

Those involved in disability claims administration may wish to consider the potential impacts of the current global pandemic. In the current crisis, disability claims regulations may not be at the top of many peoples’ minds....more

White and Williams LLP

Eleventh Circuit Reinforces the Importance of Broad-Form Language in “Related Claims” Provisions

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“Related claims” provisions are critical and necessary elements of “claims made” policies. That is because “claims made” policies cover only those claims that are first made — or are deemed first made — during the policy...more

McGuireWoods LLP

Hurricane Florence Commercial Property Damage and Business Interruption Insurance Checklist

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Over the weekend, Hurricane Florence caused substantial damage in many communities in North and South Carolina. Early estimates put the damages from Florence in the billions of dollars. These losses include both direct...more

Winstead PC

Bullet Proofing Your Claims Procedures

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Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more

Bass, Berry & Sims PLC

Action Needed by Certain ERISA Plans – New Disability Claims Procedures Apply Beginning April 2018

In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more

Farella Braun + Martel LLP

Insurance Broker Series: Cris Christensen, ABD Insurance and Financial Services

Farella’s Insurance Recovery Group lawyers regularly collaborate with and learn from different players and functions within the insurance industry. To provide more value to our readers, we have reached out to a series of...more

Carlton Fields

Too Little, Too Late: The Harsh Bright Line of Suit Limitation Provisions

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Approximately twenty percent of Americans have been classified as chronic procrastinators, which means one in five policyholders faces a potential problem when suing for coverage. While the statute of limitations for breach...more

Carlton Fields

Catching Up To Insurers’ Use of Big Data

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Various groups within the NAIC are beginning to study the way in which insurers are using big data. On the property and casualty front, the Market Regulation (D) (Market Reg) Committee is reviewing the use of big data in...more

K&L Gates LLP

HUD’s Proposal to Terminate FHA Insurance Policies Could Terminate the FHA Program

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If there is anything that galls servicers of government-insured loans, it is the forfeiture or curtailment of all accrued interest from mortgage insurance claims resulting from the failure to foreclose fast enough within...more

Zelle  LLP

A Primer on Insurance Underwriting in China

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China is one of the largest and fastest-growing insurance markets in the world. It provides the global insurance and reinsurance industry with tremendous opportunities but also presents challenges with its unique legal and...more

Carlton Fields

Seeing the Finish Line: Courts Increasingly Exempt Claims-Made Policies from the Notice Prejudice Rule

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In a majority of jurisdictions, the “notice-prejudice rule” provides that an insurer may not deny a claim on grounds of late notice without demonstrating prejudice. The rule is statutory in some states and judicially crafted...more

Saul Ewing LLP

Bad Faith Sentinel - April 2015

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In This Issue: - En Banc Mississippi Court of Appeals Affirms Summary Judgment for Insurer, Adjuster and Employer on Bad Faith Claims Arising from Denial of Coverage and Benefits for Work-Related Injury -...more

Pullman & Comley, LLC

Start Spreading the News: With National Union v. TransCanada, New York Prepares to Broadcast Communications with Coverage...

Pullman & Comley, LLC on

The final opinion of a New York appellate court in National Union Fire Ins. Co. of Pittsburgh v. TransCanada Energy USA, Inc., 119 A.D.3d 492 (2014), is only three paragraphs long, but it raises a host of questions about how,...more

Cozen O'Connor

An Insurer Cannot Claim That It Was Unaware of Claims Handling Statutes As A Defense To Bad Faith

Cozen O'Connor on

The South Dakota Supreme Court in Bertelsen v. Allstate Insurance Co., 833 N.W.2d 545, No. 26442 (June 12, 2013) (1) held that an insurer cannot avoid bad faith liability by claiming it did not know about controlling claims...more

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