News & Analysis as of

Reimbursements Insurance Industry

Cozen O'Connor

Minnesota AG Settles with Blue Cross Blue Shield over Mental Health Parity

Cozen O'Connor on

Minnesota AG Keith Ellison has reached a settlement with BCBSM, Inc. d/b/a Blue Cross and Blue Shield of Minnesota, and HMO Minnesota d/b/a Blue Plus (collectively, “Blue Cross”) to resolve allegations that the insurer...more

McDermott Will & Emery

Trending in Telehealth: September 17 – 30, 2024

McDermott Will & Emery on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate...more

Buchalter

Actual Loss Under A Title Insurance Policy Is Calculated Based On The “Highest And Best Use” Of The Insured Real Property

Buchalter on

In a victory for all insureds who have title insurance policies, and possibly a victory for insureds under other real property related insurance policies, the California Court of Appeal in Tait v. Commonwealth Land Title...more

Rivkin Radler LLP

High-Profile Sports Insurance Fraud Rings: A Recent Conviction

Rivkin Radler LLP on

No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more

Foley & Lardner LLP

Artificial Intelligence in Health Care: Key Considerations for Oncology

Foley & Lardner LLP on

Artificial intelligence (AI) has the power to revolutionize health care. In oncology, there are now opportunities to apply AI to support diagnostics, predictive analytics, and administrative functions. This hot topic was...more

ArentFox Schiff

No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

ArentFox Schiff on

On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - June 2024

Saul Ewing LLP on

This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more

Rumberger | Kirk

Florida Supreme Court Says Permissive Language of Florida PIP Statute and Policy Provisions Dictate Payment of Medical Expenses by...

Rumberger | Kirk on

In Florida, personal injury protection (PIP) coverage limits reimbursement of medical charges to 80% of “all reasonable expenses.” What is “reasonable” is generally determined by a statutory schedule of maximum charges...more

Frantz Ward LLP

Sixth Circuit Revives an Equitable Claim for Disgorgement Under ERISA Where an Insurer Obtained Reimbursement is Not Set Forth in...

Frantz Ward LLP on

In Patterson v. United Healthcare Insurance Company, 76 F.4th 487 (6th Cir. 2023), the Sixth Circuit held that the plaintiff insured had stated an equitable claim for disgorgement under ERISA where he sought disgorgement of...more

Flaster Greenberg PC

What Types of Art Insurance Coverage & Provisions Are Available?

Flaster Greenberg PC on

Fine Art Title Insurance Artwork title insurance reimburses an insured if another owner makes a claim to the title of a piece of artwork that the insured purchased. This is an important coverage, which is often purchased...more

White and Williams LLP

First Circuit Limits Insurers’ Right to Recoup Defense Costs, Settlement Payments

White and Williams LLP on

Weighing in on an issue that has divided courts nationwide, the U.S. Court of Appeals for the First Circuit has ruled that an insurer under Massachusetts law has no right to recoup defense costs, or amounts the insurer pays...more

Farella Braun + Martel LLP

When Can an Insurer Pursue a Malpractice Claim Against Defense Counsel Retained for an Insured? Part II: When Can an Insurer...

In Part I (”When Can an Insurer Pursue a Malpractice Claim Against Defense Counsel Retained for an Insured”) of our two-part article published by the ABA’s Insurance Coverage Litigation Committee (ICLC), we addressed the...more

McDermott Will & Emery

Mobility@McDermott: Monthly Update (01/2024)

1. German Federal Court of Justice rules on reimbursement of disputed workshop invoices by insurance companies - On 16 January 2024, the German Federal Court of Justice (Bundesgerichtshof, “BGH”) decided five cases, all...more

Marshall Dennehey

County Court Rules that Insurer’s Action Seeking Reimbursement from School Board for PIP Benefits Paid on Behalf of Insured Is Not...

Marshall Dennehey on

Orange Cty. Sch. Bd., a/k/a Orange Cty. Public Schools, County Court 9th Judicial Circuit Orange County, Civil Division, Case No: 2021-CC-016105-O - State Farm sought reimbursement from the School Board of Orange County for...more

Hinshaw & Culbertson - Insights for Insurers

[White Paper] United States Insurance Trends and Decisions 2023

As 2024 rapidly approaches, we look back at some of the key decisions, trends, and developments impacting the U.S. insurance industry in 2023 and look ahead at some trends and cases to watch in 2024. Insurers continue to...more

Rivkin Radler LLP

Insurance Update - December 2023

Rivkin Radler LLP on

Our December Insurance Update features a few firsts from state high courts. For the first time: •The Supreme Court of Hawaii addresses reimbursement of defense costs. •The Supreme Court of Illinois addresses coverage for...more

Marshall Dennehey

County Court Rules in Favor of Insurer Regarding Application of the 2007 Medicare Part B Non-Facility Limiting Charge

Marshall Dennehey on

Next Medical Florida, LLC a/a/o Marvin Jackson v. United Services Automobile Assoc., Volusia County Case No: 2022-11377-CODL (71) - This suit involved the legal issue of whether or not the insurer was required to reimburse...more

White and Williams LLP

Top Developments October 2023

White and Williams LLP on

DEFENSE COST REIMBURSEMENT - Cont’l Cas. Co. v. Winder Labs., LLC, 73 F.4th 934 (11th Cir. 2023) Eleventh Circuit predicts that, under Georgia law, insurers found to have no duty to defend underlying suits could not...more

Marshall Dennehey

An Insurer Does Not Have a Duty to Investigate Potential Transportation Costs Unless Its Insured Notifies the Insurer That They...

Marshall Dennehey on

Eric R. Cruz v. Security National Ins. Co., Circuit Court, 17th Judicial Circuit in and for Broward County, Case No. CACE 20-00612 (07), Feb. 24, 2023 - The trial court granted the defendant’s motion to dismiss the...more

Marshall Dennehey

County Court Rules in Favor of Plaintiff Regarding Defendant’s Use of Budget Neutrality Adjustor in Calculating Reimbursement Made...

Marshall Dennehey on

ISO Diagnostic Testing Inc. v. United Automobile Ins. Co., Broward County Case No: COINX-22-024098 - This suit was for allegedly underpaid PIP benefits. ISO Diagnostic Testing billed seven units of CPT code 95851. United Auto...more

Marshall Dennehey

2007 Medicare Part B Non-Facility Limiting Charge is Not a Fee Schedule, and Insurers Are Permitted to Use Rates Established by...

Marshall Dennehey on

Progressive Express Ins. Co. v. SimonMed Imaging a/a/o Hilleri Brown, 6th District, Case No. 6d23-1145. L.T. Case No. 2020-SC-043217-O, (48 Fla. L. Weekly D990a) - This suit involved a dispute regarding application of the...more

Marshall Dennehey

Fourth District Court of Appeals Reverses Itself Regarding Application of the 2007 Medicare Part B Non-Facility Limiting PIP...

Marshall Dennehey on

Progressive Select Ins. Co. v. In House Diagnostic Services, Inc. a/a/o Darryl Frazier, No. 4D21-2581 - This suit involved the legal issue of whether Progressive Select Insurance Company incorrectly determined the...more

Proskauer - Employee Benefits & Executive...

Sixth Circuit Highlights Importance of the Plan Document

A recent decision by the U.S. Court of Appeals for the Sixth Circuit (Patterson v. United HealthCare Ins. Co., No. 22-3167, 2023 WL 4882436 (6th Cir. Aug. 1, 2023)) illustrates the importance of clearly describing key plan...more

Pillsbury - Policyholder Pulse blog

Subrogation 101 (and Why Should I Care?)

What is subrogation? Why am I being asked to waive it? Should I care? To answer that last question, let’s take a quick run at the first two. What Is Subrogation? “Subrogation” refers to the act of one person or party standing...more

Lowenstein Sandler LLP

Finding the Right Fit: The Duty to Defend vs. the Duty to Reimburse (Part II)

Lowenstein Sandler LLP on

Hosts Lynda A. Bennett and Eric Jesse of Lowenstein’s Insurance Recovery Group continue their discussion about the difference between the duty to defend, the duty to reimburse, and the duty to advance. They run through the...more

74 Results
 / 
View per page
Page: of 3

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide