Appeals, Fraud, Insurance Industry

EKRA Gets Teeth: Ninth Circuit Strengthens EKRA Enforcement in Schena Ruling

Polsinelli on 7/14/2025

Key Takeaways - First Appellate Interpretation of EKRA: The Ninth Circuit’s decision in United States v. Schena marks the first appellate court interpretation of the Eliminating Kickbacks in Recovery Act (EKRA), affirming...more

Fraud Doesn’t Pay in New York – February 2025 Update

Goldberg Segalla on 3/5/2025

As a part of our Quarterly Practice Group Update, we are pleased to produce another installment with examples of our continued success in the area of fraud litigation. The New York State Workers’ Compensation Board has...more

Two Cases Directly Impacting Insurers are Currently Pending Before the United States Supreme Court

Hinshaw & Culbertson - Insights for Insurers on 11/7/2023

Rulings by the United States Supreme Court profoundly impact insurers as businesses and corporate citizens. Additionally, decisions from the U.S. Supreme Court can also influence claims and policyholders' liabilities for...more

The Haunting in the Cornfield: Relators’ Qui Tam Claim Confirmed Dead by the Eighth Circuit

Bradley Arant Boult Cummings LLP on 10/31/2023

The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more

Fifth Circuit Overturns Receiver’s Settlement Barring Third-Party Claims Against Stanford Financial Insurers

Winstead PC on 6/27/2019

The Fifth Circuit overturned a U.S. District Court’s approval of a settlement between Ralph Janvey, the Receiver for Stanford International Bank, and various insurance company Underwriters, under which the Underwriters had...more

When Is Property Damage From a Release “Expected or Intended”? Only After the Owner Learns of the Spill and Ignores It

Foley Hoag LLP - Environmental Law on 3/14/2019

Any good trial lawyer will tell you that the law is about telling stories. Once upon a time, Timothy and Stacy Creamer bought a house. Only after they closed did they realize that some strategically placed rugs were hiding...more

Plaintiffs’ Notice That the ‘Taxman Cometh’ Was Sufficient to Trigger Statute of Limitations

Carlton Fields on 4/10/2018

In a November 16, 2017 ruling, a California appellate court affirmed a summary judgment ruling in favor of several financial advisors, and insurer American General Life Insurance Company, holding that plaintiffs’ fraud and...more

The Ghost of Systems Past: “Big Data” Suits Loom, But Old Data Issues Remain Unresolved

Pullman & Comley, LLC on 12/24/2016

2017 could be big for litigation over “Big Data” applications in insurance. This past year saw the filing of several “price optimization” class actions, and claims against a fraud detection tool, similar to the ones used by...more

Sixth Circuit: Substantial Risk of Harm and Mitigation Costs Sufficient to Confer Standing in Data Breach Case

Robinson+Cole Data Privacy + Security Insider on 10/20/2016

On October 12, 2016, the U.S. Court of Appeals for the Sixth Circuit denied a petition for an en banc rehearing of its September 12 decision in Galaria, et al. v. Nationwide Mutual Insurance Company (Nos. 15-3386/3387). In...more

Forgery May Not Constitute “Theft” Under an Employee Dishonesty Coverage

Cozen O'Connor on 8/9/2016

Ruling in favor of the insurer on a motion for summary judgment, on July 29, 2016 the Fifth Circuit Court of Appeals held that under the terms of a commercial crime policy, proof of a forgery by the insured’s employee in...more

Phishing for Cybersecurity Coverage: When is a Fraud a “Computer Fraud”?

Carlton Fields on 10/9/2015

In late June, the New York Court of Appeals affirmed a trial court ruling that there was no coverage for a health insurance company policyholder, under a “Computer Systems Fraud” rider issued by its insurer, for an underlying...more

Appellate Courts + STOLI = Mixed Results

Carlton Fields on 6/17/2015

In recent years, federal district courts addressing claims and defenses with respect to stranger-originated life insurance (STOLI) schemes have reached a variety of results. Accordingly, federal appellate courts have...more

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