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Department of Justice (DOJ) Insurance Claims

McGuireWoods LLP

DOJ Targets Neurofeedback Billing in $15 Million Behavioral Health Fraud Case

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On March 6, 2025, federal prosecutors charged a Minnesota couple — Gabriel Adam Alexander Luthor and Elizabeth Christine Brown — with orchestrating a $15 million healthcare fraud scheme involving overbilling and submission of...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

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In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Adams & Reese

Hurricane Helene Federal Disaster Recovery Funding

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Almost exactly two years to the day from when Hurricane Ian (Category 4) struck Florida’s western coast near Cayo Costa, Florida, on Sept. 26, 2024, Hurricane Helene, also a catastrophic Category 4 storm with winds topping...more

Lowenstein Sandler LLP

Closing Coverage Gaps: California Court Emphasizes the Importance of Coordinated Insurance Policies in Complex Claims Environments

Policyholders must be vigilant in coordinating their insurance program across coverage lines in today’s complex claims environment. Often resembling a “patchwork quilt” – modern businesses protect against a wide range of...more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

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On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more

Wiley Rein LLP

Claims Arising from Undisclosed Circumstances Barred by Exclusion in Application

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The United States Court of Appeals for the Sixth Circuit, applying Ohio law, has held that a warranty exclusion barred coverage for a claim arising from circumstances that were not disclosed in an insured’s application for...more

Lowenstein Sandler LLP

In the Know: The Lowenstein Insurance Recovery Group’s Tip of the Month - October 2021

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A recent coverage case from Illinois is a helpful reminder to policyholders that they should not take no for an answer when insurers deny a claim based on uninsurability, restitution, disgorgement, or fraud. In fact, those...more

Robins Kaplan LLP

Financial Daily Dose 3.31.2020 | Top Story: US retail giants furlough hundreds of thousands of workers as locations remain closed

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Macy’s announced on Monday that it will furlough most of its nearly 130,000 workers (at its Macy’s, Bloomingdale’s, and Bluemercury retail locations) starting this week as its stores remained shuttered due to the pandemic....more

Robinson & Cole LLP

Data Privacy + Cybersecurity Insider - August 2019 #4

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We have definitely seen an uptick in the number of ransomware attacks against municipalities around the country. Thus far, the attacks have been against single cities, towns, and court systems, and recently against a...more

Carlton Fields

Court Finds No Coverage for $42 Million False Claims Act Suit Due To Late Reporting

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A federal court has found no coverage for a $42 million whistleblower settlement due to the insured’s failure to timely report the claim to its carrier. PAMC, Ltd. v. National Union Fire Insurance Company of Pittsburgh, Pa.,...more

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