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Fraud › Appeals › Insurance Industry

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Polsinelli

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

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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

Goldberg Segalla

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

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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

Hinshaw & Culbertson - Insights for Insurers

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

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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

Bradley Arant Boult Cummings LLP

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

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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

Winstead PC

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

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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

Foley Hoag LLP - Environmental Law

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

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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

Carlton Fields

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

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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

Pullman & Comley, LLC

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

Pullman & Comley, LLC on

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

Robinson+Cole Data Privacy + Security Insider

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

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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

Cozen O'Connor

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

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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

Carlton Fields

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

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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

Carlton Fields

Appellate Courts + STOLI = Mixed Results

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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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