News & Analysis as of

Insurance Claims Insurance Industry

Maynard Nexsen

Keeping an Eye Out for Litigation Involving Increasingly Popular Gap Coverage

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So-called “gap” insurance policies – policies that provide critical-illness, hospital-indemnity and specified-disease coverage – have been on the rise due to a number of factors, including the frequency of high-deductible...more

Bradley Arant Boult Cummings LLP

Texas Court Exposes Key Gap in Professional Liability Coverage for Home Health Franchisors

In the home health care business? Whether a franchisor, franchisee, or independent agency, beware of bodily injury exclusions in professional liability policies that could eliminate coverage for otherwise covered claims....more

Wiley Rein LLP

Professional Services Exclusion Bars Coverage for Suit Stemming from Faulty DNA Analysis

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In a win for Wiley’s client, a Florida federal court held that a professional services exclusion barred coverage for underlying litigation arising out of the insured’s faulty DNA analysis services. A DNA laboratory provided...more

Kennedys

Proposed Washington code amendments modify insurer claims handling requirements

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Proposed Washington Administrative Code amendments would tighten the deadlines and increase insurers’ requirements while simultaneously finding a single misstep a basis for a violation....more

Jackson Walker

Senate Bill (SB) 2544: Mediation Filing Deadlines for Out-Of-Network Facilities

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The recently enacted Texas Senate Bill (SB) 2544 imposes mandatory mediation filing deadlines for out-of-network (OON) facility providers. Under Insurance Code Chapter 1467, OON facility providers (including ambulatory...more

Phelps Dunbar

Louisiana Changes its "Proof of Loss" Law

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The Louisiana Legislature recently passed HB 437 which enacts La. § R.S. 22:1892.3 (effective August 1), in an attempt to clarify parties’ respective obligations as it relates to Proof of Loss statements and corresponding...more

Goldberg Segalla

Navigating the Time-Limited Policy Limits Demand: Best Practices for Insurers and Defense Counsel

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In the evolving landscape of insurance litigation, the time-limited, policy limits demand has emerged as a high-stakes challenge for insurers, defense counsel, and claims professionals alike. These demands – often issued...more

Pillsbury - Policyholder Pulse blog

Strength in Numbers—The Class Actions Strategy for Insurance Claims

When wildfires, floods or other disasters strike, multiple policyholders can be affected in similar ways. But historically, each policyholder would take on their insurance company alone—a tough task, especially for individual...more

WaterStreet Company

2025 Trends in P&C Insurance: Technology, Competition and Innovation

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The U.S. P&C insurance industry is in the midst of profound transformation in 2025, driven largely by rapid technological advancement and evolving risk dynamics. According to Kelly King, a seasoned expert with over 30 years...more

J.S. Held

Fidelity Investigations: A Comprehensive Guide to Successful Claims Outcomes – Second Edition

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Introduction: Understanding Fidelity Investigations - Fidelity / Crime / Financial Institution Bonds, in a general sense, cover an insured from the willful theft of property, money, and securities by one of their employees...more

Orrick, Herrington & Sutcliffe LLP

Who Is Accountable for AI?

Orrick’s John Bautista sat down with Rune Kvist, founder and CEO of Artificial Intelligence Underwriting Company, to explore accountability in AI and how creating auditable standards and insurance products could unlock...more

Bracewell LLP

Q&A: Essential Questions to Ask When Preparing Your Commercial Property’s Hurricane Insurance Policy

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Commercial property hurricane insurance presents complex challenges that require careful consideration and strategic planning. Business owners must understand critical coverage elements, policy limitations and claim...more

Davis Wright Tremaine LLP

Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact...

Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more

Kennedys

Appellate Court of Illinois decision reminds insurers to communicate with insureds or face potential consequences: Estoppel of...

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The Appellate Court of Illinois recently reminded insurers that they may be estopped from raising coverage defenses through their misleading acts or statements, including silence. In Monroy-Perez v. Sentry Select Ins. Co.,...more

Schwabe, Williamson & Wyatt PC

OP-ED: How to Repair Landslides‎—One Insurance Policy at a Time

If a landowner receives a government order to clean up a landslide on their property, who should pay for it — the property owner or their liability insurer? About 20 times per year, the city of Portland issues an order to...more

Cozen O'Connor

Texas Supreme Court Reaffirms Procedure for Litigating Bad Faith Claims in UM/UIM Cases

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In In Re State Farm Automobile Insurance Co. and Lindsey Nicole Dessart, 712 S.W.3d 53 (Tex. 2025), the Texas Supreme Court clarified the proper procedure for litigating bad faith claims related to uninsured/underinsured...more

Stevens & Lee

New Changes to Medicare and Private Prior Authorization Processes

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Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more

Lowenstein Sandler LLP

Bad Faith No More: New York Courts Shift the Insurance Paradigm

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In this episode of Don't Take No For An Answer, Lynda A. Bennett and Eric Jesse discuss two New York cases that mark a turning point in allowing policyholders to pursue bad faith claims against their insurers. The cases shift...more

Zelle  LLP

Court Grants Insurer’s Motion for Summary Judgment on Nearly All of Insureds’ Causes of Action

Zelle LLP on

Schnatzmeyer v. State Farm Ins. Co., No. 3:23-CV-02820-K, 2025 WL 1697505, at *1 (N.D. Tex. June 17, 2025). In a case involving two overlapping freeze claims—and a substantial array of legal issues affecting insurers in...more

Butler Weihmuller Katz Craig LLP

Governmental Immunity and Your Subrogation Claim in Texas: Navigating the Texas Tort Claim Act

Property insurers are often frustrated when damage occurs due to the actions of others, especially when a governmental agency is at fault. In the Lone Star State, the Texas Tort Claim Act (TTCA) establishes that these...more

JUSTICENTER

How Long Is an Insurance Check Good For?

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If you’ve received a settlement check from an insurance company after a car accident, property damage claim, or injury settlement, you might be wondering: how long is an insurance check good for? While holding onto it for a...more

Wiley Rein LLP

SEC Tolling Request Not a Securities Claim Against Insured Company Under D&O Policy

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A Delaware Superior Court, applying Delaware law, has held that the United States Securities and Exchange Commission’s (“SEC”) request to toll the statute of limitations did not constitute a “Securities Claim” under a D&O...more

WaterStreet Company

Certified Mail vs. Proof of Mail for Insurance

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Insurance carriers operate in one of the most regulated industries. Communication with policyholders is not only essential, but legally required. When sending cancellation notices, conditional renewals, or premium increases,...more

JUSTICENTER

Consequences of Not Seeking Medical Attention After a Car Accident

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Adrenaline takes over after a car crash. People feel shaken up, but they might think they’re physically fine. They don’t feel pain, so they brush it off and go home. It might not sound like a big deal, but it actually is. ...more

Goldberg Segalla

[Webinar] Time-Limited, Policy Limits Demand: Critical Issues Facing Insurers When Settling Third-Party Liability Claims - July...

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Join Goldberg Segalla partners Brady Yntema and Jeff Matty for an interactive webinar discussing critical issues facing insurers when presented with a time-limited, policy-limits demand to settle third-party liability claims...more

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