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Insurance Claims Workers' Compensation Claim

Goldberg Segalla

Another Win for Professional Employer Organizations at New York Third Department

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Another day, another chapter in the evolving world of New York Workers’ Compensation for Professional Employer Organizations (PEOs). As discussed in prior updates, this decision follows the foundational Third Department...more

Goldberg Segalla

Court Highlights Distinction Between Pre- and Post-Retirement Benefits and Workers’ Compensation Carrier’s Reimbursement Rights...

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The recent New York Court of Appeals decision in Matter of Schulze v. City of Newburgh Fire Department (April 10) has significant implications for municipal employers and workers’ compensation insurance carriers in New York,...more

Carlton Fields

Texas Appeals Court Finds Project Owner Excluded From Coverage as Claimants’ Statutory Employer

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On April 3, 2025, a Texas state appeals court reversed a trial court order awarding Exxon Mobil $25 million under an umbrella insurance policy issued by Lexington Insurance Co. to Brock Services Ltd. The appeals court found...more

Marshall Dennehey

A Double Take: Workers’ Compensation Liens Render UIM Non-Duplication Clauses Unenforceable

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Key Points: Delaware Superior Court permits injured plaintiffs-employees to board medical bills and lost wages already paid by the workers’ compensation carrier in subsequent UIM claim related to the same incident, despite a...more

Laughlin, Falbo, Levy & Moresi LLP

A NEW MEDIC-ERA; Changes to CMS Review Guidelines in 2025

Vast changes are swiftly approaching regarding the efforts Workers’ Compensation practitioners must make in protecting Medicare’s interests in future medical settlements. The Centers for Medicare/Medicaid Services (CMS) has...more

Gray Reed

Using Evidence to Fill Gaps in Pleadings Silent on Important Coverage Facts

Gray Reed on

A decision out of the United States District Court for the Southern District of Texas showcases the practical challenge in the relationship between workers’ compensation and the pleading standards required to trigger...more

Hendershot Cowart P.C.

Your Employee Lawyered Up. Now What? Best Practices for Contractors Following a Worksite Injury

Hendershot Cowart P.C. on

When a workplace injury occurs at your construction site, the actions you take in the immediate aftermath can significantly impact potential legal consequences, insurance claims, and your business's financial health....more

Marshall Dennehey

Treatment With Authorized Provider Tolls Statute of Limitations, Although Treatment Occurred Without Employer/Carrier’s Knowledge...

Marshall Dennehey on

Ortiz v. Winn-Dixie, Inc., No. 1D2021-0885, Fla. 1st DCA 2024, DCA#: 1D2021-0885, Decision date: Dec. 23, 2024 - The First District Court of Appeal issued another opinion in the ongoing statute of limitations saga triggered...more

Marshall Dennehey

Right to Subrogation for Medical Bill Payments Not Waived by Failing to Properly Preserve Issue at All Stages of Litigation,...

Marshall Dennehey on

City of Philadelphia v. Wayne Deloatch and Independence Blue Cross (WCAB); Independence Blue Cross v. City of Philadelphia and Wayne Deloatch (WCAB); No. 541 C.D. 2022 and No. 589 C.D. 2022; Filed Dec. 24, 2024 - Wayne...more

Morris James LLP

After the Route 1 Rollovers: Understanding Injury and Death Benefits

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On February 25, 2025, two separate rollover accidents occurred on Delaware's Route 1, resulting in one fatality and one individual sustaining serious injuries. These incidents not only highlight the inherent dangers present...more

Morris James LLP

Subrogation and UIM Claims: Unpacking the Recent Henry and Manz Decisions

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The Delaware Supreme Court's decisions in Henry I and Henry II have had a significant impact on workers’ compensation claims involving underinsured motorist (UIM) benefits. Here, we break down the complex issues surrounding...more

Woodruff Sawyer

P&C Looking Ahead Guide for 2025: Experts Expect Stabilized Rates

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After years of sustained rate increases, 2025 offers a brighter outlook for commercial insurance buyers. We expect premiums to stabilize or rise modestly, varying by line of business and industry. Increased market competition...more

Goldberg Segalla

Defending HIMP-1 Claims: Top Things to Know

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In New York State, the Health Insurance Matching Program – widely known as HIMP – provides means for a claimant’s private health insurer to seek reimbursement for treatment they believe a workers’ compensation carrier or...more

Goldberg Segalla

Fraud Doesn't Pay in New York – August 2024 Update

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As a part of our Quarterly Practice Group Update, we are pleased to produce our latest installment of our continued success in fraud litigation. This report was originally conceptualized three years ago as a one-time...more

Goldberg Segalla

[Webinar] Risk Transfer, Employer Liability, and Grave Injuries: Who Is Going to Pay? - May 15th, 12:00 pm - 1:00 pm EDT

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While this webinar will focus primarily on the New York construction aspect of risk transfer, it will be helpful for anyone dealing with risk-transfer issues. The presenters will also discuss activating the employer-liability...more

McGlinchey Stafford

What Is My Assumption of Risk? - McGlinchey Commercial Law Bulletin - September 11, 2023

McGlinchey Stafford on

Assumption of the Risk- Smith v. Be Fit with Michelle, LLC, 11th Dist. Lake, No. 2023-Ohio-3118. In this appeal, the Eleventh Appellate District affirmed the trial court’s decision to grant the defendant summary judgment...more

Goldberg Segalla

[Webinar] Risk Transfer, Employer Liability, and Grave Injuries: Who Is Going to Pay? - June 14th, 12:00 pm - 1:00 pm EDT

Goldberg Segalla on

While this webinar will focus primarily on the New York construction aspect of risk transfer, it will be helpful for anyone dealing with risk-transfer issues. The presenters will also discuss activating the employer-liability...more

Cozen O'Connor

California Court of Appeal: Insurers Not Liable Under the California Insurance Frauds Prevention Act

Cozen O'Connor on

In its recent decision, People ex rel. Ellinger v. Magill, et al., —Cal.Rptr.3d—, No. E076378, 2022 WL 1077988 (Cal. Ct. App., Mar. 18, 2022), the California Court of Appeal refused to extend liability under California’s...more

Butler Weihmuller Katz Craig LLP

Pennsylvania Finds Exception to Anti-Subrogation Rule

The Pennsylvania Supreme Court recently adopted the “no-coverage exception” in Arlet v. Workers’ Compensation Appeal Board. 2022 WL 529350 (Pa. 2022). As most subrogation professionals are aware, the anti-subrogation rule...more

Esquire Deposition Solutions, LLC

COVID-19 Litigation: Clear Sailing or Calm Before the Storm?

The last time we looked at litigation arising from the COVID-19 pandemic, it appeared that businesses and their insurers faced a grave risk of being buried by COVID-related lawsuits. So far, however, the worst fears within...more

McDermott Will & Schulte

Unfall zwischen Schlafzimmer und Home Office-Arbeitsplatz – Besteht Versicherungsschutz?

Einer der größten Vorteile im Home Office ist die Reduzierung des Arbeitsweges. Die meisten Beschäftigten werden es von ihren Schlafzimmern zum Arbeitszimmer bzw. Arbeitsplatz nicht besonders weit haben. Dennoch wird sich der...more

Woodruff Sawyer

Insurance Rates for the Technology Industry: 2022 Trend Report

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In this report, we identify the emerging trends that are impacting insurance for the tech sector, with a specific review of the property, general liability, and workers’ compensation (WC) coverage areas. The big takeaway?...more

Esquire Deposition Solutions, LLC

On COVID-19 Insurance Coverages: We Haven’t Seen Anything Yet

No doubt you’ve seen the Farmers Insurance ads claiming, “We know a thing or two because we’ve seen a thing or two.” Most describe insurance claims paid on foreseeable calamities caused by familiar animals — bears, deer,...more

Chambliss, Bahner & Stophel, P.C.

Protecting Your Business from Liability for COVID-19 Transmission

As businesses continue to evaluate current operations and how they will modify them as shelter-in-place orders are lifted and employees and customers return, it is important for each business to anticipate potential COVID-19...more

Buchalter

Buchalter Client Alert COVID-19: Opposite Sides of the Table: Restaurants Seek Recovery From Insurers for Business Interruption in...

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As COVID-19 cases have continued to spread across the country resulting in government-issued “shelter in place” orders, few industries have felt the impact as swiftly and deeply as the restaurant industry. Indeed, such...more

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