Law Brief®: Steve Polyakov and Richard Schoenstein Explore Healthcare Agreements
On Demand Insurance is Here But Will it Stay?
Umpire Not Immune from Insurer’s Suit for Undisclosed Conflicts - A toilet supply line leak damaged Rike’s home. She submitted a claim to her property insurer and demanded an appraisal. Rike and the insurer selected their...more
Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more
Car accidents are an unfortunate reality on the roads of Tallahassee, Florida. With thousands of vehicles traversing the city daily, collisions are bound to occur. Determining fault and liability in these incidents is often a...more
It’s apt to name a blog post after one of history’s great action movies when the case involves a “conceptual artillery duel” that “ends in a draw,” and that is exactly how U.S. District Judge Gerald Austin McHugh Jr. of the...more
In Meyer v. Massachusetts Mutual Life Insurance Co., the U.S. District Court for the District of Colorado entered summary judgment for an insurer after video evidence showed that the insured was not entitled to the benefits...more
No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more
Jason Brand made a claim for disability benefits under his disability policy with Principal Life Insurance Company on the basis that he was totally disabled by extreme anxiety that began in July 2014 after a warrant was...more
As interest rates and financial pressures on families continue to mount, more and more drivers may be unable to pay their repair bill for damage they caused or for mechanical issues on their vehicles. A common response is...more
The North Carolina Department of Insurance recently announced that a new investigative unit formed as part of the Cooperative Disability Investigations (CDI) Program will be located in Raleigh, North Carolina, with the goal...more
Following the easing of Covid pandemic restrictions, we are now facing a fresh “cost of living crisis” created by rising inflation and soaring energy bills. The Guardian newspaper reported that forecourts at petrol...more
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
Archegos Executives Charged With Conspiring To Defraud Banks Out of Billions - On Wednesday, April 27, 2022, the US Attorney’s Office for the Southern District of New York unsealed an indictment charging Sung Kook “Bill”...more
A District Court in the Eastern District of Pennsylvania recently held that an insured’s submission of invoices altered to inflate replacement costs for water-damaged inventory constituted material misrepresentations. ...more
When an owner seeks the appraisal of a property insurance claim, insurers commonly object by demanding that the trial court must first rule on defenses to coverage before allowing appraisal panel to value the total claim...more
I. INTRODUCTION - Insurance fraud - whether in the auto, workers’ compensation, or health insurance arenas - is an enormous and costly national problem. It hurts policyholders who have to pay increased premiums to offset...more
According to the FBI, “The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S.family between $400 and $700 per year in the...more
On March 23, 2020, the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) issued an alert to the public about fraud schemes related to the novel coronavirus (COVID-19)....more
Recent decisions provide worthwhile guidance for insurers handling slayer claims. According to traditional inheritance law, a “slayer” is one who intentionally kills, or conspires to kill, feloniously or unjustifiably,...more
On demand insurance allows insurance policies to be purchased via the internet or smartphone applications. Millennials are more than twice as likely as prior generations to purchase an insurance policy in this manner. Valerie...more
Zelle LLP invites you to join us for a week of webinars featuring insurance topics that are of critical importance to adjusters and insurance professionals. This series will cover managing insurance claims in the wake of...more
Law enforcement in Miami-Dade County, Florida recently arrested nine individuals described by Florida Chief Financial Officer Jimmy Patronis as the “ringleaders of an elaborate fraud scheme” led by Barbara Maria Diaz de...more
Insurance Industry for InsurTech Noobs - So you developed the newest insurance innovation that is going to revolutionize the industry – congratulations! But we also have a couple of questions: What sector of the...more
The Hartford affiliate Sentinel Insurance Company continued its successful campaign to limit dubious claims by securing another favorable decision – this time in California in the rapidly developing area of financial elder...more
Assignment of Benefit Scams - According to the Coalition Against Insurance Fraud, about $80 billion is stolen every year by unscrupulous companies supposedly acting in the best interests of U.S consumers during critical...more
While issues of fact can preclude summary judgment in some cases involving failure to cooperate and misrepresentation, a New York federal court recently granted summary judgment to an insurer in this context. ...more