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Reimbursements Insurance Litigation Insurance Claims

Marshall Dennehey

Commonwealth Court Rejects Insurer’s Reimbursement Claim Against Pharmacy in Billing Dispute

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Pioneer Construction Company, Inc., Eastern Alliance Insurance Company, and employers Alliance, Inc. v. Insight Pharmaceuticals, LLC d/b/a Insight Pharmacy; No. 867 C.D. 2022; filed May 12, 2025; Judge Covey - A workers’...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

Stoel Rives - Notice of Appeal

Oregon Supreme Court Clarifies Contribution Rights under the Oregon Environmental Cleanup Assistant Act

Last week, the Oregon Supreme Court issued an important decision interpreting the Oregon Environmental Cleanup Assistance Act (OECAA), clarifying the boundaries of insurer contribution rights and the scope of the statute’s...more

Marshall Dennehey

Reimbursement of Pennsylvania Department of Human Services Lien Is Found Not Automatic by Pennsylvania Commonwealth Court

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Key Points: No formal liability for payment of work-related medical expenses is triggered on the part of the employer/insurer until such expenses are properly submitted in accordance with the terms and provisions of the...more

Laughlin, Falbo, Levy & Moresi LLP

Who Pays What: The Pitfalls of Contribution and Reimbursement Among Co-Defendants in Workers’ Compensation

The recent Barahona v. ABM Janitorial Services (2024) 53 CWCR 4, decision sheds light on a common but often misunderstood issue in California workers’ compensation: how liability is shared among multiple employers and...more

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

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Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

Buchalter

I Just Lost My Home or Business to a Fire, What Do I Do Next?

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Take a deep breath. Losing one’s home or business to a fire is devastating and the road to recovery will be long and winding. First and foremost, you need to take care of yourself and your family. Make sure everyone is safe,...more

Rivkin Radler LLP

Insurance Update - December 2023

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Our December Insurance Update features a few firsts from state high courts. For the first time: •The Supreme Court of Hawaii addresses reimbursement of defense costs. •The Supreme Court of Illinois addresses coverage for...more

White and Williams LLP

Top Developments October 2023

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DEFENSE COST REIMBURSEMENT - Cont’l Cas. Co. v. Winder Labs., LLC, 73 F.4th 934 (11th Cir. 2023) Eleventh Circuit predicts that, under Georgia law, insurers found to have no duty to defend underlying suits could not...more

Marshall Dennehey

Fourth District Court of Appeals Reverses Itself Regarding Application of the 2007 Medicare Part B Non-Facility Limiting PIP...

Marshall Dennehey on

Progressive Select Ins. Co. v. In House Diagnostic Services, Inc. a/a/o Darryl Frazier, No. 4D21-2581 - This suit involved the legal issue of whether Progressive Select Insurance Company incorrectly determined the...more

Lowenstein Sandler LLP

Finding the Right Fit: The Duty to Defend vs. the Duty to Reimburse (Part II)

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Hosts Lynda A. Bennett and Eric Jesse of Lowenstein’s Insurance Recovery Group continue their discussion about the difference between the duty to defend, the duty to reimburse, and the duty to advance. They run through the...more

Lowenstein Sandler LLP

The Difference between the Duty to Defend and the Duty to Reimburse: What Policyholders Need to Know

In this episode of “Don’t Take No for an Answer,” hosts Lynda A. Bennett and Eric Jesse of Lowenstein’s Insurance Recovery Group discuss the difference between a duty to defend versus a duty to reimburse. They explain why...more

Ervin Cohen & Jessup LLP

Companies That Pay Hackers May Be Able to Recoup Their Losses

Where companies are victimized by ransomware or email scams, their losses arise from payments made by an officer or employee of the company. In the case of ransomware, a company’s files are held hostage pending payment...more

Carlton Fields

Court Dismisses Reinsurance Litigation in Favor of Prior Pending Action

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The plaintiffs, U.S. Fire Insurance Co. and North River Insurance Co., issued 12 umbrella and excess umbrella liability policies for a combined coverage of $244 million to a manufacturer of respiratory protection equipment...more

Carlton Fields

SDNY Compels Arbitration of Payment Obligation Dispute Under General Liability “Fronting” Policies

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A New York district court has granted a motion to compel arbitration of matters arising out of general liability “fronting” policies issued by member companies of AIG. ...more

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