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 | Decision to Terminate Benefits Upheld because of Principled Decision-Making Process
November 6, 2009, previously published on October 2009 Charles McDonald ("McDonald"), former Constellation Energy Group employee, claimed that he was unable to perform his duties as supervisor of distributions operations, due to tremors in his left arm, which were later determined to be related to McDonald's emotional state. Specifically,... |
 | Financial Action Task Force Adopts AML Guidance for the Life Insurance Industry
Karen A. Benson; Jorden Burt LLP; November 5, 2009, previously published on October 28, 2009 New international guidance ("Guidance") aimed at applying a risk-based approach to combating money laundering ("ML") and terrorist financing ("TF") in the life insurance industry was adopted at the October 2009 Plenary Session of the Financial Action Task Force... |
| Insurer Cannot Necessarily Deny Coverage if Attorney Ignores Malpractice Claim
Hinshaw & Culbertson LLP; November 5, 2009, previously published on October 27, 2009 Attorney failed to notify insurer of malpractice claim and failed to respond to plaintiff¿s repeated attempts to obtain insurer information until after the policy notification period had lapsed. The insurer tried to deny coverage based on late notice, but plaintiff had a statutory right to give... |
| Pipefitters Local 636 Insurance Fund v. Blue Cross Blue Shield of Michigan Matthew T. Fornataro, Arthur N. Lerner; Crowell & Moring LLP; November 3, 2009, previously published on October 30, 2009 In 2006, plaintiffs filed a class action lawsuit under ERISA, on behalf of hundreds of self-insured customers and its trustees against Blue Cross, alleging that Blue Cross breached its fiduciary duty when it charged fees that allegedly should not have applied to their funds under federal benefits... |
| Glen Ridge SurgiCenter, LLC v. Horizon Blue Cross Blue Shield of New Jersey, Inc Matthew T. Fornataro, Arthur N. Lerner; Crowell & Moring LLP; November 3, 2009, previously published on October 30, 2009 A District Court in New Jersey ruled that a course of dealing between a health benefits plan and a non-participating provider may be sufficient to establish a waiver of an anti-assignment provision in an ERISA health care plan. Glen Ridge SurgiCenter ("GRS") sued Horizon Blue Cross Blue... |
| Glaus v. Kaiser Foundation Health Plan Matthew T. Fornataro, Arthur N. Lerner; Crowell & Moring LLP; November 3, 2009, previously published on October 30, 2009 The Northern District of California granted defendant Kaiser Foundation Health Plan's ("Kaiser") motion to dismiss against Nicole Glaus ("Glaus"). Glaus alleged that she recovered a settlement of $4,250 from the individual responsible for her auto accident, and that Kaiser did... |
| Choice Healthcare Inc., et al. v. Kaiser Foundation Health Plan of Colorado, et al Matthew T. Fornataro, Arthur N. Lerner; Crowell & Moring LLP; November 3, 2009, previously published on October 30, 2009 Various Kaiser Foundation Health Plans in several states (collectively "the Defendants") had each individually contracted with Meritplan, a New York based preferred provider organization that negotiated reduced rates with participating health services providers. Choice Healthcare, Inc.... |
| Blue Cross Blue Shield of Montana, Inc. v. Montana State Auditor Matthew T. Fornataro, Arthur N. Lerner; Crowell & Moring LLP; November 3, 2009, previously published on October 30, 2009 In late 2006 Blue Cross Blue Shield of Montana ("BCBS") submitted a form for approval by the Commissioner of Insurance ("Commissioner"), as required by Montana law. The form included language excluding payment of benefits to the insured if the insured received or is entitled to... |
| Federal Court Finds ERISA-Covered Plan may be Comprised of Individual Rather than Group Insurance Policies
Joelle C. Sharman; Ford & Harrison LLP; November 2, 2009, previously published on October 27, 2009 Employers should be aware that an employee welfare benefit plan may be comprised of individual, rather than group, insurance policies, as illustrated by a recent federal court decision from Tennessee. In Alexander v. Provident Life and Accident Insurance Co., No. 1:09-CV-27 (E.D. Tenn. Oct. 16,... |
| Insurance & Reinsurance Industry Group: Corporate Insurance & Regulatory Bulletin Mayer Brown LLP; November 5, 2009, previously published on October 2009 On 5 October 2009, the European Commission (the "Commission") published a proposed new Block Exemption Regulation for the insurance sector (the "Draft IBER"), to replace the current Block Exemption Regulation (the "Existing IBER") when that expires on 31 March 2010...... |
