Healthcare News from Capitol Hill and the Department of Health and Human ServicesIn an open letter to the “health care provider community,” Senators Max Baucus (D-MT) and Orrin Hatch (R-UT), the leaders of the Senate Finance Committee, have asked for suggestions on reforming the Medicare physician payment system. The letter notes that the current Medicare sustainable growth rate (SGR) formula is broken and must be repealed. read more
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Earlier this week, the Connecticut House passed HB 5072, limiting the abilities of insurance companies or their representatives to “steer” insureds to specific automotive glass repair facilities. The new legislation follows a trend in Connecticut to dissuade insurers from directing insureds to use specific facilities. Connecticut’s existing laws prevent appraisers from requiring that specific locations or companies be used for automotive repairs. read more
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On Monday, Southern District of New York Judge Shira Scheindlin dismissed the entire suit in Gusinsky v. Barclays, without leave to amend and with prejudice. The plaintiffs, holders of American Depository Shares in Barclays Bank, had brought claims under Section 10(b) and Rule 10b-5 of the ’34 Act against Barclays, and Section 20(a) control person liability claims against individual directors of the bank for the bank’s role in the manipulation of LIBOR. read more
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On 13 May 2013, HM Treasury published the response to its further consultation on the transposition into UK law of the Alternative Investment Fund Managers Directive. Published with the response were the amended regulations, representing the near-final draft form of the regulations as the Treasury plans to implement them. read more
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The Financial Stability Oversight Council released its third annual report on April 25, 2013, which fulfills its Congressional mandate under the Dodd-Frank Wall Street Reform and Consumer Protection Act to annually report on its activities, describe significant financial market and regulatory developments, analyze potential emerging threats, and make recommendations for additional steps that should be taken to strengthen the financial system. read more
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On May 9, 2013, the Office of Foreign Asset Control (“ OFAC”) announced a settlement with the American Steamship Owners Mutual Protection and Indemnity Association, Inc. (the “ American Club”) under the OFAC sanction programs against Cuba, Sudan and Iran. The American Club is a non-profit international marine mutual insurance association of merchant ship owners and charterers with its principal offices in New York. read more
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At Connecticut’s first Captive Insurance Day at the Capitol May 14, 2013, representatives of the Connecticut Insurance Department (the “CID”), the Connecticut Captive Insurance Association, the Department of Economic and Community Development, and the co-chairs of the Connecticut General Assembly’s Insurance and Real Estate Committee emphasized Connecticut’s continuing efforts to attract new captive insurers to the state, including through SB 1093. read more
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In PHL Variable Insurance Company v. The P. Bowie 2008 Irrevocable Trust (May 13, 2013), the United States Court of Appeals for the First Circuit issued an order holding that a life insurer may retain premium in a case involving a stranger originated life insurance transaction. read more
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Last week, Representative Bennie Thompson, a Democrat Congressman from Mississippi, introduced the Fostering Resilience to Terrorism Act of 2013, which would extend the Terrorism Risk Insurance Act by ten years. TRIA, which is set to expire at the end of 2014, was the subject of another proposed extension earlier this year but that proposal merely extended the program five years. read more
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On 29 April 2013, Michael Joseph James Lewis (a former mortgage broker) appeared at Medway Magistrates Court to face criminal charges brought against him by the Financial Conduct Authority ( FCA). read more
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On May 7, 2013, the Consumer Financial Protection Bureau (“CFPB”) announced the first criminal prosecution of a debt-relief service provider that arose specifically from an investigation conducted by the CFPB. Pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010, the CFPB was created to supervise banks, credit unions and other financial companies, such as debt-relief service providers and consumer credit reporting firms, and to enforce federal consumer financial laws. read more
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On 30 April 2013, the Financial Conduct Authority ( FCA) issued a public censure to Horn Express Ltd (formerly Qaran Express Money Transfer Limited). The censure stated that it would have been accompanied by a fine of £136,687, if the firm had not shown that it was in financial difficulties and that the fine would have caused it serious financial hardship. read more
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June 4, 2013 Edwards Wildman Palmer LLP 750 Lexington Avenue, 8th Floor New York, New York 10022 read more
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CCIIO ISSUES BROKER GUIDELINES FOR EXCHANGES
On May 1, the Center for Consumer Information and Insurance Oversight (CCIIO), a part of the Centers for Medicare and Medicaid Services (CMS), issued guidance on the “Role of Agents, Brokers, and Web-brokers in Health Insurance Marketplaces.” The marketplaces, commonly known as health insurance exchanges, are scheduled to be in operation for open enrollment on October 1, 2013, with coverage to take effect on January 1, 2014. read more
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Members of the Rhode Island House of Representatives met on May 1, 2013 to discuss H.B. 5459, the Stop-Loss Insurance Act (the “Act”), which was introduced on February 14, 2013. The Act proposes to place further restrictions on the use of stop-loss insurance by employers who self-insure their employee benefit health plans. read more
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Brian Green (NY) is attending the Aviation Insurance Association Conference in Orlando, FL, on May 4-7. The AIA annual conference is the biggest conference in the aviation and aerospace insurance space. read more
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Several Bureau of Economic Analysis (“BEA”) reports will be due later this month, on May 31st, including a 5-year Benchmark Survey of Foreign Direct Investment. U.S. companies with foreign affiliates should ensure their compliance departments are working to timely file any applicable reports, including filing of any appropriate claims for exemption. read more
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The Commercial Court has decided that the 9/11 terrorist attacks on the World Trade Center constituted two events and not one, the first time an English court has ruled on this issue. read more
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The Hong Kong Federation of Insurers presented a study report on How to Position Hong Kong as a Maritime Centre for the Asia-Pacific Region to the Hong Kong Maritime Industry Council on 29 April 2013 ( Report). read more
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On April 1, 2013, the National Association of Insurance Commissioners (NAIC) issued its draft White Paper entitled The U.S. National State-Based System of Insurance Financial Regulation and the Solvency Modernization Initiative (the “Paper”). Broadly, the purpose of the Paper is to provide international regulators with a description of how the U.S. system of regulation works. read more
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The High Court recently handed down a judgment in which a claims control clause in a reinsurance contract was held not to be breached by the conduct of the reinsured in agreeing to pay the insured their retention and the share of one reinsurer who had been involved in settling that part of the claim. read more
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The following is a summary of select developments and discussions addressed at the NAIC Spring National Meetings held in Houston, Texas on April 5-9, 2013. 1 read more
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The Supreme Judicial Court of Massachusetts recently held that where title insurers pursue litigation to cure defects to a title, they do not have a broad duty to defend any uncovered counterclaims against the insured. See GMAC Mortgage, LLC v. First American Title Ins. Co., No. SJC-11161 (Apr. 4, 2013). read more
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The U.S. Treasury Department’s Federal Insurance Office (FIO) is seeking comments on natural catastrophes and the current state of the market for insurance of natural catastrophe perils in the United States. FIO has also called for submission of papers analyzing natural catastrophes and the catastrophe insurance market. read more
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On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Notice updating the Provider Self-Disclosure Protocol (the “SDP”). read more
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The European Union has lifted its sanctions in relation to Myanmar/Burma. read more
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This case concerned which one of two insurers was liable for the losses caused by damage to economiser blocks which were to be incorporated in two boilers on a new energy-from-waste facility near Slough. The blocks were manufactured in Romania and transported by road or by road and sea. On installation at the facility, testing revealed cracking in the rows of tubing contained in the blocks. read more
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At the Spring Meeting of the National Association of Insurance Commissioners (NAIC), the NAIC Reinsurance Task Force announced that the Federal Insurance Office (FIO) requested that the NAIC conduct a survey on access to reinsurance data. read more
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On April 17, 2013, the Florida Senate Committee on Banking and Insurance approved SPB 7152 as committee bill SB 1888 (the “Bill”). The Bill would eliminate Florida’s no-fault personal injury protection (“PIP”) coverage requirements, which were reformed just last year as the result of serious negotiations. read more
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The Bermuda Monetary Authority (BMA) announced that it has appointed Craig Swan, formerly the BMA’s Director, Insurance Supervision, to the newly created post Managing Director, Supervision. Mr. Swan will lead all of the BMA’s regulatory functions. The Director, Banking, Trust, Corporate Services and Investment and Director, Insurance Supervision will each report to Mr. Swan. read more
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Monday’s attack affected hundreds of lives and businesses struck by the tragedy. Insurers and reinsurers will undoubtedly face claims and losses in the wake of Monday’s devastation. read more
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On April 3, 2013, the Federal Reserve Board (“FRB”) approved a final rule (“Final Rule”) that establishes (1) definitions of the terms “significant nonbank financial company” (or, more commonly referred to as SIFIs or “systemically important financial institutions") and “significant bank holding company,” and (2) the requirements for determining when a company is “predominantly engaged in financial activities.” read more
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On 1 April 2013, the Prudential Regulation Authority ( PRA) published a Policy Statement on its decision-making process, and disciplinary and enforcement procedures. read more
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For insurers doing business in Florida, a recent appellate court decision reaffirms the importance of a timely offer of settlement even in extremely challenging conditions to protect against bad-faith liability. read more
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On 1 April 2013, the Prudential Regulation Authority (PRA) published a policy statement on its power of direction over qualifying parent undertakings, incorporating feedback from a consultation on this power. read more
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In the recent case of Alliance of Nonprofits for Ins. v. Scott J. Kipper, et al., the Ninth Circuit determined that the Liability Risk Retention Act of 1986 (“ LRRA”) preempted an order issued in 2010 by the Nevada Insurance Commissioner barring the Alliance of Nonprofits for Insurance Risk Retention Group (the “ Alliance”) from issuing first dollar automobile insurance policies (the “ Order”). The LRRA is a federal law which authorizes risk retention groups (“ RRG”) to provide liability insurance coverage. read more
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This updates our December 3, 2012 blog post. Attorneys from Edwards Wildman attended the Principle-Based Reserving Implementation (EX) Task Force (“Task Force”) meeting of the National Association of Insurance Commissioners (“NAIC”) in Houston on April 6, 2013, where the Task Force released a new draft of its principle-based reserving (“PBR”) implementation plan (“Plan”) for comment. read more
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The Fourth Report of the Parliamentary Commission on Banking Standards "'An accident waiting to happen': the Failure of HBOS" makes surprisingly interesting reading for insurers. (The Report, published on 5 April 2013, is available here.) read more
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The Centers for Medicare & Medicaid Services (“CMS”), part of the United States Department of Health and Human Services, has proposed new rules to create conflict-of-interest standards applicable to navigators. Under the Patient Protection and Affordable Care Act (the “Act”), navigators will assist consumers in obtaining coverage from health insurance exchanges to be established under the Act. read more
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On 1 April 2013, the Bank of England published "The Prudential Regulation Authority's approach to insurance supervision". read more
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On 6 April 2013, the Consumer Insurance (Disclosure and Representations) Act 2012 ("the Act") will come into force, and apply to all consumer insurance contracts entered into on and after that date. read more
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A federal court, applying New York law, recently held that a “professional services” exclusion in a D&O policy applied to lawsuits against a broker-dealer arising out of its underwriting and marketing of shares issued by a set of real estate investment trusts (or “REITs”). See David Lerner Assocs. v. Philadelphia Indem. Ins. Co., No. 2:12-cv-01609-JFB-AKT (E.D.N.Y. Mar. 29, 2013). read more
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23 April 2013 Edwards Wildman Palmer UK LLP Dashwood, 69 Old Broad Street London EC2M 1QS United Kingdom read more
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The Connecticut Insurance Department (the “CID”) has approved Swiss Reinsurance Co. Ltd. as the first certified reinsurer eligible for reduced credit for reinsurance collateral requirements in Connecticut, according to a notice published on the CID website April 2, 2013. read more
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In an exhaustive 161-page ruling issued on Friday, Judge Naomi Reice Buchwald of the Southern District of New York dismissed the majority of the claims brought by plaintiffs seeking damages for losses caused by LIBOR. read more
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HHS UPS MEDICAID EXPANSION PAYMENTS FUNDING
On March 29, the U.S. Department of Health and Human Services (HHS) issued a final rule under which the federal government will pay the entire cost of covering newly eligible enrollees under the Patient Protection and Affordable Care Act's Medicaid expansion for the first three years of the program. read more
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