Jurisdictions

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On 9 May 2011, the British Bankers Association (BBA) announced that it would not be appealing the High Court judgment that decided the Financial Service Authority’s complaints handling rules relating to the mis-selling of payment protection insurance (PPI) were lawful. …
Read More UK: British Bankers Association decides not to appeal Payment Protection Insurance judgment

In 2009, Middlesex Mutual Assurance Company denied coverage under a Business Owners Policy for the collapse of a pier owned by its insured, Puerta de la Esperanza (“Puerta”). …
Read More In Pier Collapse Case, Mass. District Court Finds Breach of Contract, But No Duty to Interpret Policy in Favor of Insured

In Pennsylvania, as in many jurisdictions, a liability insurer’s initial duty to defend is determined solely on the basis of the allegations of the complaint in the underlying action. …
Read More Pennsylvania Federal Court Holds That Liability Insurer Must Defend Claim for Negligent Design Because It Is Unclear Whether the Claim Sounds in Contract or Tort

The Connecticut Appellate Court held recently that an exclusion in a liability policy for “Athletic Activity or Sports Participants” precluded coverage for a claim stemming from injuries that a participant in an outdoor team-building exercise allegedly suffered during a rope-assisted free fall from an elevated platform.  Community Renewal Team, Inc. v. United States Liability Ins. Co., AC 31317 (Conn. App., April 19, 2011). …
Read More Connecticut Appellate Court Holds That Athletic Activity Exclusion Applies to Outdoor Team-Building Activity

Numerous states are currently examining certain claims procedures of life insurance companies.  In its most basic form, life insurance is designed to provide a death benefit to a named beneficiary upon the death of the insured life.  State law generally requires that carriers disburse death benefits to the named beneficiary in a timely manner, or, if the beneficiary cannot be located after due diligence, submit the payment to the state under the applicable escheat law.  State regulators are currently examining the manner in which life insurance companies investigate and determine whether a particular insured is deceased, and locate beneficiaries. …
Read More Claims Procedures of Life Insurance Companies Come Under Scrutiny

On April 25, 2011, the Rhode Island Superior Court (Silverstein, J.) ruled in favor of the constitutionality of the Voluntary Restructuring of Solvent Insurers Act (the “Restructuring Act”), a state statute enacted in 2002 that allows Rhode Island domestic commercial insurers and reinsurers (including those that redomesticate to Rhode Island) to enter into a commutation plan for their run-off business.  Under such a plan, the insurer/reinsurer agrees to pay policyholders/cedents the estimated value of their claims as of a set date in exchange for extinguishing the right to make any future claims. …
Read More Rhode Island Statute Allowing for the Commutation of a Solvent Insurer’s Run-Off Business Held Constitutional

CMS RELEASES FY 2012 PROPOSED RULE FOR HOSPITAL PAYMENTS:

The Centers for Medicare and Medicaid Services (CMS) recently released its annual inpatient prospective payment system (IPPS) proposed rule that determines Medicare reimbursements for the upcoming fiscal year. Under the proposed rule, Medicare payments to acute care hospitals for inpatient services in fiscal year (FY) 2012 would decrease by a projected $498 million, or 0.5 percent. …
Read More Healthcare Update: CMS Releases FY 2012 Proposed Rules for Hospitals and Rehab Facilities; Supreme Court Decides Not To Fast-Track Healthcare Lawsuit

The Vermont House of Representatives has passed legislation, H.438 (the “Bill”), that would allow for the incorporation of protected cells.  Under current Vermont law (Title 8, Section 6034) protected cells may be formed, but they are not officially recorded as existing legal entities with the Secretary of State. …
Read More Vermont Considering Legislation To Expand Captive Insurance Market