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A Nevada federal judge has determined that an insurer did not breach its contract or act in bad faith when it terminated payment for chiropractic services for two policyholders injured in an automobile accident. The Court found that the plaintiff policyholders failed to counter medical testimony that they did not require additional chiropractic care because the “maximum medical improvement” had been reached. …
Read More Nevada Federal Judge Finds No Breach of Contract or Bad Faith Where Insurer Ceased Payment to Policyholders for Chiropractic Services Following Auto Accident

A New Jersey federal judge dismissed a bad-faith claim for underinsured-motorist benefits, finding that Plaintiff’s complaint lacked necessary factual support and did not rise above the level of “bare averment.”  The Court also dismissed Plaintiff’s claim for punitive damages, finding that Plaintiff failed to allege sufficient facts to show egregious circumstances or that the insurer’s conduct was wantonly reckless or malicious. …
Read More “Bare Averment” Insufficient to Maintain Bad Faith Claim in New Jersey for Underinsured-Motorist Benefits

The Centers for Medicare and Medicaid Services (CMS) announced on August 18 that states have until September 24 to request an extension of the enhanced Federal Medical Assistance Percentage (FMAP) – the federal government’s share of Medicaid funding. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – August 30, 2010

A decision of the Eighth Circuit Court of Appeals, Northport Health Services of Arkansas, LLC v. Rutherford, No. 09-2433 (8th Cir. 2010), recently held that diversity of citizenship jurisdiction in the context of a motion to compel arbitration under § 4 of the Federal Arbitration Act (“FAA”) can be determined by looking at the citizenship of the parties named in the proceedings before the district court, plus any indispensible parties who must be joined. …
Read More Eighth Circuit Rules on Diversity Jurisdiction for Federal Actions to Compel Arbitration

Earlier this month, the Massachusetts Division of Insurance (the “Division”) struck a deal with Health New England to settle a dispute over rate increases.  In the winter of 2009, Health New England, a Springfield, Massachusetts health insurer, attempted to increase its health insurance premiums by a range of 11.5% to 21.3% for about 21,000 customers.  The Division denied this increase on April 1, 2010, along with other insurers who sought double-digit increases. …
Read More Massachusetts Health Insurer Settles With Division of Insurance On Rate Increases

Plaintiff moved to vacate an arbitration award issued in favor of defendant Stroehmann Bakers on the grounds that, among other things, the arbitrator’s decision was in “manifest disregard of the law.”  The U.S. District Court for the District of New Jersey, relying upon Third Circuit case law, noted that plaintiff was required to establish that the arbitrator’s award had absolutely no support from the record in order to prevail on this basis.  The court found that plaintiff had failed to meet the standard for manifest disregard of the law, and thus denied plaintiff’s motion to vacate. …
Read More New Jersey Federal Court Finds That Arbitration Award Was Not in Manifest Disregard of the Law

The National Association of Insurance Commissioners (“NAIC”) has released a derivatives risk mitigation proposal (“Proposal”) prepared by the American Council of Life Insurers (“ACLI”) for interim comment.  The Proposal would modify the formula for calculating risk-based capital (“RBC”) to reflect insurers’ use of derivatives to hedge  the risks of default or adverse change in fair market value to fixed income securities and common stocks. …
Read More NAIC Releases Derivatives Risk Mitigation Proposal for Comment

EAPD’s New York office will host an Insurance Federation of New York (IFNY) Breakfast on Thursday, September 30, 2010 featuring New York State Insurance Department’s Deputy Superintendent and General Counsel, Martha A. Lees.  As General Counsel, Lees advises the Superintendent and other officers of the Department regarding a wide array of legal matters and is responsible for supervision of the Office of General Counsel. …
Read More Prominent New York State Insurance Department Official to Speak at IFNY Event

As previously reported in this blog, President Obama signed into law the Comprehensive Iran Sanctions, Accountability and Divestment Act of 2010 (the “Iran Sanctions Act”) in July, following the less stringent sanctions passed earlier by the U.N.  For a more detailed discussion of the Iran Sanctions Act, see here.  Canada, the European Union and Australia soon followed with similar sanctions aimed at Iran’s financial and energy sectors. …
Read More Lloyd’s Market Drafts Exclusion to Ensure Compliance With Iran Sanctions

As a reminder, the U.S. Reinsurance Under 40s Group event will be hosting an event at the rooftop of Hotel Indigo on August 26, starting at 5:30.  The rooftop promises great views of New York and an opportunity to network with others in the industry. …
Read More Reminder: Please Join the U.S. Re Under 40s Group on August 26 in New York