On August 8, 2016, the 11th Circuit issued its opinion in Humana v. Western Heritage, 15-11436 (11th Cir., August 8, 2016). It is a major victory for Medicare Advantage Organizations (MOAs) and a major blow to liability insurers. Matthiesen, Wickert & Lehrer (MWL) attorney, Ryan Woody, filed an amicus brief for America’s Health Insurance Plans…
Insurance subrogation professionals are routinely faced with minimum limits scenarios which complicate otherwise straightforward subrogation cases. When a third-party liability carrier’s insurance limits are insufficient to pay the claims of multiple claimants, the carrier must begin to assess the hierarchy of the claimants. In order to do this, the carrier must be familiar with the…
The amount and dollar value of insurance claims relating to property loss alone dwarf all other lines of insurance. Water losses in the U.S. result in more than $9 billion in property damage annually. Fire losses result in more than $12 billion in annual damage. Hailstorms cause over $1 billion in damage. Homeowners’ and commercial…
“Move fast and break things. Unless you are breaking stuff, you are not moving fast enough,” Mark Zuckerberg famously said. Good advice, unless you’re a residential moving company. The residential home moving industry is changing rapidly and it’s essential that the subrogation professional keep up to date on the most recent developments. For decades, the…
In a recent major water and mold damage subrogation case in New York, the focus was on negligent maintenance and the failure to detect a major defect in a commercial HVAC system, which ultimately led to major water and mold damage and a large subrogation claim. The interesting aspect of this case, aside from the…
While drafting this article, I looked up at a video monitor in my office which streams Fox News. Two men playing Pokémon Go had just fallen off a cliff in Encinitas, California. It was not reported at the time what injuries they sustained, but the men were taken to a trauma center. One of them…
In the 2003 Walt Disney blockbuster Pirates of the Caribbean: The Curse of the Black Pearl, Hector Barbossa and the crew of the Black Pearl are in a cavern trying to reverse their curse when Elizabeth invokes the right of parley and notes that, according to the Pirate Code, she must be taken to their…
Even Non-Employer Contractors Are Entitled To Exclusive Remedy Protection Exclusive remedy protection is being handed out to non-employers like candy on Halloween by courts and legislatures across the nation, and Ohio is the latest state to join the giveaway. On April 19, 2016, the Ohio Supreme Court ruled for the first time that on construction…
Until recently, the District of Columbia workers’ compensation subrogation statute, found at § 32-1535, was silent on how or whether attorneys’ fees/costs are to be charged or apportioned when the worker files suit. When an employer or workers’ compensation insurance carrier initiates an action or negotiates a settlement when it is received and assigned, because…
Trucking insurers issuing motor carrier policies which contain MCS-90 Endorsements may be overlooking significant subrogation and recovery opportunities. MCS-90 subrogation is a fascinating and under-utilized means of recovery that can significantly increase an insurance carrier’s bottom line. Understanding the history behind and developing a working knowledge of MCS-90 Endorsements is essential for any adjuster or subrogation…