In Humana v. Farmers Texas County Mutual, et al., 13-cv-006111 (W.D. Tex. Sept. 24, 2014), the plaintiff, a Medicare Advantage Organization (MAO), sought reimbursement from a no-fault automobile insurer. The magistrate judge previously granted the defendant’s motion to dismiss holding that MAOs did not possess a private right of action under the Medicare Secondary Payer…
DetailsGovernor signs amendment to § 143.24d making arbitration of small auto property claims mandatory but not binding. In 2013, Illinois enacted a new statute requiring the mandatory arbitration of collision subrogation claims involving less than $2,500. 215 I.L.C.S. § 5/143.24d. The new § 143.24d required mandatory, binding arbitration of smaller property subrogation cases between…
DetailsInsured motorists are called upon every day to pay their deductibles in order for their carriers to cover the necessary repairs to their motor vehicles after accidents. Many carriers refuse to include those deductibles in the subrogated claims they make against the other motorists involved in accidents with their insureds. Because they are left on…
DetailsOn June 27, 2013, the Council of the District of Columbia enacted emergency and temporary legislation resulting in an amendment to § 32-1535 which narrows the window during which a workers’ compensation carrier has to file a third-party action. An injured employee had six months after accepting a workers’ compensation award in which to file…
DetailsA number of changes have affected the success of subrogation in the healthcare insurance setting – changes that financial executives need to be aware of in order to both mitigate negative impact and maximize opportunities. Kurt Ullman, this article’s author, interviewed Gary Wickert for this article, published in Healthcare Finance News on May 14, 2014. To read…
DetailsFor the time being, trial lawyers are celebrating the recent 2nd Circuit decision in Wurtz v. Rawlings Co., LLC, 2014 WL 3746801 (2nd Cir. 2014), which on July 31st, held that a class action suit seeking to enjoin three defendants from seeking reimbursement of benefits paid under fully-insured health plans based on New York’s anti-subrogation…
DetailsProperty insurers along all lines could simplify their business practices and lower their overhead considerably by simply paying any and all property damages, claims, expenses, and consequential damages alleged to have been incurred by and in the amounts claimed by their insureds. Obviously, such a practice would be a shortcut to insolvency and would lead…
DetailsA recent unpublished and quite puzzling decision from the New Jersey Superior Court, Appellate Division, threw decades of established New Jersey subrogation law into question when it announced that a workers’ compensation carrier has no subrogation/reimbursement rights on the medical portion of a third-party claim against an uninsured/underinsured motorist (UM/UIM) carrier. The Court in Dever…
DetailsThe Wisconsin Court of Appeals recently had occasion to address the issue of whether “subjective” and/or “objective” intent to cause injury must be found in the context of an intentional act exclusion. In Fetherstone v. Parks, 2014 WI App. 2, the Court interpreted an American Family insurance policy to determine whether a showing of both…
DetailsThe Wisconsin Supreme Court recently expanded the scope of coverage under auto policies when it held an auto insurer must defend and indemnify a permissive user of the auto who is sued by the named insured. Blasing v. Zurich Amer. Ins. Co., 2014 WI 73, aff’g 2013 WI App 27, 346 Wis.2d 30, 827 N.W.2d…
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