(California Court of Appeal) – In a class action for unfair competition, unjust enrichment and financial elder abuse, brought by a plaintiff enrolled in a private health plan offering benefits to persons 65 and over as well as disabled persons under the federally funded Medicare…
(United States Second Circuit) – Conviction of various fraud and conspiracy charges arising out of defendant’s involvement in a conspiracy to defraud insurance companies in connection with claims under New York’s No Fault Comprehensive Motor Vehicle Insurance Reparation Act, N.Y. Ins. Law section 5102 et…
(United States Supreme Court) – In a case brought by nonprofit organizations that provide health insurance to their employees, challenging the federal regulations require them to cover certain contraceptives as part of their health plans, unless they submit a form either to their insurer or…
(United States Second Circuit) – In a civil action, brought by insured plaintiff claiming that defendant violated the Department of Labor’s claims-procedure regulation, 29 C.F.R. section 2560.503-1, in handling her health insurance claim, the district court’s grant of summary judgment to defendant is vacated and…
(Court of Appeals of New York) – In an insurance action, brought by plaintiff insurance companies seeking declaratory relief, the Appellate Division’s order is affirmed where Insurance Law section 5102 does not require no-fault insurance carriers to pay a facility fee to reimburse New York…
(California Court of Appeal) – In a suit by a hospital over defendants’ refusal to pay approximately $1,996,265.50 for the cost of medical services it provided to an insured patient following extensive communications with insurer-defendant over a period of approximately 50 days regarding ‘authorization’ for…
(United States Supreme Court) – In an action seeking a declaration that the Employee Retirement Income Security Act of 1974 (ERISA) pre-empts application of Vermont’s law requiring certain entities, including health insurers, to report payments relating to health care claims and other information relating to…
(California Court of Appeal) – In a taxpayer’s mandamus action to determine whether Blue Shield of California and Anthem Blue Cross are “insurers” under the California Constitution’s gross premium tax provision, Cal. Const., art. XIII sections 28(b)-(d), the trial court’s sustainment of defendants’ demurrer without…
(United States Third Circuit) – In an action for unpaid insurance benefits brought under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. section 1001 et seq., the district court’s dismissal for lack of standing under ERISA is reversed where a patient’s explicit…
(California Court of Appeal) – In a writ of mandate under Code of Civil Procedure section 1085 to required respondents’ compliance with their duties in administering certain aspects of the Medi-Cal program related to defendant’s database with codes that indicate whether a Medi-Cal beneficiary has…
