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8 Jan 2016, 12:52 pm by Kenneth Vercammen Esq. Edison
These Federal HIPAA regulations aim to safeguard patient medical records by imposing privacy rules on doctors, pharmacists, other medical staff, insurance companies and so on. [read post]
12 Feb 2023, 4:13 am by McKennon Law Group
If you get AD&D insurance on your own, it will usually be controlled by state laws, as opposed to the federal ones of ERISA. [read post]
Authorities Uncover $20 Million Health Care Scheme in California Federal authorities arrested five individuals connected to San Fernando Valley clinics and a significant health care fraud scheme. On May 22, a federal grand jury indictment was unsealed. The indictment alleges that the five individuals engaged in a health care fraud conspiracy over multiple years and targeted at least eight health insurance companies and the International Longshore and Warehouse Union, the Pacific Maritime Association Benefit Plan, and the Federal Employees Health Benefits Program. The Conspirators According to the Department of Justice (DOJ) press release, the co-conspirators included: Roshanak “Roxanne” or “Roxy” Khadem, 50: Khadem owned and operated two clinics, R&R Med Spa and Nu-Me Aesthetic and Anti-Aging Center. Dr. Roberto Mariano, 59: Mariano helped operate the clinics. Marina Sarkisyan, 49: Sarkisyan was a clinic office manager. Lucine Ilangezyan, 38: Ilangezyan was an insurance biller for the clinics. Gary Jizmejian, 44: Jizmejian was previously a senior investigator at the Anthem Special Investigations Unit, the insurer’s anti-fraud unit. The Allegations The indictment alleges that the co-conspirators induced patients to visit the clinics for free cosmetic procedures, such as Botox injections, facials, and laser hair removal. These procedures were not covered by insurance. The co-conspirators would gain the patients’ insurance information and bill their insurers for medical services that were unnecessary or never provided. The defendants then used some of the illegally obtained proceeds to calculate a “credit” the patients could use for discounted or free cosmetic procedures. The defendants submitted at least $20 million in insurance claims and were paid approximately $8 million. The indictment also states that Jizmejian, for cash payments, would provide Khadem and others with confidential Anthem information. This information helped the defendants submit fr
30 May 2018, 5:43 am by Gregory J. Brod
Additionally, the indictment alleges Jizmejian strove to prevent insurance companies from detecting the fraud, including helping Khadem avoid responding to insurer’s inquiries and diverting insurers’ investigators’ attention to other issues. [read post]
13 Oct 2012, 12:41 pm by Sean Minahan
Federally re-insured crop insurance policies require farmers to arbitrate their disputes with crop insurance companies according to the rules of the American Arbitration Association (AAA). [read post]
9 Jul 2012, 3:30 am by Shaun Marker
Federal regulations mandate that loss payments under policies of flood insurance shall be made by the Company from federal funds retained in the separate bank accounts. [read post]
26 Jun 2011, 5:40 am by Ray Mullman
The insurers’ recent prosperity — big insurance companies have reported first-quarter earnings that beat analysts expectations by an average of 30 percent — may make it difficult for anyone, politicians and industry executives alike, to argue that the industry has been hurt by the federal health care law. [read post]
19 Apr 2023, 12:45 pm by Chip Merlin
Surplus line insurance companies often claim they are exempt from a state’s insurance regulations and statutes. [read post]
11 Feb 2023, 6:07 pm by McKennon Law Group
If a policy is, for example, under a company that federal laws instead of state ones govern, it will payout any claim to the listed beneficiaries, regardless of state laws that may dictate otherwise. [read post]
7 Jun 2024, 5:48 am
If you are involved in a dispute with your business insurance company, contact Schwartz Conroy & Hack. [read post]
21 Aug 2015, 7:24 am by Associates and Bruce L. Scheiner
In short, federal appeals court found insurer had a duty to defend and breached that duty and for that, must reimburse the carrier’s insurance company the cost to defend and the settlement amount. [read post]
16 Jun 2020, 8:06 am by Jenny Hohenstein
Insurance Bad Faith in Pennsylvania contains overviews of this complex area of law, commentary and summaries of case law from Pennsylvania state and federal courts. [read post]
10 Apr 2019, 1:49 pm by Kevin LaCroix
One potential area of potential legal exposure facing corporate executives – including even executives of private companies – is the risk of liability under laws designed to protect competition, including (but definitely not limited to) state and federal antitrust laws. [read post]
22 Jul 2022, 5:35 am by Chip Merlin
“The purpose of insurance commissioners is to maintain fair pricing for insurance products, protect the solvency of insurance companies, prevent unfair practices by insurance companies, and ensure availability of insurance coverage. [read post]
7 Jul 2010, 8:37 pm by Peter Vodola
  They alleged that they were approached by a viatical settlement company, Wm. [read post]
25 Jul 2014, 6:53 am by Jon Gelman
Tpday's post is shared from the wsj.comTravelers Cos. reported an 18% decline in second-quarter operating profit as insurance claims from wind and hail storms eroded earnings, which were below analyst estimates and a catalyst for a sharp drop in the company's shares Tuesday.Separately, the company was hit with an adverse ruling in a long-running case involving asbestos-related claims of more than $500 million tied to the insurer's coverage of… [read post]
3 Apr 2013, 9:21 am by Joe Consumer
Writes one policyholder, “No matter insurance company has documentation already and has approved repairs. [read post]
15 Nov 2008, 5:18 am
Several insurance groups with ties to the structured settlement industry submitted applications to become bank holding companies to the Office of Thrift Supervision (OTS) on Friday November 14, 2008.The Hartford Financial Services Group, parent of current structured annuity issuer Hartford Life Insurance Company, Genworth Financial Inc., and Aegon NV, parents of former structured annuity issuers were among the insurance groups.Hartford is seeking to… [read post]
15 Apr 2019, 2:29 pm by Kevin LaCroix
  As I have emphasized before in commenting on SEC actions involving private companies, the potential federal securities law liability exposures for private company executives has important D&O insurance implications, as well. [read post]