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In Brief: A Digest of Insurance Projects

 
 
Client Success

Insurers

  • Won dismissal of a bad faith lawsuit brought against an insurer by a lender in Puerto Rico
  • Defended an insurance company in a putative class action case, alleging insurance redlining against multiple homeowners’ insurers
  • Successfully represented an international reinsurer in a series of disputes in state, federal and bankruptcy courts with the managing general agent of a non-standard automobile insurance program
  • Secured dismissal of claims against an insurance company under Environmental Impairment Liability policies for cleanup costs and personal injury claims from multiple sites
  • Obtained summary judgment on behalf of a major health insurer in a $600 million ERISA class action involving allegations of improper employee classification of insurance agents.
  • Secured summary judgment in favor of an insurance company in a claim for business interruption losses arising from Hurricane Rita evacuation orders
  • Surety Claims
  • Hired mid-litigation as lead counsel for two large sureties in declaratory judgment action against a contractor and international, government-owned bank
  • Negotiated settlement with the New Jersey Meadowlands Commission and the New Jersey Department of Environmental Protection that resolved client’s liabilities on a $140 million surety bond
  • Investment Management and Financial Matters
  • Successfully represented international brokerage and investment banking business in nine lawsuits brought in state and federal court by a loan servicer of three different commercial mortgage-backed securities trusts
  • Obtained a favorable settlement in a securities and RICO case for a national life insurance company
  • Developed and completed a closing process for the estate of an insolvent insurance company in which the company had been in liquidation for 10 years
  • INSURANCE REGULATORY
  • Federal Regulatory
  • Represented statutory rehabilitator of financially distressed insurer in all facets of ACA issues, including extensive negotiations with the U.S. Department of Health and Human Services (HHS)
  • Prosecuted insurer’s appeal and legal challenge to Risk Adjustment methodology under the Affordable Care Act (ACA)
  • Represented national insurance industry group and insurer on claims for outstanding Risk Corridors under the ACA
  • Represented insurer in relation to APTC, CSR, and related set-off claims
  • Prosecuted insurer’s claims to outstanding Risk Corridors under the ACA
  • Advised clients in relation to potential changes to rules that may allow small businesses to secure insurance coverage through the large group insurance marketplace

State Regulatory/Market Conduct and Enforcement Actions

  • Extensive experience working with state insurance departments in relation to oversight of the financial condition of insurers, including supervision, rehabilitation, and liquidation proceedings
  • Represented the Department of Insurance in relation to Form A filing, change of control, and restructuring of a multi-billion dollar insurance company
  • Advised the Department of Insurance on propriety of insurer’s investments and reserves in state department investigation of insurer
  • Advised on significant, multi-state market conduct exams
  • Successfully defended major health insurer in multi-state market conduct examination and related enforcement and administrative proceedings
  • Developed policy forms to comply with state regulations; worked with insurer to protect sensitive information from public disclosure; worked with insurer in relation to open records act request to state department of insurance; advised insurer on navigating potential deviation from state-approved forms
  • Advised clients on state laws regulating a wide range of insurer conduct, including Prompt Pay Act claims, Unfair Claims Settlement Practices Act, market exit implications; newborn coverage mandates; coverage for out of network ambulance services and other out of network charges; and transitional policies
  • Advised insurer facing multiple private lawsuits and state insurance department actions in relation to claims of improper marketing of policies
  • Advised insurers on coverage issues and extra-contractual liability for bad faith failure to settle and violation of state payment statutes
  • Counseled state regulatory agencies regarding insurer mergers, acquisitions and capital restructurings

CORPORATE AND TRANSACTIONAL

  • Represented national property and casualty insurance company in spinoff of its captive 40-branch agency in a transaction valued in excess of $40 million
  • Represented large publicly-traded bank in the acquisition of a property/casualty and risk consulting business in all stock transaction valued in excess of $100 million
  • Represented international insurance carrier in acquisition of a distressed travel insurance business
  • Represented multiple companies (including captive insurance company-owned venture capital funds) in investments into InsurTech products and businesses
  • Designed and created numerous executive compensation arrangements, rabbi trusts, and other custom deferred compensation packages for insurance company officers and directors
  • Represented large property/casualty and benefits consulting company in the acquisition of an ESOP-owned agency in a combined cash and stock transaction

AGENCY AND BROKER

  • Prosecute and defend suitability claims
  • Prosecute and defend actions based on alleged gaps in insurance coverage
  • Advise insurer on commission issues and resolution of claims against insolvent insurer
  • Advise brokers and partner entities on referral fee issues and innovative business relationships

GOVERNMENT AFFAIRS

  • Represented Fort Bend County Levee Improvement District #2, and several other levee and drainage district clients, during the National Flood Insurance Program (NFIP) reauthorization process on the issue of residual risk; we successfully led a small coalition to spearhead efforts and worked with Committees of jurisdiction and the Texas delegation to see legislation written dealing with the issue of residual risk (which the District strongly supported). We continue to represent the District on flood insurance reform and various matters.
  • Represented the Nebraska Medical Center during the drafting and passage of the Affordable Care Act (ACA) to secure changes protecting their interests in the final legislation; the representation involved multi-year outreach and concluded in favorable language being included in the final bill.
  • Our client, Asurion, a leading provider of device insurance, warranty and support services for cell phones, consumer electronics home appliances sought to revise and update the Nebraska Portable Electronics Limited Lines Insurance Act in order to modernize the law to reflect changes in the electronic marketplace. Our team drafted legislation that was introduced and passed with no dissenting votes and was signed by the Governor. By achieving modernization of this act, it helps our client have uniformity amongst state laws and keeps legislation in line with the times.
  • Helped introduce legislation for client Enhanced Capital LLC addressing the treatment of insurance premium tax credits earned under the Nebraska Job Creation and Mainstreet Revitalization Act. The legislation was included in the Revenue Committee’s priority bill and added approximately $1 to $3.5 million in insurance premium tax credits.