Category Archives: Insurance Law News

New York State Department of Insurance Fines UnitedHealth

The New York Insurance Department, now known as the Department of Financial Services, has fined Oxford (UnitedHealth) $665,000. The Department released a stipulated order in which Oxford, owned and controlled by UnitedHealth, has admitted to various regulatory violations. The violations involve either failing to issue Explanation of Benefits Forms or […]

Insurance Brokers Can Be Liable for Both Breach of Contract and Negligence

A ruling by the Appellate Division in New York concluded that insurance brokers can now be held liable to their clients on a negligence theory for failing to obtain an insurance policy to cover a loss that the broker was hired to cover. Prior to this decision, the law was […]

Bill Signed Into Law Stops Claim Denials Based on Late Notice

New York’s Governor signed into law a long-awaited bill that will prevent insurance companies from denying claims when they believe the policyholder was “late” in reporting the loss. New York was the last state in the country to maintain a harsh rule that allowed claims to be denied completely based […]

Governor Spitzer Issues a Veto on Late Notice Bill

In an unexpected twist, Governor Spitzer rejected a long-awaited bill that would no longer allow insurance companies to deny claims based on “late” filing of the claim. He asked the Legislature to make certain improvements and revisions to the bill but did indeed embrace the concept that such a law […]

Long Awaited Legislative Victory in New York—Will Denials for Late Notice Be Dead?

Both houses of the New York Legislature have passed a bill that would prohibit insurance companies from denying claims based on alleged late filing of the claim (late notice). The late notice defense has been one of the most harsh and unfair bases for claim denials in New York. Claims […]

Court Ruling Requires Insurance Companies to Pay Benefits to People with Preexisting Conditions

In a key court ruling, New York’s highest court ruled that disability insurers must pay claimants under group policies who have preexisting conditions. The insurance company may only exclude the first 12 months of payments, but must make full payment after that, starting the 13th month of a long-term disability. […]

Predicted Problems with Long-Term Care Insurance Claims Beginning to Surface

When the nations’ life, health and disability insurers began to lose money on their book of disability insurance business, they turned to increased sales of long-term care insurance to beef up their balance sheets. But as The New York Times has reported, as the claims have now begun to come […]

Recent Ruling by New York State to Invalidate Discretionary Clauses

Firm Believes Thousands of Policyholders Will Be Aided by Decision. In a landmark ruling, the New York State Insurance Department (Discretionary Clauses) has taken critical action to help thousands of New Yorkers who file health and disability insurance claims under policies purchased by their employers. In issuing a Circular Letter, […]

New York High Court Bars Stacking in Lead Exposure Case

Although an infant’s exposure to lead paint spanned three consecutive years in which a building owner carried liability insurance, coverage is limited to one annual policy limit, the New York Court of Appeals affirmed Oct. 25 (Christopher Hiraldo, et al. v. Allstate Insurance Co., et al., No. 139, N.Y. App.; […]

Water Exclusions for Katrina May Be Invalidated

The Mississippi Attorney General filed a lawsuit seeking to prohibit insurers from using water exclusions to deny coverage to property owners whose homes were destroyed or damaged by Hurricane Katrina (Jim Hood, Attorney General for the State of Mississippi, ex rel. the State of Mississippi v. Mississippi Farm Bureau Insurance, […]