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The Patient Protection and Affordable Care Act and the Health Care and...

Eric M. Peterson from the law firm of Dorsey & Whitney LLP has done a nice job summarizing the recently enacted Patient Protection and Affordable Care Act.  Peterson’s article, ‘Health Care Reform...

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New California Health Insurance Legislation Moves Forward

The debate over national health care reform has moved to the California Legislature, which will begin taking the initial steps to implement the complex series of health insurance overhauls prescribed...

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Documents Reviewed by Independent Medical Examiner Sufficient to Satisfy Plan...

The United States Court of Appeals for the Ninth Circuit, in an unpublished decision, addressed the question of whether documents reviewed by an independent medical examiner, but not by the plan...

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Ninth Circuit Court of Appeals Applies Montour to the Conflict of Interest...

In the aftermath of the United States Supreme Court holding in Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105, 128 S.Ct. 2343, 2348 (2008), the courts have struggled to apply this holding. The Ninth...

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Submission of the Claim File: Seal or Redact?

For most insurance litigation, the majority of the evidence used by both sides comes from the claim file, also known as the administrative record in ERISA cases.  The claim file represents the...

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District Court Provides Additional Guidance on Scope of Discovery Under Glenn

In the last several years, the scope of discovery in ERISA cases has been a point of contention between plaintiff and defense counsel.  Plaintiffs typically want free range to conduct discovery on any...

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Federal Insurance Office Is Now A Reality

On July 21, 2010, President Obama signed into law the Dodd-Frank Wall Street Reform and Consumer Protection Act (H.R. 4173).  The Act directs the U.S. Treasury Department to create a Federal Insurance...

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Cell Phone Users Catch a Break

The Thursday August 5, 2010 edition of the Los Angeles Daily Journal featured my article entitled “Cell Phone Users Catch a Break,” in the Perspective column. It discusses the U.S. Copyright Office's...

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New Appeal Regulations For Health Plans Require Final Claims Decision To Be...

The Department of Health and Human Services issued new appeal regulations under the recently enacted Patient Protection and Affordable Care Act (“Affordable Care Act”).  These regulations give...

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New Regulations Take Aim at Policy Rescissions

Insurance Commissioner Steve Poizner has announced new regulations that go into effect aimed at combating improper rescissions by insurance companies.  These will go into effect on August 18, 2010....

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The Waiver Doctrine, Alive And Well in ERISA Cases

The Wednesday August 11, 2010 edition of the Los Angeles Daily Journal featured my article, entitled “The Waiver Doctrine, Alive And Well in ERISA Cases,” in the Perspective column. It explains a very...

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Disability Policy Discretionary Clauses Come Under Congressional Attack

Policyholder/Employee groups who have group disability insurance coverage through their employers and who find themselves operating in the byzantine world of ERISA have long criticized discretionary...

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Certain Health Insurance Reforms Go Into Effect as of September 23

On September 23, 2010, the Patient Protection and Affordable Care Act, part of the recently enacted health care reform law, went into effect for insurance plans that begin on or after this date....

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Governor Schwarzenegger Vetoes AB 1868 That Would Have Banned Discretionary...

Today Governor Schwarzenegger vetoed AB 1868 that would have banned discretionary clauses in group insurance policies.  This is a disappointment to consumer groups but not to insurers who rely on them....

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California's Largest Health Insurers are Fined by California Department of...

In today’s Los Angeles Times Business Section, Duke Helfand writes about an 18-month investigation by the California Department of Managed Health Care into the payment practices of Aetna Inc., Anthem...

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California's Office of Administrative Law Approves Homeowners Underinsurance...

Because of fairly recent California wild fires and California’s history of rising property values (at least this was the case a few years ago), many California homeowners have found themselves...

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Dave Jones Reveals the Priorities for His Tenure as California's Insurance...

California’s new Insurance Commissioner, Dave Jones, identified his priorities at his inauguration on January 3.  He plans to accomplish his objectives by making the California Department of Insurance...

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California Insurance Commissioner Jones Announces New Regulations On...

In recent years there have been many cases of insurance agents selling unsuitable annuities to members of the public, especially seniors.  These annuities typically involve large premiums and very...

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New California Law Requires That Insurers and Agents Verify that an Annuity...

California Governor Jerry Brown recently signed a new law that will provide increased protection to seniors and other consumers who are interested in purchasing an annuity.  AB 689, which was sponsored...

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California Bans the Inclusion of Policy Provisions Giving Insurance Companies...

In a major victory for consumers, Governor Jerry Brown signed a bill that makes discretionary clauses – typically contained in ERISA-governed life, health and disability insurance policies/ERISA plans...

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