California Cuts To Rural Healthcare Services Violate Medicaid Act

California Ass’n of Rural Health Clinica; Avenal Community Health Center v. Douglas et al. United States Court of Appeals for the Ninth Circuit, July 5, 2013 California recently enacted legislation that eliminates coverage for certain healthcare services in under-served rural areas to help curb the State’s budgetary woes. Specifically, the legislation cut coverage for adult dental, podiatry, optometry and chiropractic services in rural areas. The court ruled that eliminating coverage for such programs would be in conflict with the Medicaid
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Insurers’ Goal Line Stand: California Coverage Action Stayed While New York Case Marches On

National Football League v. Fireman’s Fund Ins. Co. (Cal. App. Ct. May 28, 2013) A California appellate court recently affirmed a stay of California litigation commenced by the NFL against multiple insurers seeking coverage for traumatic brain injury cases. The court held that the NFL was not a California resident for purposes of a forum non conveniens analysis even though it has three teams in California. The NFL administration and its intellectual property marketing arm were sued in multiple states
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Blue Shield California Seeks Supreme Court Review on ERISA Waiver

Blue Shield of California v. Harlick Petition for Writ of Cert from U.S. Ct. Apps. 9th Cir., (filed Oct. 10, 2012) The Petition for Cert comes after the Ninth Circuits ruling that barred Blue Shield from considering on remand whether the plaintiff’s services were medically necessary. The court held that the ERISA plan had waived its right to conduct an investigation and to potentially make the medically necessary determination because it did not identify those specific grounds in its initial
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California Supreme Court Adopts All-Sums-With-Stacking Approach in Major Policyholder Victory

State of California v. Continental Ins. Co. (Cal. Aug. 9, 2012) In a much-anticipated decision, the Supreme Court of California ruled last week that several excess insurers were obligated to indemnify the State of California for all sums relating to the clean-up of the Stringfellow Acid Pits waste site, regardless of whether the damage occurred during the insurers’ policy periods. The court also held that the State could stack its policies from multiple years to maximize recovery. The State sought
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California Appeals Court Rules Against Coverage for Proposition 65 Claims

Ulta Salon, Cosmetics & Fragrance, Inc. v. Travelers Prop. & Cas. Co. of Am.(Cal. Ct. App. July 11, 2011)  A California appeals court recently held that an insurer was not obligated to defend or indemnify its insured against a claim that the insured violated Proposition 65, the California Safe Drinking Water and Toxic Enforcement Act of 1986. The court based its ruling on the complaint’s failure to allege “bodily injury” and rejected the notion that an insurer’s duty to defend
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California Appellate Court Reverses Lower Court on Asbestos Coverage Dispute Involving “Single Occurrence” Issues

Kaiser Cement & Gypsum Corp. v. Ins. Co. of the State of Pennsylvania (Cal. App. 2d Dist. June 3, 2011) Plaintiff manufactured a variety of asbestos-containing materials, including joint compound, finishing compounds, fiberboard, and plastic cements, from 1944 through the 1970s..  By 2004, the company faced more than 24,000 claims from people alleging they suffered bodily injuries as a result of their exposure to asbestos contained in the company’s products. In 2007, the court considered whether thousands of asbestos bodily
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California Passes Critical Life Insurance Bill

California became the 34th state to regulate life settlements when Gov. Arnold Schwarzenegger of California signed Bill S.B. 98.  The bill preserves a policyholder’s right to sell the life insurance policy for value prior to lapse or surrender.  Additionally, individuals can obtain life settlements through an agent, an prohibit insurance companies from restricting life insurance agents from informing policyholders about such settlements.  The law provides stronger consumer-orientated provisions, including licensing mandates for brokers and settlement companies, requiring disclosures regarding offers,
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California Court Affirms Judgment Against Insurance Agent HRH

Williams v. Hilb, Rogal & Hobbs Ins. Services of California, Inc. (Cal. App. September 9, 2009) Following a bench trial, an insurance agency was found liable for negligence in advising on, procuring and maintaining an insurance package for a new business venture that did not include worker’s compensation insurance.  The court held that although an insurance agent does not have a duty to volunteer to an insured that the latter should procure specific insurance coverage, the rule changes under certain
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The Insurance & Reinsurance Report: Year in Review — Why We Think It’s the Best Legal News Blog of 2018

Goldberg Segalla’s Insurance and Reinsurance Report is in the running for The Expert Institute’s Best Legal News Blog of 2018. Fans and readers of the Report and others who stay abreast of developments in the legal blogosphere are invited to vote for the best legal news blog through the following link: The Insurance & Reinsurance Report Honored to be in the running and by the support we’ve seen thus far, we took this opportunity to reflect on some of the
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Use of Uninsured Vehicle To Transport Victim To Site of Assault Does Not Trigger UM Coverage

On August 14, 2018, in a case of apparent first impression in New Mexico, the New Mexico intermediate appellate court in Crespin v. Safeco Ins. Co. of Am., 2018 (N.M. Ct. App. 2018) upheld a lower court’s ruling that transporting a minor in an uninsured motor vehicle to another location in order commit a sexual assault does not trigger uninsured motorist (UM) coverage because the assault did not arise out of the use of the uninsured vehicle. The decision rebuffs
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