Insurance Law and Insurance Regulation

These schemes rarely look like obvious scams. Instead, they’re often embedded within otherwise legitimate medical claims, making them difficult to detect. Over time, however, improper billing practices, unnecessary procedures, or referral-driven treatment patterns can add millions of dollars in expenses to employer health plans and insurance systems.

When a liability insurer defends an insured under a reservation of rights, does a conflict of interest arise if the factual issues in the underlying litigation are the same facts that determine coverage availability? The Minnesota Court of Appeals addressed this critical question in a case involving a construction zone accident, establishing when insurers must fund independent counsel for their insureds.

Two Georgia employees allegedly misappropriated trade secrets and proprietary software to launch a competing insurance brokerage, prompting their former employer to sue. When their professional liability insurer denied coverage, a critical question emerged: what types of actions by an insured actually constitute "professional services" under Georgia law, and does establishing a rival business using stolen confidential information fall within that definition?