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TODAY'S TOP DEVELOPMENTS Friday, December 16, 2016  

Industry news, expert analysis, and daily updates on the most significant insurance coverage legal developments—from the insurance and legal experts of The National Underwriter Company.


Health Insurance
Vermont Supreme: Wife Was Eligible for ACA Subsidies Despite Husband's Decision Not to Enroll in His Employer's Healthcare Plan
The Vermont Supreme Court has ruled that a wife was eligible for a subsidized healthcare plan on the Vermont Health Connect exchange under the Patient Protection and Affordable Care Act of 2010 as a person who did not have available health insurance where her husband had elected not to enroll in his employer's healthcare plan and she could not enroll in that plan herself unless he enrolled. Read More

Life Insurance
Wells Fargo Fraud Extended to Prudential Life Insurance Policies, Whistleblowers Allege
Three former supervisors at The Prudential Insurance Company of America have filed a lawsuit alleging that a life insurance program called "MyTerm," created by Prudential with Wells Fargo Bank, had a large number of similarities to how Wells Fargo had opened fraudulent bank accounts. Read More

Automobile Insurance
No Insurance Coverage for Man Who Was Not "In," "Upon," "Getting In," "On," "Out," or "Off" Insured Vehicle When He Was Injured, Louisiana Court Decides
A federal district court in Louisiana has ruled that a man who had not been "in," "upon," or "getting in," "on," "out," or "off" an insured vehicle had not been "occupying" an insured vehicle and, therefore, was not entitled to recover benefits for injuries he suffered after being struck by another vehicle. Read More

N.Y.'s Top Court Is Asked: What Does Reinsurance Policy's Per Occurrence Liability Cap Really Cap?
The U.S. Court of Appeals for the Second Circuit has asked New York's highest court, the New York Court of Appeals, to decide whether a decade-old decision imposes "either a rule of construction, or a strong presumption, that a per occurrence liability cap in a reinsurance contract limits the total reinsurance available under the contract to the amount of the cap regardless of whether the underlying policy is understood to cover expenses such as, for instance, defense costs?" Read More

View All Case Law Developments

Life Insurance

New York Insurance Regulator Proposes to Require Prior Notice Before Life Insurance Premiums Can Be Raised
The New York State Department of Financial Services has proposed a new regulation to govern life insurance company practices related to increases in the premiums of certain life insurance and annuity policies. Read More

Insurance Fraud
Insurance Broker and Wife Charged with Life Insurance Fraud Relating to Death of Their Son
An insurance broker and his wife from Albany, New York, have been charged with stealing life insurance payments and attempting to wrongfully obtain life insurance payments by submitting false claims with respect to the death of their son. Read More

View All Legislative/Regulatory Developments
NY Life's Relationship with Susan B. Anthony…  Read More

Lack of Transparency in Auto Insurance Market Cost Consumers $101 Billion in the Last Five Years, ValChoice Asserts  
Read More

Allstate Announces Autonomous Vehicle Research Agreement  
Read More

FC&S Legal Publishes "9 Fraudsters Join the Hall of Shame"  
Read More

FC&S Legal Publishes "6 Factors That Affected Insurers in 2016"  
Read More

View All Industry News
Potentially Covered Claims and the Duty to Defend


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60px_newMeyerowitz Steven A. Meyerowitz, ESQ.
Director, FC&S Legal
60px_newSpears Victoria Prussen Spears, ESQ.
Associate Director, FC&S Legal
FC&S Legal Editorial Advisory Board
Mitchell J. Auslander, Willkie Farr & Gallagher LLP
Carrie Cope, Cope Ehlers, P.C.
Anjali C. Das, Wilson Elser
John F. Finnegan, Chadbourne & Parke LLP
Michele L. Jacobson, Stroock & Stroock & Lavan LLP
Timothy P. Law, Reed Smith LLP
Cort T. Malone, Anderson Kill, P.C.
Richard D. Milone, Kelley Drye & Warren LLP
Joseph P. Monteleone, Rivkin Radler LLP
Anne M. Murray, Rivkin Radler LLP
Jerold Oshinsky, Kasowitz, Benson, Torres & Friedman LLP
Seth B. Schafler, Proskauer Rose LLP
Thomas F. Segalla, Goldberg Segalla
David D. Thamann, The National Underwriter Company

FC&S Daily Legal Report ($1,295 annual subscription) is included as part of your subscription to FC&S Legal: The Insurance Information Center. FC&S Daily Legal Report and The Insurance Coverage Law Report are publications of The National Underwriter Company. For more information, visit To subscribe to FC&S Legal, please contact customer service at 1-800-543-0874 or

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