Tag: medical benefits

Health Care Plan Provider’s Conspiracy / Scheme to Underpay Insurance Claims Submitted by Providers and Beneficiaries Not “Errors or Omissions” and Reinsurance Policies Covering Professional Liability Policies Not Implicated

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In June, a Court of Appeals panel in Indiana issued an unpublished, and therefore, non-binding, opinion speaking to an issue that has significant relevance for several of our insurer and employer clients, and third-party claims administrators with whom we work.The insurance coverage case, Wellpoint, Inc., et al. v. National Union Fire Ins. Co., et al, arose out [...]

No-Fault Insurer Entitled to Judgment on Hospital’s Claim for Reimbursement of Medical Expenses for Motorcyclist’s Injuries for Accident Caused in Avoiding Collision with Motor Vehicle

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In DMC v. Progressive, The Court of Appeals reversed a trial court judgment for the plaintiff hospital which sought reimbursement from defendant no-fault insurer of medical expenses for care to an injured motorcyclist. The motorcyclist suffered serious injuries after he ditched his bike to avoid a collision with an automobile about to cross into his path. [...]