Investigating and litigating singular fraud cases for first- and third-party claims used to be the mainstay of special investigation units. While these tactics can be relatively successful, there is still a whole world of abuse and misrepresentation stemming from medical providers, durable medical equipment suppliers, diagnostics entities, premium fraudsters, auto body shops, copy service providers, and more.
Montana Attorney General Tim Fox announced this week a Three Forks man charged with fraudulently collecting workers’ compensation benefits from the Montana State Fund has pled guilty.
You see it unfold in slow motion. Your brother-in-law trips on your $45,000 Persian rug and puts his hand through your $220,000 Andy Warhol. Your rug now has an 8” tear, and your Warhol has been sliced and diced.
When Arthur Mosely moved to East Austin in the 1980’s he didn’t worry about flooding. His property was not in a designated floodplain, and he thought of the creek that ran behind the house as an amenity. It guaranteed privacy and a green space full of Muscatine grapes and pecan trees.
Turbocharged by winds reaching hurricane force, wildfires whipped across Northern California on Monday, burning tens of thousands of acres, driving almost 200,000 people from their homes and seriously injuring a firefighter.
A federal district court has refused to dismiss litigation filed by a golf course operator against Willis Towers Watson U.S. LLC in connection with coverage litigation filed against it and American International Group Inc. unit over Hurricane Harvey damage, stating a ruling is premature.
Massachusetts sued Exxon Mobil Corp (XOM.N) on Thursday, accusing the oil giant of misleading investors and consumers for decades about the role fossil fuels play in climate change.
Chasing perfect claims results can seem like chasing the wind, especially when it comes to making denial decisions. As Isaac Newton presented in his third law of motion, every action has an equal and opposite reaction, and deciding when to deny a claim is no exception.<br /><br />When initially evaluating claims, there are three general claims types encountered: the likely valid, the possibly valid, and the likely invalid. There is an art to analyzing and balancing these three types of claims and deciding which should be denied and fought. An initial analysis requires a grasp of the applicable legal standards and associated potential risks and exposure. Knowing up front how to navigate between types of claims, the applicable law, how much time to devote to a claim, when to hit a decision point, and when to deny and fight is essential to any claims-handling st
Wildfires in both Los Angeles County and Northern California’s wine country continued to burn Friday morning, with tens of thousands of people under evacuation orders, many schools closed and more than 50 houses or other buildings destroyed.
There are those in the field of Philosophy that will tell you that the “slippery slope” argument is not an acceptable one. In fact, in the arena of Formal Logic it is referred to as the “Slippery Slope Fallacy” and any reasoning that attempts to use it is declared to be invalid.
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Over an October weekend, a friend of my boyfriend visited us from California. Since I wasn’t in the mood to drive across the city to the Philadelphia airport to pick him up, he did what most people would do. He pulled out his phone and called an Uber.
The family of one of the men who died when the Hard Rock hotel collapsed two weeks ago in downtown New Orleans has filed a wrongful death lawsuit against the building’s developers.
Insurance experts estimated on Wednesday that the tornadoes which slammed North Texas on Sunday night caused $2 billion in damage, making it the costliest tornado event in Texas history.
