Weil has in-depth knowledge of the complex issues faced in the insurance industry. Comprising lawyers located in offices around the US, our Insurance Litigation practice is well-equipped to handle the full spectrum of issues on behalf of the world’s most sophisticated insurance and reinsurance companies.

Our lawyers bring a powerful blend of litigation and transactional experience to complicated matters, and have successfully defended clients against private, government and class action suits, and before state insurance agencies. We have also represented numerous plaintiffs in major cases of first impression. We have a proven track record of success and have successfully represented insurance and reinsurance companies in some of the largest insurance disputes ever.

Highlights of our insurance litigation practice include:

• Significant and repeated representation of several of the world’s largest insurance companies, including AIG, United HealthCare, Farmers Insurance, Ability Insurance, Genworth Financial, The Hartford, Travelers, and Prudential, in bet the company litigations on a wide variety of issues.
• Defense of dozens of nationwide and statewide class actions involving failed “vanishing premiums,” modal premium rates, long-term care insurance rate increases, deceptive and unfair trade practices and ERISA violations.
• Representation, as lead counsel, of United HealthCare in one of the largest insurance disputes ever – a multidistrict litigation with billions of dollars at stake.
• Extensive experience handling "UCR" class actions, claims by insured that they were under-reimbursed because of "usual, customary and reasonable" limitations in policies.
• Representation of insurance companies in proceedings before the House Committee on Commerce, the Senate Finance Committee and instituted by various state attorneys general.
• Negotiation of some of the most creative and favorable settlements of complex nationwide matters.

Highlights of our reinsurance litigation and arbitration practice include:

• Defense and prosecution of several major reinsurance arbitrations, including achieving total victory in a $75 million reinsurance arbitration for Life Re (now part of Swiss Re), resulting in rescission of a multi-year reinsurance treaty with bad claims experience.
• Successful representation of Penn Treaty in a reinsurance arbitration regarding multiple reinsurance treaties.
• Representation of Employers Reinsurance Company, formerly an affiliate of GE, in reinsurance matters.
• Representation of Swiss Re in a major reinsurance arbitration involving complicated reserving issues.
• Successful representation of Conseco Life in major reinsurance litigation where the plaintiff claimed over $50 million in damages.
• Extensive experience with Special Committee and SEC investigations, including several internal investigations of major companies involving complex reinsurance arrangements.

Our lawyers also have extensive experience in effecting insurance company public and private mergers, cash and partial cash deals, leveraged transactions, restructurings, asset-based transactions, spin-off transactions, and auction situations.

• Lead counsel in the acquisition of over 100 insurance companies.
• Directly involved in obtaining state regulatory approvals for these transactions.
• Extensive experience with complex and politically sensitive transactions.
• Hundreds of public hearings in front of state insurance regulatory authorities.
• Effectively collaborate with local counsel where appropriate or strategically advantageous.

Our Insurance practice provides comprehensive services to ensure the success of our clients’ insurance transactions:

• Creation of contractual provisions tailored to unique issues in the insurance industry.
• In-depth industry-specific due diligence review and analysis of insurance regulatory structuring issues to provide optimal solutions.
• Preparation and filing of insurance regulatory filings (e.g., change of control, affiliate transactions, anti-competition, extraordinary dividends).

Recent Insurance and Reinsurance Litigation and Arbitration Highlights

Farmers Insurance Exchange

Weil secured several major victories – including the dismissal of one putative subclass, and the denial of class certification of another – for clients Farmers Insurance Exchange and Mid-Century Insurance Company in a putative class action in federal court in Colorado asserting claims of breach of contract, declaratory relief, and statutory and compensatory damages arising out of adjustments allegedly made to medical payment claims under certain auto insurance policies.

Weil represented Farmers Insurance Company, Inc., Farmers Insurance Exchange, Truck Insurance Exchange, Fire Insurance Exchange, Mid-Century Insurance Company, Farmers Group, Inc., and Illinois Farmers Insurance Company's (collectively, Farmers) in reaching a nationwide class settlement relating to the use of computerized systems in order to determine reasonable expenses for necessary medical services under the Medical Payments or Personal Injury Protection coverages afforded in Farmers’ automobile insurance policies. The settlement resolved a number of separate putative class action lawsuits that have been pending against Farmers for the past several years.

Weil defeated class certification in a putative class action filed in Oklahoma state court against Farmers Insurance Company, Farmers Group, Inc., Mid-Century Insurance Co., and Truck Insurance Exchange (collectively “Farmers”), where the plaintiffs challenged Farmers’ payment of medical expense benefits based on amounts paid by Medicare or private health insurers. Farmers argued in its opposition briefs and at oral argument that class certification was inappropriate because numerous individualized inquiries would be required to adjudicate each class member’s claim and that the named class representatives were atypical. The court denied Plaintiffs’ motion for class certification in its entirety.

UnitedHealth

Out-of-Network Reimbursement Class Actions

Weil has long represented UnitedHealth Group (UHG) and its affiliates (collectively, United) in a number of high-value actions challenging the out-of-network (OON) reimbursement practices of various United entities, as well as a database tools for OON reimbursement licensed by a UnitedHealth Group subsidiary (Ingenix, Inc.) to most major health care insurers. In 2010, we were able to settle the claims of United health plan members challenging their OON reimbursements (American Medical Association v. United HealthCare, Inc. (S.D.N.Y)).

We continue to represent United in the consolidated cases of Doctor’s Hospital of Slidell, LLC v. United HealthCare Insurance Co., et al. (E.D. La.) brought by provider and facility plaintiffs who opted out of the class-wide American Medical Association v. United HealthCare, Inc. settlement. The physicians and medical facilities in these cases asserted a variety of state statutory, federal statutory, and common law claims – including claims arising under ERISA, the Sherman Act, state prompt pay and unfair trade practices statutes, and contract and quasi-contract claims. We obtained the complete dismissal of all claims asserted against the United defendants. The court granted plaintiffs leave to amend their complaint to replead certain claims, but expressly required plaintiffs to provide specific factual allegations as to each and every medical claim for reimbursement they place at issue in the case. Only 7 of the 27 plaintiffs filed amended complaints against the United defendants. We have moved to dismiss the new, amended complaints.

We also represent UHG and Ingenix in two MDLs involving claims by putative class members in health benefit plans insured or administered by Aetna and Wellpoint.

• In In re Aetna, MDL 2020 (D.N.J.), plaintiffs claim that UHG and Ingenix conspired with Aetna to under-reimburse Aetna health plan members for OON services using the Ingenix databases. Our motion to dismiss is pending.
• In In re Wellpoint, MDL 2074 (C.D. Cal.), plaintiffs claim that UHG and Ingenix conspired with WellPoint to under-reimburse WellPoint health plan members for OON services using the Ingenix databases. On September 6, 2012, the court dismissed all claims brought against UHG and Ingenix, including those brought by provider-plaintiffs, association-plaintiffs, and health plan member-plaintiffs.

We also successfully represented UHG and Ingenix in a purported class action by members of Cigna health plans (Nelson v. Cigna). Like In re Aetna and In re WellPoint, this case involves claims that UHG and Ingenix conspired with Cigna to under-reimburse Cigna health plan members for OON services using the Ingenix databases. We obtained the dismissal of the federal claims and most of the state claims brought against UHG and Ingenix in September 2011 on a motion to dismiss. We thereafter obtained the dismissal of the remaining state claim in January 2012 on a motion for judgment on the pleadings.

Weil represents UnitedHealth Group and various employee benefit plans in a putative class action brought by two ambulatory surgery centers (ASCs), which challenges United’s reimbursement of facility fees for surgeries performed by out-of-network providers under different employee benefit plans. Plaintiff asserts ERISA claims for benefits and for failure to provide a full and fair review, as well as claims under RICO, the Sherman Antitrust Acts, and various common law theories based on United’s alleged methods for reimbursing ASCs for out-of-network claims.

In Re Managed Care Multidistrict Litigation

Weil successfully obtained a major victory in a multi-billion dollar matter for UnitedHealth in its defense against allegations of industry-wide fraud and conspiracy among managed care companies to underpay physicians. The United States District Court in Miami granted United HealthCare’s summary judgment motion, finding that the plaintiffs could not demonstrate any wrongdoing on the part of United HealthCare, and dismissed all claims against the company.

Other Cases

Weil represents UnitedHealth Group in a nationwide putative class action brought by a physical therapy provider who purports to have received an assignment of the rights and benefits of at least sixty participants and/or beneficiaries of various group health plans, two individuals treated by the plaintiff provider, and the Arizona Chiropractic Society. Weil is also representing 35 of the 45 group health plans, who are sponsored by corporations including Abbott Laboratories, ADP TotalSource, Inc., Citigroup, Discount Tire Company, General Motors, Genuine Parts Company, Home Depot U.S.A., Insight Enterprises, Kodak, MetLife, Pfizer, Proctor & Gamble, Qwest, Revlon Consumer Products Corporation, and Wells Fargo. Plaintiffs assert claims under ERISA sounding in breach of contract and breach of fiduciary duty and seek a declaration that the physical therapy on a “VAX-D Table” is a covered benefit under the plans. Plaintiffs have valued their claims at more than $5 billion.

Weil represented UnitedHealth Group in defending a case filed by a participant in a self-funded health plan sponsored by AllianceBernstein L.P. The plaintiff commenced a putative class action against AllianceBernstein and United alleging that defendants misapplied her plan’s requirements for coordination of her benefits with Medicare. Plaintiff asserted three claims against United: (1) improper coordination of benefits with Medicare (class-wide); (2) failure to provide a full and fair review under ERISA (class-wide); and (3) failure to provide documents and information as required by ERISA (individual). On July 16, 2012, the Honorable Katherine B. Forrest dismissed all claims against United and its affiliates. Judge Forrest dismissed the failure to provide documents and information claim as to all defendants, and held that United was not a proper party as to the first two claims because United was not a “plan administrator” as defined in ERISA.

Ability Resources and Ability Insurance Company

Weil has been successfully representing Ability Resources, and its insurance subsidiary, Ability Insurance Company, in unrelated disputes with long-term care policyholders in federal courts in Iowa and South Dakota. To date, we have won several important victories on dispositive and procedural motions that have significantly narrowed each case, including winning partial summary judgment in Iowa federal court that dismissed plaintiff’s claim for fraud and misrepresentation, and winning partial summary judgment in South Dakota federal court dismissing another plaintiff’s claim for emotional damages.

Citigroup and Met Life

Citigroup/Metlife Structural Settlement Class Action Litigation

Weil obtained a significant victory for our clients Citigroup and MetLife in a purported nationwide class action alleging that our clients had engaged in illegal rebating in connection with the use of structured settlements to settle insurance claims. After the Connecticut state court certified a nationwide class in May 2004, we appealed. After fully briefing, the Connecticut Supreme Court took the appeal (as opposed to it being heard by the Connecticut Appellate Court), and we argued the appeal before a five judge panel. In a unanimous decision, the Supreme Court reversed the trial court’s ruling in its entirety and decertified the nationwide class because, in part, individual issues of fact and law predominated.

Genworth Financial and The Travelers Insurance Company

Weil obtained summary judgment in a purported class action for breach of contract and declaratory relief in which plaintiff was seeking tens of millions of dollars in future insurance premiums. Plaintiff alleged that The Travelers Insurance Company did not apply premium rate increases to its long-term care policyholders on a "class" basis as required by the applicable insurance policies.

Weil also defended Genworth Financial in two nationwide insurance "modal premium" class actions in New Mexico state court asserting claims for breach of contract, failure to disclose and violations of state unfair and deceptive trade practices statutes.

Empire HealthChoice, Inc.

Weil secured a major victory for Empire HealthChoice, Inc. (now called WellChoice) and its Board of Directors in the New York State's Court of Appeals in a litigation challenging Empire's November 2002 conversion from a not-for-profit health insurer to a publicly traded, for-profit corporation. The conversion was challenged by Consumer Union, other public interest groups and individual subscribers on a variety of grounds, including alleged violations of the "Takings," "Contracts" and "Due Process" clauses of the federal and state constitutions, violation of the state constitutional prohibition on "special" or "private" legislation, and violations by Empire's board of its fiduciary duties.

At stake was the existence of Empire as a for-profit corporation, as well as the viability of its initial public offering. Also at stake was $3 billion to $4 billion in proceeds from Empire's conversion and IPO that had been earmarked by the statute authorizing the conversion for various public health initiatives in New York State. In a 4-2 decision, the Court of Appeals dismissed all of the challenges to the conversion and its attendant IPO as legally insufficient.

Conseco Life Ins. Co.

Successfully defended Conseco against allegations brought by a putative class of more than 400,000 policyholders alleging more than $600 million in damages that policyholders were defrauded into purchasing policies with features that required them to pay more in premiums if they paid premiums monthly, quarterly or semiannually. Although more than a dozen similar class actions had been certified elsewhere, after a two-day long hearing, Weil convinced the court that certifications should be denied, thus claiming what is believed to be the first judicial victory on class certification for the insurance industry in these expanding class actions suits.

Weil successfully defended Conseco Life in an insurance matter involving allegations of fraud, negligent misrepresentation, negligent hiring and supervision, bad faith and violations of the Texas Deceptive Trade Practices Acts. Plaintiffs claimed over $50 million in purported damages. Following almost two years of heated discovery, we achieved a favorable settlement for Conseco after the filing of dispositive motions.

Penn Treaty American Corp.

After two years of litigation, we successfully settled a nationwide long term care insurance class action involving over 200,000 policy holders. Plaintiffs asserted claims of fraud, negligent misrepresentation, breach of fiduciary duty, restitution and reformation and sought hundreds of millions of dollars in damages. Case was settled with creative policy options for policy holders with no cash paid to plaintiffs.

HealthMarkets

Represented insurance carrier HealthMarkets, Inc. (f/k/a UICI) in over thirty individual and class action cases in multiple states and national multi-district litigation in which consumers claimed fraud in selling insurance policies. We negotiated a national class settlement and defeated opt-outs and an objector group.

Insurance Group of North America

Defeated class certification in a matter alleging multiple causes of action arising out of failed “vanishing premium” insurance policies.

Philadelphia Insurance Companies

Convinced a Texas appellate court to reverse the certification of two classes involving more than 30,000 policyholders in 18 states. The class action challenged the right to collect certain fees as part of a premium, as well as its attempts to withdraw from certain markets.

Insurance/Reinsurance Transactional Experience Highlights

Insurance/Reinsurance Mergers & Acquisitions

UnitedHealth Group

• $9.2 billion acquisition of PacifiCare Health Systems, Inc.
• $2.95 billion acquisition of Mid Atlantic Medical Services.

General Electric

• $6.8 billion sale of the property casualty business of GE Insurance Solutions to Swiss Re.
• $2.15 billion sale of GE Edison Life Insurance Company (now AIG Edison Life Insurance Co.) to American International Group.
• $2.1 billion sale of Financial Guaranty Insurance Co. to an investor consortium lead by The PMI Group, Inc.
• $1.8 billion acquisition of First Colony Life and numerous other life insurance acquisitions.
• $1.4 billion acquisition of Life of Virginia, Union Fidelity Life and subsidiaries.
• $884 million acquisition of The Signature Life Insurance Company of America; Montgomery Ward Life Insurance Company; Montgomery Ward Insurance Company and Forum Insurance Company.
• $525 million acquisition of Great Northern Annuity Insured Corporation and subsidiaries
• $400 million acquisition of Harcourt General Insurance and subsidiaries.

Genesis

• $1.5 billion acquisition of The Multicare Corporation.

American General Financial Group

• $1.2 billion acquisition of American Franklin Company.

Life Partners Group

• $850 million sale to Conseco.

Old Mutual

• $635 million acquisition of Fidelity and Guaranty Life Insurance Company from St. Paul Companies.

Employers Re

• $625 million acquisition by GE Capital of the Medical Protective Company.
• Regulatory counsel in the $530 million acquisition of Kemper Reinsurance Company.

PennCorp Financial Group, Inc.

• $400 million acquisition of Washington National Corporation and subsidiaries.

Conseco

• $400 million purchase of Transport Life Companies.

Insurance/Reinsurance Private Equity

Hellman & Friedman LLC/GIC/Farallon

• $1.1 billion pending acquisition of Universal Underwriters Group from Zurich Financial Services Group.

Leucadia

• $1 billion sale of Colonial Penn Insurance Group to GE Capital.
• $460 million sale of Colonial Penn Insurance Companies to Conseco.

HM Capital Partners

• $495 million acquisition of Massachusetts General Life Insurance Company, Philadelphia Life Insurance Company, and certain of their affiliates.
• Pending acquisition of Bank of America Capital Investors and Emeral Capital Group of Swett & Crawford from Aon Corporation.

Capital Z

• Represented in their investment in PxRe and Endurance.
• Acquisition of Permanent General Group of Insurance companies.
• Acquisition of SBJ Group Limited.
• $19 million acquisition of Instant Auto Insurance Company.

Merchant Banking Partners

• Represented in their investments in Axis Capital Holdings Limited, Montpelier Re Holdings Ltd., Aspen Insurance Holdings Limited and White Mountain Insurance Group Ltd.

Hellman & Friedman LLC

• Pending acquisition with Friedman, Fleisher & Lowe of Pacific Select Property Insurance Company, GeoVera Insurance Company, USF&G Specialty Insurance Company from St. Paul Travelers Companies, Inc., United State Fidelity and Guaranty Company.

Representative Mutual/Not-for-Profit Transactions

Empire Blue Cross & Blue Shield

• Conversion of Empire/Blue Cross into WellChoice, including related HMO restructuring and legislative amendment.

Connecticut Mutual Life Insurance Company

• $3.5 billion merger with Massachusetts Mutual Life Insurance Company.

Swiss Re

• Privatization and acquisition of The Texas Workers Compensation Insurance Facility and related legislative amendment.

Capital Z

• $35 million acquisition of British Marine Mutual Association (demutualization)

Northwestern National County Mutual Insurance Company

• Sale to Queensway Financial Holdings.

Middlesex Mutual Assurance

• $50 million reinsurance pooling transaction with Country Mutual Insurance Company.

Representative Transactional Reinsurance Matters

The Pyramid Life Insurance Company

• Represented as ceding company in indemnity reinsurance flipping to novation (life) to reinsuring company Continental General Insurance Company.

Union Fidelity Life Insurance Company

• Represented as reinsuring company in indemnity reinsurance (accident & health) and retrocession to ceding company American Combined Life Insurance Company, in indemnity reinsurance & retrocession (group life and accident & health) and retrocession to ceding company Combined Insurance Company of America and in indemnity reinsurance (life & accident & health) to ceding company Virginia Surety Company.
• Represented as ceding company in indemnity reinsurance (credit life & credit accident & health) to reinsuring company Combined Insurance Company of America and in indemnity reinsurance (credit life & credit accident & health) to reinsuring company American Combined Life Insurance Company.

Employers Reassurance Corporation

• Represented as reinsuring company in indemnity reinsurance (group life) to ceding company Phoenix Home Mutual Life Insurance Company.

Wards® Montgomery Ward Insurance Company

• Represented as reinsuring company in indemnity reinsurance flipping to novation (commercial liability, credit mortgage, A&H and club coverage) and excess of loss reinsurance (auto and homeowners) to ceding company GE Auto and Homeowners Insurance Companies sold to AIG.
• Represented as ceding company in indemnity reinsurance (auto) to reinsuring company GE Property & Casualty Insurance Company.

Intramerica Life Insurance Company

• Represented as ceding company in indemnity reinsurance (variable annuities) to reinsuring company Allstate Life Insurance Company of New York.

The Life Insurance Company of Virginia

• Represented as reinsuring company in indemnity reinsurance (life) to ceding company Combined Insurance Company of America.

Life Reassurance Corporation of America

• Represented as reinsuring company in retrocession to ceding company Combined Insurance Company of America and in retrocession and indemnity reinsurance (credit life and disability) to ceding company American Combined Life Insurance Company.

Empire Blue Cross & Blue Shield

• Represented as ceding company in indemnity reinsurance flipping to assumption (life and accident & health) to reinsuring company Empire HealthChoice Assurance, Inc.

AMEX Life Assurance Company

• Represented as ceding company in indemnity reinsurance flipping to assumption (life and accident & health) to reinsuring company IDS Life Assurance Company.

European International Reinsurance Corporation

• Represented as reinsuring company in excess of loss reinsurance (workers' compensation) to ceding company Facility Insurance Corporation (successor-in-interest to Texas Workers Compensation Insurance Facility).

Representative Bermuda Reinsurance Investment Transactions

Capital Z

• Represented as investing company in PxRe, a Bermuda property reinsurer, and Endurance Specialty, a Bermuda start-up company.

Merchant Banking Partners

• Represented as investing company in several Bermuda reinsurers, including Axis Capital Holdings Limited, Montpelier Re Holdings Ltd. and Aspen Insurance Holdings Limited.

Thomas H. Lee Partners, L.P.

• Represented as investing company in three major Bermuda reinsurance companies – Axis Capital Holdings Limited, Endurance Specialty and Allied Specialty.

Imagine Reinsurance

• Represented in connection with an abandoned investment in another Bermuda reinsurer.

Attorneys

Litigation

Mindy J. Spector (Co-head of Insurance Practice)
David L. Yohai (Co-head of Insurance Practice)
Jeffrey S. Klein
Edward Soto
Salvatore Romanello
Penny P. Reid
Yvette Ostolaza
John P. Mastando III
Nicholas J. Pappas
Bruce S. Meyer
Angela Zambrano

Corporate

Thomas A. Roberts
Joseph T. Verdesca
Michael J. Aiello
William M. Gutowitz
Raymond O. Gietz
Peter King