The California Court of Appeal has affirmed the Fresno County Superior Court's grant of summary judgment to NORCAL Mutual Insurance Company (NORCAL), finding there was no potential for coverage for a False Claims Act investigation under a medical professional liability insurance policy, as the gravamen of such a claim is the presentation of false claims to the government, not any deficiencies in the underlying patient care. In doing so, the court also affirmed that the insured's speculation about what the government could have alleged was not the appropriate standard for determining the duty to defend. Jennifer Mathis and Michael Cassata of Troutman Pepper represented NORCAL in the case.
The underlying matter involved a False Claims Act investigation into the alleged submission of fraudulent bills to Medicare for excessive, medically unnecessary, and/or inadequately documented cardiovascular procedures. The relevant insuring agreement provided coverage for "medical incidents" that may result in a claim for "damages." The insured argued that the potential harm to patients caused by the purportedly unnecessary diagnostic radiation exposure for the alleged unnecessary scans at issue in the government's FCA investigation created the possibility of a future claim that would fall within the coverage of the policy, and NORCAL accordingly owed a duty to defend. In rejecting this argument, the court affirmed that the "FCA attaches liability, not to the underlying fraudulent...
Turkish base fake news in Armenia For several days, a video has been circulating on social media claiming that Armenian Prime Minister Nikol Pashinyan allegedly signed a “secret agreement” with EU ...