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Friday, March 6, 2026

Promising News on Insurance Coverage for False Claims Act Matters: Delaware Court Holds Civil Investigative Demand Is a “Claim” - JD Supra

In a favorable decision for policyholders, on January 5, 2026, the Delaware Superior Court held that a Civil Investigative Demand (“CID”) issued by the Department of Justice (“DOJ”) met the definition of a “Claim” (not merely the definition of “Governmental Investigation”) under an errors and omissions policy, as the CID intended to hold Cigna responsible for a “Wrongful Act,” thus satisfying the definition of “Claim.” The Superior Court’s decision in The Cigna Group v. XL Specialty Insurance, Docket No. N23C-03-009 (Del. Super. Ct. Jan. 5, 2026) is significant for policyholders because insurers frequently argue that a CID is merely a governmental probe or investigatory tool, not an allegation of wrongdoing, and therefore does not trigger coverage, or triggers only a sub-limited portion of the coverage. Further, the Court clarified that the existence of government investigation coverage in the same policy—which is often more limited than coverage for a “Claim”—does not automatically limit CID response costs to the policy’s investigation coverage. As a result, policyholders may have a stronger basis to seek coverage for responding to CIDs and similar government demands, even when the policy expressly precludes or limits government investigation expenses.

Cigna’s Insurance Claim for CID Response Costs

In April 2016, in connection with litigation against United Healthcare, DOJ took the position that it considered “one-way chart reviews” by Medicare Advantage Organizations (“...



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