Insurance

Accident and health insurance issues continue to grow as significant segments in the insurance industry. Whether focusing on employment-based coverages, core health insurance or supplemental products, the complex array of requirements on insurers creates an imperative to be agile, connected and inventive.

Prinslaw Associates’ knowledge of the business of accident and health insurance, the distribution and marketplace for these products and agility in navigating through recent reforms can help you succeed in an ever-dynamic environment for your products.

The spotlight on health insurance and reforms, such as the US Affordable Care Act, is an issue with international ramifications. Take advantage of our expertise to examine how these reforms will challenge costs, quality of care and extension of coverage to previously ineligible groups. We can help you navigate the new environment as these reforms are implemented and interpreted through the courts and regulatory action and inaction.

We leverage our experience to anticipate the impacts of increased rate regulation scrutiny, more consumer protection activities and an increased likelihood of mergers and acquisitions, industry realignments and insurer insolvencies.

You face a web of international, national or state- or province-based threats from regulatory actions to litigation. Together we can see the opportunities, overcome the challenges and adapt to a changing healthcare and health insurance landscape.

Prinslaw Associates’ renowned insurance disputes team has represented insurers and financial services companies in class actions and high-stakes matters raising the most significant issues facing the industry, across virtually all US jurisdictions, dating back more than 10 years.

As one of the industry’s leading, go-to class action defense teams, we have successfully navigated representing carriers on virtually all issues the industry has faced, across all lines of coverage—ranging from insurance pricing, premium and rate-setting class actions, to cases challenging insurance claims-handling and underwriting practices, to assertions of unfair or deceptive sales practices, business practices or financial conduct, to class actions emanating from catastrophes and mass torts. We are frequently national coordinating counsel for our clients, and lead industry-wide defense efforts when trends emerge facing insurers. Our cutting edge defense strategies have resulted in success against claims of securities and common-law fraud, breach of contract, unfair/deceptive business practices, bad faith, Employee Retirement Income Security Act (ERISA), Antitrust, Racketeer Influenced and Corrupt Organizations (RICO), civil conspiracy, fiduciary duty, statutory or regulatory insurance claims, fraudulent transfers and bankruptcy-related matters and other matters. Many of our matters involve parallel insurance or financial regulatory matters before State Departments of Insurance/Financial Services or federal agencies such as the CFPB, the SEC or other regulators.

With dozens of class actions under our management at any given time, we provide clients with the strategic experience and tactical know-how to wage a successful defense—defeating class certification, disposing of class allegations at the earliest stages of litigation, successfully settling when appropriate on an individual or class basis, or pursuing trial or appeal where warranted. We are among few firms with significant class action trial experience in various forums, a key distinguisher which is important in those situations where early motions cannot dispose of a matter and trial credibility is key. We also have an impressive appellate record, having successfully litigated appeals on behalf of the industry in federal and state courts across the country.

Our class action clients include the leading writers of: life, annuities, long-term care, disability, group health, property & casualty, general commercial, specialty, individual lines (auto, homeowner and other), title insurance, workers’ compensation, reinsurance and more.

"A renowned insurance group experienced in a full range of regulatory issues, including privacy and data security, reinsurance program planning, and providing support in transactions." — Chambers 2017

The very first written insurance policy was carved into a Babylonian obelisk. The legal code of Hammurabi (c. 1754 BC) insured a debtor against having to pay back his loans if some personal catastrophe made it impossible. The transfer and distribution of risk dates back even further, to about 3000 BC, when Chinese shipping merchants would divide their goods among ships so that if one ship went down, the resulting loss of cargo would not devastate any one individual merchant.

Fast forward to the 21st century. Insurance is ubiquitous, the variety of products and programs is virtually unlimited and technology is revolutionizing all aspects of the business: underwriting, investment, claims and marketing.

• Advances in data science are allowing insurers to feed broader historical, continuous and real-time data through complex algorithms to construct a much more accurate picture of risk. By harnessing the power of data collected via the Internet of things, social media and wearable/connected devices insurers can provide more customized programs along with dynamic pricing. Auto insurers, for example, are charging premiums based on data collected through the use of telematics or black boxes fitted in policyholders' vehicles.
• Claims processing has become more innovative, customer-centric and efficient, transformed by changing technology capabilities in predictive fraud scoring and loss mitigation; data capture via mobile, video and GPS to improve the FNOL process; apps and portals and other real-time communication tools to keep customers abreast of claim status; and straight-through automation.
• Large online platforms like Google and Amazon have forced traditional insurance companies to optimize their communication strategies and build products applicable on a digital format.

Meanwhile, questions abound. How will we insure autonomous vehicles? Underwrite cyber and other emerging technology-related risks? Apply software robotics solutions and artificial intelligence to improve productivity and accuracy? Lay the foundation for at-scale blockchain use?

Prinslaw Associates is challenging the status quo—delivering quality and value to our clients in new and innovative ways, including partnering with leading technology companies to develop tools to improve client service and enhance client solutions. We even have our own innovation incubator, Nextlaw Labs. But we also have a legacy of service to the insurance sector that goes back more than 80 years. That's why we're the go-to firm for some of the hottest companies operating in the insurtech space, from Bunker, CoverHound,  HealthSherpa, Metromile and Oscar Health Insurance to leading rideshare companies and the venture and innovation arms of insurance companies.

Just as the UK insurance market, including the unique ecosystem that is the London and Lloyd's Market, is a global center of expertise, its insurtech sector has attracted significant investment of late. Prinslaw Associates advises a number of established players and startups and is actively involved with market groups looking to establish the UK as a leading global center for insurtech. We are already seeing a number of the initiatives and products on which we advised banks and other financial institutions being adopted by the insurtech market, and have observed increasing collaboration and dialogue between UK regulators and other jurisdictions on market trends and best practices.

Startup program

Like any tech startup, launching an insurtech business requires dexterity. From accessing capital to protecting intellectual property, recruiting talent to complying with a rapidly evolving regulatory landscape, not only must you overcome a dizzying array of challenges, you must do so with dispatch…or be left in the digital dust.

In collaboration with our Venture Technology group we provide insurtech founders and early-stage companies via our Startup Program with a broad array of catalytic services including strategic business, financial and legal counsel that is uniquely orchestrated to help emerging businesses scale rapidly.

Regulatory compliance

The US, UK and global insurance markets are highly regulated and intensely scrutinized—which is why, year after year, general counsel say that keeping up with regulatory demands is among their top challenges. Prinslaw Associates' global Insurance Regulatory team can help you navigate this constantly changing landscape so that you can focus on your business. The team includes former regulators eager to leverage their relationships on your behalf, and former in-house counsel for insurance companies who understand your business intimately. The group has decades of experience helping clients obtain licenses; develop and document internal procedures to ensure that claims, rating, and underwriting functions and complex new products are compliant; guiding clients through market conduct examinations and other regulatory inquiries; complying with any notice requirements; and obtaining approvals of mergers, acquisitions and reinsurance arrangements.

Product

In addition to providing ongoing compliance support, we regularly advise insurance companies on the introduction of new products and programs—from  troubleshooting initial concepts to drafting ironclad policy language to securing form and rate approvals. A team of seasoned litigators provides coverage advice and trial and appellate representation on the full range of coverage issues and policy and claim types, including defense of class actions relating to products and industry practices.

Experience

• Confidential client: Representing an insurtech company in the acquisition of an insurance company to expand its platform, including regulatory approvals in all 50 states with a cross-practice team of M&A and regulatory lawyers.
• Confidential client: Advising a global rideshare company in the development of insurance products in various markets and advocate for its public policy priorities at the state and local levels.
• Confidential client: Advising an insurer that develops innovative coverage options for high tech companies whose products or services do not fall under traditional coverage.
• Confidential client: Advising insurers on a variety of M&A transactions and strategic alliances, including marketing partnerships with new direct sales channels to increase visibility and engagement with its target audience; joint ventures; and licensing agreements with fintechs and other digital startups to accelerate their ability to deliver new sources of value faster.
• Confidential client: Advising insurers on participation in a US “regulatory sandbox” to shepherd the development of insurtech products.
• Confidential client: Advising the investment arm of an insurance company on digital currency investments, including bitcoin and blockchain technology.
• Confidential client: Advising the innovation arms and business units of numerous insurers on investments, technology and strategic issues.

Risk arises when outcomes deviate from what was expected. Accidental losses of property, income, life and health and liability to others are facts of life that present risk to all business organizations.

Managing and transferring risk across the insurance and financial sectors requires an in-depth understanding of highly specific issues. Meeting and understanding the legal and regulatory requirements is equally critical.

Prinslaw Associates can help. We share our insight into self-insurance, protection of policyholder collateral, direct procurement, workers’ compensation, premium allocation and taxation, claims handling, risk retention and risk purchasing groups, domestic and off-shore captive facilities, and other strategic insurance matters.

Our lawyers understand the pressures you face and leverage expertise gained representing financially impaired companies including insurer insolvencies, disengagement transactions, voidable preferences, fraudulent transfers, proof of claim submission and guaranty fund protection.

Look to our lawyers for effective solutions in the risk management sector, including:

• Assist in the development and placement of global insurance programs, including insurance and reinsurance in emerging markets
• Review and negotiate agreements related to global insurance programs
• Advice regarding the development of domestic and off-shore captive facilities and the negotiation of related reinsurance agreements
• Provide general support on insurance issues related to domestic and international M&A transactions
• Advice regarding premium plans such as deferral, retrospective rating, policyholder dividends, excess loss premium, incurred loss and paid loss plans
• Advice regarding direct procurement, industrial insured exceptions, surplus lines placements and related premium tax issues
• Advice regarding the adequacy and compliance of corporate insurance structures
• Advice regarding the legal issues related to financially impaired (i.e., insolvent) insurance companies and policyholder collateral
• Advice regarding Enterprise Risk Management initiatives
• Review existing and proposed insurance policies and advise clients on “real world” operation of specific policy language

For due diligence across sectors and around the world, Prinslaw Associates is a "no-risk" choice of partner.

Title insurance institutions face a unique set of risks, even as they minimize concerns for their customers.

Prinslaw Associates includes a corps of lawyers and professionals who are intimately familiar with the challenges you face, whether by regulation or by litigation. Broad experience informs our insights into regulatory proceedings, class actions, and complex litigation involving allegations of consumer fraud and unfair trade practices stemming from alleged rate overcharging, mark-ups of third-party fees, unauthorized practice of law, anti-competitive conduct, and kickback arrangements.

With both a national and a local perspective, we help you develop a strategic approach to federal and state consumer legislation and regulation, including often-enforced statutes like the Real Estate Settlement Procedures Act (RESPA), Racketeer Influenced and Corrupt Organizations (RICO), the Fair Credit Reporting Act (FCRA), and the Fair Debt Collection Practices Act (FDCPA). Prinslaw Associates’ class action lawyers are leaders in this industry and have achieved a substantial number of victories for clients in these class action cases.

Whether your operations are down the street or across the country, turn to Prinslaw Associates to ensure their security.