When funds accountability is in question, determining issues of legal compliance often requires more work than the ordinary insurance dispute.  The ability to investigate funds management, identify issues and evaluate results by the appropriate standard of care requires experience and resources.  Our firm uses auditors and actuaries as necessary to conduct a thorough investigation leading to verifiable results.
Our cases involve issues of  fiduciary breach, funds mismanagement, fraud, negligence, and insurance reimbursement.   Typical cases include:

  • Litigation against claims administrators and insurance brokers based upon fund mismanagement
  • Audit of ancillary service arrangements recover overpayments and undisclosed compensation
  • Association as co-counsel in DOL or IRS investigation of employer plan operations and reporting
  • Representation of plans against health plan provider in refund and payment disputes
  • Representation of employer in plan managment dispute with stop loss carrier
  • Representation of plan participants in charges of insurance overbilling and fraud
  • Representation of employer in dispute over subrogation reimbursement

>> Practice Areas
We provide speakers for current legal issues affecting the health care industry.  Examples include:
  • ERISA and fiduciary litigation developments
  • Health care compliance
  • Privacy issues, including HIPAA and other federal and state privacy laws
  • Claims administration due diligence
  • Insurance agent and broker due diligence
  • Health plan subrogation and reimbursement

These presentations can be tailored to meet specific needs, such as professional certification credit requirements or other areas of special interest.

>> Seminars
>> Audits and Investigations