The insurance industry presents multi-faceted legal issues. Pierce Atwood has experience in virtually all areas that affect insurance companies, and self insurance groups and programs, including their formation, corporate structuring, mergers and reorganizations, state insurance regulation, market conduct, and policy coverage issues.

On the corporate and business side, we have advised insurers on a host of internal, structural, and operational matters, including bulk reinsurance transactions, extraordinary dividends, mutual policyholder dividend plans, federal income tax issues, policyholder/shareholder governance matters, permitted business activities, TPA contracts, and contracts with vendors and service providers for insurers. On regulatory matters, we work with our clients at every level, including representation at state insurance departments and lobbying for insurance-related legislation.

On the litigation side, Pierce Atwood attorneys have built careers litigating insurance coverage and benefit disputes involving life, health, property/casualty, errors & omission, CGL, reinsurance and director & officer lines. Our experience extends to litigating ERISA (see Employee Benefits) and non-ERISA disputes in courts nationwide. We have defended insurers regionally and nationally, as well as advising corporate clients on coverage matters.

For more information about our practices serving clients in the insurance industry, please contact Christopher Howard (transactional) or Brooks Magratten (litigation).

Representative Experience

Represented Anthem Insurance Companies, Inc. in its $102.5 million acquisition of Blue Cross and Blue Shield of Maine.

Anthem $102.5 Million Acquisition of Blue Cross/Blue Shield of Maine

The First Circuit affirmed summary judgment for our client Standard Insurance Company in a disability benefits case. The court held that Standard was not liable for payments of benefits to treat Chronic Lyme Disease beyond the 24 month limitation period set by the ERISA plan for limited physical and mental conditions.

First Circuit ERISA Win for Standard Insurance Company

In two separate class actions, in which Pierce Atwood separately represented Unum Life Insurance Company and Sun Life Assurance Company, the U.S. Court of Appeals for the First Circuit held that using Retained Asset Accounts (RAAs) to pay death benefits claims on group life insurance policies does not violate the Employee Retirement Income Security Act (ERISA), where the policies either require or permit payment by RAA.

First Circuit Wins for Life Insurance Companies in ERISA Class Actions

Pierce Atwood serves as outside immigration counsel for Unum, the largest provider of disability insurance products in the United States and the United Kingdom, employing more than 9,000 people, with total revenue for the fiscal year ending December 31, 2016 in excess of $11.05 billion. A Fortune 500 company, Unum Group is publicly traded on the New York Stock Exchange under the symbol “UNM.”

International Mobility in Key Technology Positions at Unum

Pierce Atwood partner Michael Daly successfully represented an insured food processing company in an appeal before the Massachusetts Appeals Court to obtain insurance coverage for accidentally damaging its customer’s product.  The appeal turned on the issue of whether an unexplained cause of damage to property constitutes an “occurrence” under a commercial general liability (CGL) insurance policy.

Mass. Appeals Court Decision on Definition of ‘Occurrence’ in CGL Policy

Lead negotiator for major property and casualty insurance company on enterprise performance management software contract. Successfully introduced and negotiated solution to an inter-operability issue that threatened to sink the deal.

Negotiation of Enterprise Performance Management Software Contract

Lead negotiator on behalf of a New England-based insurance company in connection with replacing a home-grown IT system (including self-hosted servers and legacy software platforms) with an outsourced core insurance platform consisting of a policy administration system, claims processing and settlement solution, rating engine and underwriting and decisioning tools. When the vendor’s in-house counsel proved to be an obstacle to compromise and progress, we suggested and implemented strategies to minimize counsel’s role to enable the vendor’s senior business leaders to make key decisions.

Negotiation of Outsourced Technology Platform for Insurance Company

The Maine Legislature in 2011 passed a landmark bill (PL 90) aimed at reforming the failing individual health insurance market in Maine. The bill authorized establishment of a new non-governmental insurance company (the Maine Guaranteed Access Reinsurance Association, or “MGARA”) that would provide reinsurance to cover the sickest individuals historically responsible for the bulk of the health services used and corresponding costs, with the ultimate goal of reducing premiums in that market. The Board of Directors of MGARA retained Pierce Atwood to analyze the new groundbreaking law, form the new reinsurance company, guide its financing and other operations, and work with the Legislature and Bureau of Insurance through this complex process. MGARA began its operations in July 2012 as planned and is currently providing reinsurance for over 3,000 of Maine's sickest individuals. Pierce Atwood is proud to have served MGARA and the State in this important work.

Organization of Maine Guaranteed Access Reinsurance Association

We advised a major national insurer regarding the privacy law implications of its big data marketing initiatives.

Privacy Law Implications of Marketing with Big Data