The lawyers of Pierce Atwood’s Insurance Practice Group understand the many dimensions of the insurance industry, the different concerns of market participants, and the legal, regulatory and tax issues that confront insurers. Engaged in a highly diverse insurance law practice, we draw from a cross-section of practice groups to serve our insurance industry clients, including Business, Litigation, Privacy & Data Security, Tax, Construction, Energy, Employment, Environmental, Maritime, and Government Relations. These lawyers practice in specialties including insurance regulation, litigation, employment law, employee benefits, tax, and corporate law, which play important roles in advancing the interests of our insurance clients. In addition, the practice group is supported by several corporate and litigation paralegals.

Over many decades, our Insurance Practice Group attorneys have developed special expertise and in-depth knowledge in virtually all areas that affect insurance companies, insurance agencies and self-insurance groups and programs, including their formation, corporate structuring, mergers and reorganizations, state insurance regulation, market conduct, and policy coverage issues. 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 insurance-specific vendors and service providers. Our experience includes workers' compensation, property & casualty (P&C), life & health, surety, and disability insurance.

With respect to mutual insurers, attorneys in our Insurance Practice Group have extensive, hands-on experience on issues relating to formation, demutualizations, mergers and acquisitions, liquidations, dividend practices, federal taxation and ongoing operational matters – issues that affect both the companies and their policyholders.

In addition to our corporate expertise, our attorneys team with our insurance clients on regulatory matters, including representation at state insurance departments and lobbying for insurance-related legislation.

When other solutions don't get the results our insurance companies desire, we can call on the litigators in our group, who have decades of experience in insurance-related lawsuits. Whether it is a corporate fight for control of the company, or defending a class action for extra contractual remedies, including punitive damages, we deliver tough advocacy for our clients. When an insurer's regular defense counsel runs into trouble, Pierce Atwood attorneys have extensive experience in handling insurance issues on appeal. For example, our firm successfully overturned one of the largest jury verdicts in Maine history in a bad faith disability insurance case. We have an extensive library of coverage opinions and, in addition to coverage advice, have tested those opinions for many years in coverage litigation in the state and federal courts.

Areas of Expertise

On the corporate and business side, Pierce Atwood lawyers have advised insurers on a host of internal, structural, and operational matters, including their formation, corporate structuring, mergers and reorganizations, state insurance regulation, market conduct, and policy coverage issues. Representative operational matters include 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.

On regulatory matters, we work with our clients at every level, including representation at state insurance departments and lobbying for insurance-related legislation.

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

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.”

More
International Mobility in Key Technology Positions at Unum

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

Pierce Atwood has extensive experience in all facets of insurance-related litigation. Whether representing an insurance company, a corporate insured, or an insurance agent, Pierce Atwood provides effective and practical legal services at the trial court level or on appeal in cases ranging from declaratory judgment actions, breach of contract suits, uninsured motorist claims, and extra-contractual litigation. Pierce Atwood consistently obtains successful results for clients whether it is overturning a large jury verdict in a bad faith disability insurance case, defending a class action for extra-contractual remedies, or prosecuting or defending a coverage case.

Pierce Atwood attorneys litigate insurance coverage and benefit disputes involving life, health, property/casualty, errors & omission, CGL, reinsurance and director & officer lines. Our experience extends to litigating ERISA and non-ERISA disputes in courts nationwide.

Representative Experience

Pierce Atwood won an insurance coverage appeal to the Massachusetts Appeals Court for our client, an insured food processing company. 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. The appeals court reversed summary judgment that the trial court entered in favor of the insurer, and remanded the matter to the trial court for further proceedings. The decision is significant because it is the first in the country where the court ruled that an insured’s liability based on application of the res ipsa loquitur doctrine could be sufficient to establish an “occurrence” under a CGL policy, despite not knowing the actual cause of damage. This is an important decision that is extremely beneficial to policy holders.

Appeals Court Victory in Insurance Coverage Dispute

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.

More
First Circuit Wins for Life Insurance Companies in ERISA Class Actions

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.

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

We represent a leading insurer in defense of claims for MedPay benefits under Massachusetts automobile policies brought in Massachusetts Superior Court.  In 2016, we negotiated and obtained court approval for a class action settlement to resolve the claims of class members for whom Personal Injury Protection (“PIP”) benefits had been exhausted.  We currently represent the insurer in a putative class action brought on behalf of claimants for whom PIP benefits were not exhausted.

Massachusetts Automobile Insurance Litigation

We recognize that insurance is an important, but complex, tool to manage risk. Pierce Atwood attorneys regularly work with clients to understand and evaluate the terms of many types of insurance policies, and develop strategies to efficiently and economically achieve their goals. When disputes over insurance coverage arise, the litigators in our Insurance Practice Group have significant experience representing both insureds and insurers in large-scale and complex insurance coverage matters in state and federal courts around the country. Even in lawsuits where the terms of insurance are not the focus of the dispute, insurance coverage frequently plays an important practical role in the handling and resolution of a case. Our insurance coverage litigators are able to draw on their deep understanding both of complex insurance coverage concepts, as well as of the insurance industry, to accomplish our client’s goals. In a recent example, Pierce Atwood was able to convince a client’s insurer to reverse its decision and pay the legal fees to defend the client from a customer’s lawsuit, and eventually, through a separate lawsuit, persuade the court to order the insurer to fully indemnify our client for all of its losses in the underlying lawsuit.

We represent plan fiduciaries and insurers in ERISA benefit disputes, including pension, health, life, and disability plans, throughout the northeastern United States. We defend benefit claims as well as claims for breaches of fiduciary duty, both in single-plaintiff cases and class actions. Our expertise runs the gamut of benefits issues including disputes over entitlement to benefits and associated removal/ERISA preemption issues, prohibited transaction claims, subrogation actions, bad faith and rescission suits, and complex class actions in both ERISA and non-ERISA contexts. We also represent employers in the defense of withdrawal liability claims by multiple employer pension plans.

We have assumed a lead counsel role in both routine and complex benefits cases in courts throughout the nation, and have represented clients in connection with several important U.S. Supreme Court ERISA cases. We have argued benefits cases before the U.S. Supreme Court and the First, Second, Third, Fifth, Sixth and Eleventh Circuit Courts of Appeals. We have litigated benefits cases in every federal judicial circuit and Canada.

Our team includes the editor and co-authors of the ABA book, ERISA Survey of Federal Circuits, as well as authors of articles and book chapters addressing a range of benefits issues. We are also actively involved in the DRI Life Health & Disability Committee, with group members having served as its chair and program chair. Our team members are also frequent speakers on benefits litigation topics at national meetings and forums, including the annual DRI Life, Health, Disability & ERISA Litigation Seminar.

Representative Experience

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.

More
First Circuit Wins for Life Insurance Companies in ERISA Class Actions

Cyber insurance continues to evolve rapidly, as carriers and insureds update their understandings of the nature, likelihood, and severity of key cyber threats impacting modern businesses, including hacking, ransomware, phishing, insider threats, and more. Unlike more well-established lines of insurance, cyber insurance policies differ significantly from carrier to carrier, and new endorsements and exclusions enter the cyber market regularly. Not only when dealing with a data breach, but also when entering into a new policy or conducting an important coverage review (e.g., when engaging a new service provider who will have access to your most sensitive data), Pierce Atwood’s technology and data privacy and security experts can help you understand what exactly you are buying (and not buying) with your cyber insurance premium, informed by the insights and experience of our insurance litigation colleagues.

Pierce Atwood’s Maritime Group attorneys have handled significant marine insurance coverage litigation for various types of marine insurers. The Maritime Group’s attorneys also routinely assist marine insurers in providing defense to various types of claims, and in connection with seeking subrogation recovery.

Representative Experience

Our attorneys represented an English marine insurer in coverage litigation relating to the capsize of a fishing vessel off Massachusetts.

Marine Insurer in Coverage Litigation

Our practice group includes practitioners who represent owners, developers, contractors, and design professionals in the energy infrastructure and private/public construction industries. We provide personalized guidance on platforms, tools, and contract clauses to plan for and mitigate risk on construction projects of all kind. This includes providing advice on available insurance products, additional insured coverages, and appropriate indemnification provisions and statutory limitations concerning the same.

Representative Experience

Obtained a favorable settlement for an owner of a spiritual retreat facility against its contractor and design professionals through a seven-party mediation following an incident that involved a burst sprinkler pipe, substantial property damage, and discovery of pervasive latent construction defects. Before the mediation, Pierce Atwood worked closely with the owner and the owner’s representatives to review the defective conditions and press for performance of the remedial work by the construction and design professionals.  Multiple demands on the contractor’s performance bond had to be made to ensure performance of the corrective and incomplete work.  Once the work was completed, Pierce Atwood represented the owner in the multi-party mediation that dealt with challenging issues involving construction defects with the fire protection system, reimbursement for additional costs due to the delayed project, complex insurance coverage issues (including with the owner’s property insurer), contract terms (waiver of subrogation, waiver of consequential damages), continuing warranty obligations, and the scope and finality of the release. At the end of the mediation process, the owner was paid for costs it incurred during the delayed project and it paid nothing against the claims submitted by its contractor and design professionals.

Favorable Settlement in Seven-Party Mediation

Please contact Emily Cooke for more information regarding our services in this area.

Please contact Michael Daly for more information regarding our services in this area.

Please contact Jeffrey Francis for more information regarding our services in this area.

Please contact Brooks Magratten for more information regarding our services in this area.

Please contact Christopher Howard for more information regarding our services in this area.

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

Pierce Atwood won an insurance coverage appeal to the Massachusetts Appeals Court for our client, an insured food processing company. 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. The appeals court reversed summary judgment that the trial court entered in favor of the insurer, and remanded the matter to the trial court for further proceedings. The decision is significant because it is the first in the country where the court ruled that an insured’s liability based on application of the res ipsa loquitur doctrine could be sufficient to establish an “occurrence” under a CGL policy, despite not knowing the actual cause of damage. This is an important decision that is extremely beneficial to policy holders.

Appeals Court Victory in Insurance Coverage Dispute

Represented one of two partners in partnership dispute pertaining to operation of P&C personal lines insurance agency.  Ultimately we secured an agreement to arbitrate the dispute, addressing liability and then issues of valuation for a divorce between the partners.  Secured findings in favor of our client and very successful award of damages (high six figures) for his interest in the agency.

Arbitration in Insurance Agency Partnership Dispute

Obtained a favorable settlement for an owner of a spiritual retreat facility against its contractor and design professionals through a seven-party mediation following an incident that involved a burst sprinkler pipe, substantial property damage, and discovery of pervasive latent construction defects. Before the mediation, Pierce Atwood worked closely with the owner and the owner’s representatives to review the defective conditions and press for performance of the remedial work by the construction and design professionals.  Multiple demands on the contractor’s performance bond had to be made to ensure performance of the corrective and incomplete work.  Once the work was completed, Pierce Atwood represented the owner in the multi-party mediation that dealt with challenging issues involving construction defects with the fire protection system, reimbursement for additional costs due to the delayed project, complex insurance coverage issues (including with the owner’s property insurer), contract terms (waiver of subrogation, waiver of consequential damages), continuing warranty obligations, and the scope and finality of the release. At the end of the mediation process, the owner was paid for costs it incurred during the delayed project and it paid nothing against the claims submitted by its contractor and design professionals.

Favorable Settlement in Seven-Party Mediation

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.

More
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.”

More
International Mobility in Key Technology Positions at Unum

Our attorneys represented an English marine insurer in coverage litigation relating to the capsize of a fishing vessel off Massachusetts.

Marine Insurer in Coverage Litigation

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.

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

We represent a leading insurer in defense of claims for MedPay benefits under Massachusetts automobile policies brought in Massachusetts Superior Court.  In 2016, we negotiated and obtained court approval for a class action settlement to resolve the claims of class members for whom Personal Injury Protection (“PIP”) benefits had been exhausted.  We currently represent the insurer in a putative class action brought on behalf of claimants for whom PIP benefits were not exhausted.

Massachusetts Automobile Insurance Litigation

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