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PRACTICE AREA : Trial & Litigation

Insurance Regulatory Matters / Govermental Investigations & Civil Investigative Demands: Representative Cases

HMO vs. The State of Texas and the Texas Department of Insurance

This is an insurance regulatory matter that began when the Attorney General’s Office issued several civil investigative demands to an HMO. The HMO filed a declaratory judgment action challenging the civil investigative demands, as well as the constitutionality of various provisions of the Texas Insurance Code. The State of Texas and the Texas Department of Insurance asserted a plea in abatement and a plea to the jurisdiction, both of which were denied by the trial court. Over a period of time, over 400 other private individuals and entities intervened in the case against the HMO.

With regard to the intervenors, upon motion by the HMO, the court ruled they have no private right of action against the HMO for alleged violations of the delegation oversight statute. Further, the court ruled that the Texas Attorney General and the Texas Department of Insurance can not seek to impose civil penalties against the HMO under the prompt pay law in the state court litigation. The HMO ultimately reached an agreement with the State of Texas and the Department of Insurance.

Michael Klein and Lisa Michaux Magids were the lead attorneys for the plaintiff HMO.

Self-Move Company vs. The State of Texas and the Texas Department of Insurance

This was an insurance regulatory case in which a self-move company was accused by the Texas Department of Insurance of selling insurance and damage waivers without a proper license. The self-move company filed a declaratory judgment action seeking a declaration of its rights. With regard to the damage waiver, the self-move company obtained a summary judgment that damage waiver was not insurance, and therefore did not require a license. The other issues in the case were resolved through settlement.

Michael Klein was the lead attorney for the plaintiff self-move company.

HMO vs. The Texas Department of Insurance

This was an insurance regulatory case in which an HMO filed suit to restrain the Texas Department of Insurance from releasing a report that contained confidential patient information, peer review information and quality assurance information. In order to prevent the disclosure of the confidential information, the HMO obtained a temporary restraining order against the Texas Department of Insurance. After a significant amount of discovery, the case was ultimately settled.

Michael Klein was a member of the team of attorneys representing the HMO.

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