Gallimore v. Kaiser Foundation Health Plan, Inc. Alameda County Superior
Court Case No. RG12-616206
Gianelli & Morris Wins Case on Behalf of Weight Loss Patients
Gianelli & Morris won a class action lawsuit brought against Kaiser
Foundation Health Plan (“Kaiser”) on behalf of plaintiff Wendy
Gallimore and thousands of other Kaiser bariatric patients who were denied
reconstructive surgery to remove excess skin after extensive weight loss.
Kaiser claimed that reconstructive surgery was unnecessary unless patients
experienced some sort of functional impairment, refusing to provide surgery
to eliminate excess skin from arms, thighs, hips, and other areas. According
to Kaiser, operations of this nature were “cosmetic.”
Following a month-long trial in Alameda County, the courts entered a judgment
against Kaiser, stating that they acted in violation of California’s
Health & Safety Code 1367.63. Under this law, health care plans must
cover reconstructive surgery in the event that it will improve a patient’s
function or create a normal appearance to the extent possible. As a result
of the decision, Kaiser must now alter its procedures and provide reconstructive
surgery to create a normal appearance. It is estimated that this judgment
will force Kaiser to provide more than $150 million worth of reconstructive
surgery benefits to its members.
If you or a loved one are a Kaiser weight-loss patient and wish to find
out more about how this judgment may affect your right to skin removal
surgery, call our office today at (213) 489-1600 to speak to the legal
team that won this case.
Fighting for CA Insurance Policyholders Since 1979
At Gianelli & Morris, our Los Angeles insurance attorneys have fought
and won against various insurance providers throughout more than three
decades of legal practice, recovering millions on our client’s behalf
along the way. Having earned a prestigious AV Preeminent® Rating from
Martindale-Hubbell® for our superior ethics and skills, our knowledgeable
legal team can provide the top-rated advocacy you need to ensure your
rights as an insurance policyholder are upheld in a court of law. If you
believe you have been unfairly treated by an insurance company, we urge you
contact our firm today and let us use our expertise to fight for the coverage you deserve.
For detailed information regarding the case Gallimore v. Kaiser Foundation
Health Inc, read the
Statement of Decision.