The California Department of Managed Health Care (DMHC) licenses and monitors health plans operating in the state. The DMHC Office of Enforcement works to change plan behavior to comply with the law, utilizing enforcement actions including cease and desist orders, administrative penalties (fines), freezing enrollment, and requiring corrective actions. In some cases, the DMHC... Read More »
When a health insurance company denies a valid claim, it’s more than just a financial setback—it’s a betrayal of trust at a time when policyholders are most vulnerable. Unfortunately, pursuing legal action against an insurance company for a wrongful denial isn’t as simple as it may seem. Health insurance denial cases are legally and... Read More »
If you’ve ever had a health insurance claim denied, the reason may have had something to do with a document called the Evidence of Coverage (EOC). While most people don’t pay much attention to this document when signing up for a health plan, it becomes critically important when a health insurer denies a service,... Read More »
If your health insurance claim has been denied in bad faith, you may be wondering what kind of legal help you need. Many people assume that a personal injury lawyer is the right choice, especially if they have been physically harmed by a claim denial or unreasonable delay. But bad faith insurance cases are... Read More »
If you’ve had a health insurance claim denied, your insurer may have cited a “medical policy” as the reason. But what exactly is a medical policy, and how does it impact your ability to receive the treatment your doctor recommends? Understanding medical policies is crucial when challenging an insurance company’s denial of coverage, and... Read More »
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