News & Articles
Anthem Blue Cross Receives Hefty Fine for Failures in Handling Customer Complaints
Anthem Blue Cross, one of California’s largest providers of health insurance, has recently reached a settlement with the California Department of Managed Health Care (DMHC) to address major flaws in its handling of customer complaints. Anthem will now be compelled to spend over $11 million in fines and investment in improving the customer grievance… Read More »
How Does a California Insurance Bad Faith Claim Work?
Health insurance is designed to provide its customers with care when they become sick or injured, yet insurance companies are known to unreasonably deny claims for coverage that would cut into their profits. Insurance companies already rake in billions of dollars in profits through the premiums they collect; refusing to pay valid claims is… Read More »
Insurers Facing Lawsuits over Denials of Microprocessor Prostheses
Losing a limb can change someone’s life forever. While it may never be possible to regain full mobility or use of the limb that was lost, prosthetic technology has come a long way in developing prostheses that can respond to surface conditions in real time. Sadly, many patients who would benefit from these technologies… Read More »
Lawsuit Charges Kaiser Foundation Health Plan with Unfairly Denying Coverage to Treat Lipedema
On May 16th, the California insurance law firm Gianelli & Morris filed a complaint in the Superior Court of Los Angeles County in the case of Elena Valencia, et al. v. Kaiser Foundation Health, Plan, Inc., Case No. 19STCV17131. The lawsuit alleges that Kaiser breached its contractual duties and acted in bad faith by… Read More »
ADR Can Yield Better Results than Fusion, so Why Do Insurance Companies Try to Deny It?
Artificial Disc Replacement (ADR) surgery has existed as an alternative to spinal fusion for over 30 years. Many doctors and researchers will attest that ADR provides more successful outcomes for patients than spinal fusion, offering a shorter recovery period and reducing the likelihood that patients will need additional surgical procedures in the future. ADR… Read More »
What is the Statute of Limitations for a Bad Faith Claim against a California Insurer?
California residents who enter into a contract for health insurance have a right to expect that, if they pay all premiums and co-pays, their injuries, illnesses, and other medical needs will be covered by their insurer according to the terms of their coverage. If benefits are withheld without good reason, the insurer may face… Read More »
What are the Types of Damages for Insurance Bad Faith?
When a health insurance company wrongly denies your claim for benefits in California, you may have a right to file a claim for bad faith against your insurer. If successful, an insurance bad faith lawsuit will entitle you to receive compensation in the form of money damages. If you want to learn our other… Read More »
Bad Faith Rescission of a Health Insurance Policy
For the majority of the time that you maintain a health insurance policy, you are paying—or your employer is paying on your behalf—far more in premiums than you’re receiving in benefits. You pay these premiums so that you can rest assured that you’ll have coverage when you need it, such as when you’re injured… Read More »
How Do I Choose the Right Lawyer for My Bad Faith Claim?
If you believe that you’ve had an insurance claim denied wrongfully, you may have the right to file a lawsuit for money damages. These claims can be complex, involving not only contract laws and California laws governing health insurer conduct, but also medical research and best practices. Not every attorney has the skills and… Read More »
DMHC Consumer Complaints 2017 Annual Report Exposes Bad Faith Denials
The California Department of Managed Health Care (DMHC) is the regulatory office charged with overseeing the majority of health insurance coverage in the state. Health insurance policyholders can report disputes with their insurance provider to the DMHC, which will investigate those complaints, conduct independent medical reviews of denied claims, and carry out enforcement actions… Read More »
