Case Results
We Don’t Just Challenge Insurance Companies. We Have Changed What They Cover.
Verdicts, Settlements & Class Actions
Gianelli & Morris has litigated major health insurance disputes involving some of the country’s largest health plans. Representative matters include:
- Estimated medical benefits
$150M est. benefit
Gallimore v. Kaiser Foundation Health Plan, Inc.
A class action trial against Kaiser for violating California’s reconstructive surgery law: judgment for thousands of Kaiser members entitled to excess skin surgery after massive weight loss, approximately $150 million in benefits.
Alameda County Superior Court No. RG12-616206
Read about this case: Gallimore v. Kaiser Foundation Health Plan, Inc.Health Insurance - Class action settlement
$47M
Stephens v. American Equity Investment Life Ins. Co.
A class of 7,700 senior citizens sold deceptive annuities: a $47 million settlement after winning phase one of the trial.
Class Actions - Class action settlement
$19.85M
Sanchez v. Allianz Life Insurance Co.
A class action settlement regarding wrongful surrender charges and related issues.
Class Actions - Jury verdict
$7.2M
LaRue v. Health Net of California, Inc. et al.
A $7.2 million jury verdict in a case against a managed care company over its failure to provide a Health Net member with a timely referral to a surgeon.
Los Angeles County Superior Court No. BC566095
Read about this case: LaRue v. Health Net of California, Inc. et al.Health Insurance - Class action settlement
$3.2M
Woelk v. Blue Cross of California
A class action settlement against Anthem Blue Cross over its failure to provide reconstructive surgery benefits. Class members received reimbursement for reconstructive surgery costs.
Los Angeles County Superior Court No. BC391522
Health Insurance - Class action settlement
Coverage secured
Escalante v. Blue Shield of California
A class action against Blue Shield for denying artificial lumbar disc replacement surgery as “investigational.” As part of the settlement, Blue Shield changed its practice and now covers the surgery.
C.D. Cal. 2015, 309 F.R.D. 612
Read about this case: Escalante v. Blue Shield of CaliforniaHealth Insurance - Class action
Prosthetics Covered
Trujillo v. United Healthcare Insurance Company
A class action that ensured amputees could obtain prosthetic limbs unlawfully denied by their insurer. It earned the Consumer Attorneys of California’s “Street Fighter of the Year” award.
Health Insurance - Class action
Autism Care Covered
Arce v. Kaiser Foundation Health Plan
A class action against Kaiser Permanente over its denial of treatments for autistic children, a case that reshaped treatment access for countless families.
Los Angeles Superior Court Case No. BC 388689
Health Insurance - Class action
Residential Care Covered
Dion v. Kaiser Foundation Health Plan, Inc.
Significant outcomes mandating residential treatment coverage for patients with severe mental illnesses.
Health Insurance - Medical necessity denial
Denial Overcome
Anthem Blue Cross member
Anthem rejected the treatment a specialist prescribed for a painful, debilitating disease as not medically necessary. We obtained a favorable result for our client.
Read about this case: Anthem Blue Cross memberHealth Insurance
Prior results do not guarantee or predict a similar outcome in any future matter.
Class Actions We’ve Handled
- Gallimore v. Kaiser Foundation Health Plan, Inc., Alameda County Superior Court Case No. RG12-616206 (right to weight loss reconstructive surgery)
- Arce v. Kaiser Foundation Health Plan, Inc., Los Angeles Superior Court Case No. BC 388689 (health benefits for treatment of autism)
- Ticconi v. Blue Shield Life & Health Ins. Co., Los Angeles Superior Court Case No. BC 330989 (health insurance benefits)
- Peterman v. North American Co. for Life & Health, Los Angeles Superior Court Case No. BC 357194 (annuity proceeds)
- Woelk v. Blue Cross of California, Los Angeles Superior Court Case No. BC 391522 (health benefits for reconstructive surgery)
- Iorio v. Allianz Life Ins. Co. of N. America (S.D. Cal.) Case No. 05-CV-0633 IEG (annuity proceeds)
- Chastain v. Union Security Life Ins. Co. (C.D. Cal.) Case No. 06-CV-5885 ABC (credit disability benefits)
- Kavruck v. Blue Cross of California, Los Angeles Superior Court Case No. BC 160180 (health insurance premiums)
- Vind v. Prudential Life Ins. Co., (C.D. Cal.) Case No. 07-CV-3564 CAS (long term disability income benefits)
- McNellis v. Pioneer Life Ins. Co., San Luis Obispo Superior Court Case No. CV990759 (health insurance premiums)
Published Appellate Decisions
Robert Gianelli has shaped California insurance law through published appellate decisions, including:
- Baglione v. Health Net of California (2023)
- Hendricks v. Aetna Life Insurance Co. (2021)
- Escalante v. Blue Shield of California (2015)
- Rodriguez v. Blue Cross of California (2008)
- Kavruck v. Blue Cross of California (2003)
- IT Corp. v. Gen. American Life Ins. Co. (1997)
- American States Ins. Co. v. Borbor (1987)
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