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What is the Statute of Limitations for a Bad Faith Claim against a California Insurer?

By Gianelli & Morris |

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 »

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How Do I Choose the Right Lawyer for My Bad Faith Claim?

By Gianelli & Morris |

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 »

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Insurance Consumer Complaints against denial of medical claims

DMHC Consumer Complaints 2017 Annual Report Exposes Bad Faith Denials

By Gianelli & Morris |

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 »

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Bariatric Surgery is an excess skin removal surgery

Insurers Deny Coverage for Excess Skin Removal Following Bariatric Surgery

By Gianelli & Morris |

As we have discussed time and again, insurers are always looking for reasons to deny coverage. Particularly where a procedure could possibly be defined as “cosmetic,” insurers will refuse coverage if they can find any justification to do so. But even so-called cosmetic issues can be disabling and disfiguring, and California law does not… Read More »

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Elements of a Bad Faith Insurance Claim and What to Do About It

By Gianelli & Morris |

Insurance policyholders who are current on premiums and follow the rules have a legal right to receive coverage for claims included under the terms of their policy. If health insurers fail to provide payment for these covered claims, they’re not only breaching their contract and breaking the law, they’re potentially putting their policyholder’s life… Read More »

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Health Insurance Denied

Insurance Companies Are Denying Coverage For Lipedema Treatments

By Gianelli & Morris |

Lipedema is a very common yet serious, painful, and crippling condition that affects nearly 11% of adult women worldwide. There are known treatments for lipedema, but insurance companies have taken strong stances against covering the cost of these cures for their paying policyholders. The dedicated and compassionate Los Angeles insurance bad faith attorneys at… Read More »

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Insurance Denial of Reconstructive Surgery

By Gianelli & Morris |

Too often, reconstructive surgery is denied for insurance reimbursement because insurance companies deem the surgery cosmetic and not medically necessary. The insurance companies assert that a medical necessity requires the illness to cause a functional, medical impairment for the patient, and insurance benefits are not available for a procedure done primarily to improve appearance…. Read More »

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Appealing the Denial of an Insurance Claim

By Gianelli & Morris |

Appealing denied insurance claims requires an insured to go through the internal appeals process. When your insurance claim is denied by your provider, be it disability, health, property, life, etc., you have several options. The law entitles you to challenge the denial via one of a number of processes. Your insurance plan will typically… Read More »

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Bad Faith Insurance legal concept

Top Signs Your Insurance Denial was in Bad Faith

By Gianelli & Morris |

Insurance companies have a duty to act in “good faith” when responding to policyholder claims. However, we have all heard stories of insurance companies denying claims that seem otherwise legitimate. Insurance companies are private businesses, and first and foremost they care about their profits. Sometimes insurers treat their policyholders less than fairly to protect… Read More »

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Fighting a Health Plan’s “Investigational” Denial of a Medical Claim

By Gianelli & Morris |

Health plan contracts typically have exclusions for treatments that an insurance company considers “investigational” or “experimental.” Health plans say there is insufficient proof demonstrating that certain treatments are safe and effective for their intended use, making them investigational or experimental and not a covered medical benefit. Whether a particular treatment is investigational or experimental… Read More »

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