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Blue Shield of California & Bad Faith Claims

Blue Shield of California is one of the state’s largest and longest-operating health insurance providers. Many California residents depend on Blue Shield to provide payment for both basic preventive care and advanced treatment in the event of serious illness or emergency. Unfortunately, a startling number of Blue Shield customers have been abandoned by their insurer unexpectedly or have been denied coverage of critical care necessary for their physical and mental health. Contact our firm if you need help with your bad faith claim against Blue Shield.

Help for Customers Who Have Been Wrongly Denied Coverage

Customers of Blue Shield of California deserve to know that, if they pay their premiums on time each month, they’ll receive continued coverage of the treatment and medications they need and are entitled to under the terms of their policy. When this basic expectation isn’t met, customers may have a right to take legal action against Blue Shield for their bad faith denials of coverage.

Since 1979, the California bad faith insurance lawyers at Gianelli & Morris have been fighting for insurance customers who have been turned away by their insurer at some of their most desperate moments. Our experienced and aggressive attorneys can take on your case against Blue Shield of California to get you the coverage you deserve, as we have for countless clients before you, so that you can focus on the health of yourself and your family.

Many Blue Shield Customers Startled to Find Coverage Suddenly Ended

Blue Shield of California has the dubious distinction of having the highest complaint rate among its enrollees of all the state’s largest health insurers, according to California’s Department of Managed Health Care. Many of these complaints stem from the rash of unexpected and unjustified cancellations of health insurance policies among its paying customers. For example, California resident Ashley Summers learned that her policy had been canceled only when picking up a prescription for her rheumatoid arthritis medication from the pharmacy—medication she dearly needed to remain able to walk and move.

Summers’ experience is far from unique. Hundreds more Blue Shield customers have also experienced this. These customers often feel forced to turn to social media as their only means of drawing the attention of both the public and Blue Shield customer service to their plight. One customer described having her health care coverage canceled twice in two months, with Blue Shield denying coverage of over $1,000 in doctors’ visits. Another woman tweeted that she was fighting Blue Shield after the second incident of their failure to properly charge her account which resulted in the cancellation of her policy, adding, “Wish me luck. It’s my 2nd day with no heart meds.” Summers recently filed a class action lawsuit against Blue Shield, claiming that Blue Shield breached its contract with herself and other customers by canceling their fully-paid policies without warning or justification.

Gianelli & Morris Attorneys Have Experience Fighting Blue Shield’s Refusal to Cover Essential Procedures

Insurance companies may look to cut costs wherever possible, claiming that they only deny coverage of unnecessarily expensive or experimental procedures. This desperate desire to cut costs in favor of profits can sometimes mean denial of coverage of life-saving procedures that customers deserve. For instance, Blue Shield is one of many insurers that long denied proton beam therapy as being “investigational” well after medical researchers had concluded that it should be considered standard treatment for certain forms of cancer. And in 2018, Blue Shield was forced to pay $7 million to settle the claims of a class of customers who were wrongly denied coverage of their mental health treatment.

At Gianelli & Morris, we’re no strangers to Blue Shield’s eagerness to deny coverage of so-called “investigational” procedures. Our law firm succeeded in a class certification action against Blue Shield of California on behalf of a group of back injury patients who were denied coverage for artificial lumbar disc replacement surgery. When any Blue Shield customer requested coverage of this procedure, the insurer claimed that artificial lumbar spinal discs remained an “investigational” means of treating degenerative disc disease. This is despite the fact that the FDA had years earlier granted approval of artificial lumbar discs as a safe and effective means of treating degenerative disc disease. Our Los Angeles health care coverage lawyers succeeded in having the court rule that this class of plaintiffs had a common issue that should be resolved by the court on behalf of all Blue Shield customers.

Many Blue Shield customers who have been denied the care they deserve feel too intimidated to go up against the giant insurer to appeal the denial. If you’ve been wrongly denied coverage, you may be overwhelmed at the prospect of completing confusing paperwork and arguing with the company’s experienced lawyers, all while facing serious health issues that you can’t afford to pay for out of pocket. Let us help you get the coverage you deserve. At Gianelli & Morris, our health insurance attorneys are seasoned at fighting for health care customers’ right to coverage. We understand the fear and anxiety that many individuals and families face upon learning that their insurer won’t pay for the treatments they need to survive a devastating injury or illness. Our bad faith insurance lawyers will hold insurers’ feet to the fire, compelling them to provide coverage where the customer is entitled to receive it.

If you need help contesting a bad faith denial of coverage or policy cancellation by Blue Shield of California, contact the dedicated, professional, and effective California insurance bad faith lawyers at Gianelli & Morris for a free consultation at 213-489-1600.

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