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Insurance Denials/Bad Faith Information, News & Blogs

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Health Insurance Claim Wrongfully Denied? Why You Need an Insurance Law Attorney and Not a Personal Injury Lawyer

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 »

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What Is a Medical Policy, and Why Is It Important When Your Insurance Claim Is Denied?

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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California Firefighters and Health Insurance Denials

Firefighters put their lives on the line every day to protect communities, often facing dangerous and physically demanding conditions. In return, they rely on employer-sponsored health insurance to cover medical expenses. However, when an insurance company wrongfully denies a claim, the consequences can be severe. Fortunately, California firefighters are generally exempt from the Employee... Read More »

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How Public Employee Insurance Denials Are Different

When a health insurance company denies a claim, policyholders often assume they have the right to challenge the denial in court and seek compensation for any harm caused. However, the legal options available to policyholders depend largely on whether their insurance plan is governed by the Employee Retirement Income Security Act (ERISA). Most private-sector... Read More »

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Anthem is Processing and Handling Insurance Claims Offshore: What Does This Mean for You?

If you have health insurance through Anthem, you expect your claims to be processed fairly and promptly. However, recent reports reveal that Anthem has been outsourcing the handling of insurance claims to overseas contractors, raising serious concerns about delays, denials, and the overall quality of claim reviews. If your health insurance claim has been... Read More »

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Archives

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A Busy January at the DMHC

California’s Health Care Regulator Starts the Year Off Right, Protecting Consumers and Holding Insurance Companies Accountable for Violating the Law The mission of the California Department of Managed Health Care (DMHC) is to protect the healthcare rights of Californians. Consumers can file complaints with the DMHC, and if the agency finds wrongdoing, it can... Read More »

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Anthem Blue Cross Visited With $95,000 in Penalties in January

Only one month into the new year, the California Department of Managed Health Care has already issued two enforcement actions against Blue Cross of California d.b.a. Anthem Blue Cross, penalizing the company $75,000 on January 14th and $20,000 on January 17th. The actions by the state regulator penalize Anthem for violating California law in... Read More »

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How AI Is Failing Insureds: The Dark Side of Automation in Health Insurance

Artificial intelligence (AI) has revolutionized industries worldwide, promising greater efficiency, cost savings, and improved decision-making. In the health insurance sector, insurers have embraced AI to automate claims processing, detect fraud, and assess risks. While these advancements sound promising, the reality for many insured individuals has been far less optimistic. AI is increasingly being used... Read More »

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How Insurance Companies Look for Ways to Deny Claims Rather Than Pay Them

When you purchase health insurance, you trust that your insurer will be there when you need them the most—during times of illness or injury. Unfortunately, it often seems like insurance companies prioritize corporate profits over policyholder needs, even to the extent of employing tactics to deny legitimate claims. We take a look at some... Read More »

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Carelon and Its Role in Your Health and Health Insurance Claims

Handling a health insurance claim is often challenging, especially when dealing with lesser-known entities like Carelon. If you’re a California consumer whose health insurance claim has been denied, it’s crucial to understand the role companies like Carelon play in managing claims and their relationship with larger insurers, such as Anthem. Below, we delve into... Read More »

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