Insurance Denials/Bad Faith Information, News & Blogs
What Does Material Misrepresentation Mean in the Context of Life Insurance?
Insurance companies often throw around opaque legal terminology without explaining their full meaning and context. Many policies, for example, state that coverage is void in the case of a “material misrepresentation,” but they do not specify what might constitute such a misrepresentation. The policy might even go so far as to state that a… Read More »
Lawsuit Alleges Insurance Company Has a Practice of Denying Life Insurance Claims Contrary to Law
Standard Insurance Company sued for denying accidental death benefits by claiming a heart condition contributed to the death and excluded the loss from payment On July 27, 2021, the California insurance law firm Gianelli & Morris filed a complaint in Los Angeles County Superior Court against Standard Insurance Company and the City of Los… Read More »
Is PTSD a Disability?
The growing consensus in the medical field is unequivocal: Mental health is physical health. Having poor mental health can be just as debilitating, and just as dangerous, as having a physical ailment. Unfortunately, demonstrating a mental illness for insurance coverage and other medical benefits can be more difficult than proving a physical injury. Not… Read More »
Class Action Lawsuit Against Health Insurance Company Alleging Improper Denial of Coverage for Necessary Medical Treatment
California insurance law firm Gianelli & Morris filed a complaint against Anthem, Inc. for improperly issuing blanket denials of coverage for the Coflex medical device to treat lumbar spinal stenosis. On July 29, 2021, the California insurance law firm Gianelli & Morris filed a class action complaint in the United States District Court for… Read More »
What Are Independent Medical Exams (IME)?
If you are trying to obtain short-term or long-term disability benefits from your insurance company, you will likely need to jump through a variety of hoops. All of these requirements are meant to be barriers to your obtaining the disability coverage you paid for. Often, claimants and benefits recipients are asked to attend an… Read More »
Anthem Canceling Grandfathered Insurance Plans Forcing Customers to Buy New Plans and Spend More and Get Less
One of the benefits of sticking with a company that provides a consumer service for a long time is taking advantage of good deals that don’t last. We all have that one friend who still gets unlimited data for pennies with a cell phone wireless plan they signed up for 15 years ago. Corporations,… Read More »
UnitedHealthcare Might Soon Start to Retroactively Reject ER Visits
A few weeks ago, we took a deeper look into Anthem’s policy on avoidable emergency room (ER) visits. Anthem had implemented a policy of denying coverage for ER visits that they decided were “avoidable” or “unnecessary,” even if the patient at the time felt there was an emergency. It turns out that Anthem is… Read More »
What to Do if Your Life Insurance Denies Your AD&D Claim
Accidental death & dismemberment insurance (AD&D) is meant to provide financial security for the family of a person who is killed in an unexpected accident. Accidents can generate significant financial hardship, especially when the victim is a primary income-earner for the family. Unfortunately, insurance companies are known to add insult to injury by finding… Read More »
Medical Necessity and Dental Procedures
Anyone who has had a serious dental problem knows that oral health can absolutely affect your overall health. If you don’t have dental insurance, a dental or orthodontic procedure can be prohibitively expensive. Under certain circumstances, however, you may be able to get your dental procedures covered under your general health insurance plan. If… Read More »
Anthem’s Policy on Avoidable ER Visits: A Closer Look
Anthem is one of the leading providers of health insurance in California and the second-largest insurer in the country. Like many large insurance companies, Anthem has a history of using shady tactics to avoid paying out on claims that should rightfully be covered. In addition to blanket policies denying coverage for debilitating conditions by… Read More »
