Lawsuit Seeks Class Action Against Health Insurer for Alleged Improper Policy Cancellations

California insurance law firm Gianelli & Morris files a class-action lawsuit against Anthem Blue Cross Life and Health alleging breach of contract and seeking a declaratory judgment that insurer’s notice of policy cancellations failed to comply with California insurance law.

On May 22, 2020, the California insurance law firm Gianelli & Morris filed a class action complaint in the Superior Court of the state of California for the County of Los Angeles. The case is John P. Gutierrez v. Anthem Blue Cross Life and Health Insurance Company (Case No. 20STCV19949). The complaint seeks money damages for breach of contract as well as a declaratory judgment regarding Anthem Life’s notice to certain policyholders that it was canceling their policies. The complaint alleges that the notice given to policyholders fails to conform to California’s legal requirements.

Specifically, the complaint deals with Anthem Life’s cancellation of an individual health insurance policy, Individual PPO HSA Compatible, Contract Code T160. According to court documents, in late June 2019, Anthem Life mailed a notice of cancellation to policyholders under Contract Code T160 that this plan was to be discontinued as of December 31, 2019. In its class action complaint, Gianelli & Morris alleges that Anthem Life’s cancellation notice was improper under two provisions of the California Insurance Code – section 10273.6(d) and section 791.10(e).

Section 10273.6(d) of the California Insurance Code allows an insurer to avoid a mandatory renewal of an individual health benefit plan if it stops selling new plans in the state and gives insureds 180 notice of that fact. California Insurance Code section 791.10(e) requires the insurer to provide the specific reason or reasons behind its cancellation in writing at the time of the decision.

The complaint alleges that Anthem Life chose to withdraw from the state, but Anthem Life failed to disclose it was doing so, as required by law. The complaint further alleges that Anthem Life attempted to avoid the five-year ban on offering policies after withdrawal by directing the canceled policyholders toward products offered by its sister company, Blue Cross of California, which it referred to as “Anthem Blue Cross.”

“Insurance companies that want to avoid their obligation to provide continued health coverage in California must follow the rules,” said lead attorney Rob Gianelli. “Compliance with a mandatory notice law should never be compromised by a company’s economic interest.”

The complaint alleges that its lead plaintiff, John P. Gutierrez, had to pay higher premiums, suffer from claims being uncovered, and incur other expenses as a result of Anthem Life’s actions. The lawsuit seeks a declaration from the court that Anthem Life violated the California Insurance Code and further seeks money damages for the alleged harm imposed. The lawsuit is being brought on behalf of Mr. Gutierrez and all others similarly situated.

About Gianelli & Morris

Gianelli & Morris is a Los-Angeles based insurance law firm concentrating its practice in the representation of California insurance policyholders who have been denied benefits or otherwise been the subject of maltreatment by their insurance company.