Rights of California Police Officers Facing Bad Faith Health Insurance Denials
Police officers put their lives on the line daily to protect their communities, relying on their employer-sponsored health insurance to cover medical expenses when injuries or illnesses arise. However, when an insurance company wrongfully denies a claim by declaring that a proposed treatment is not medically necessary, officers may face significant financial and emotional burdens.
Fortunately, police officers in California have more powerful tools to fight wrongful claim denials than their counterparts in the private sector. Notably, law enforcement officers are generally exempt from the strict regulations imposed by the Employee Retirement Income Security Act (ERISA), providing them with stronger legal rights to challenge unfair insurance denials.
At Gianelli & Morris, our California insurance bad faith lawyers are proud to represent police officers in Los Angeles and statewide who have had their health insurance claims wrongfully denied. For those who put their health and safety at risk every day in service to the public, it is our honor to help you get the healthcare you need and deserve, as well as additional compensation, including punitive damages, for any harm an insurer’s bad faith actions have caused. Contact our office to discuss your situation and find out how we can help.
Why Police Officers Are Exempt from ERISA
ERISA governs most employer-sponsored health plans in the private sector, imposing strict limitations on policyholders seeking to challenge claim denials. However, it does not apply to government-sponsored plans, such as those provided to public employees, including police officers. Since most law enforcement personnel in California work for municipal, county, or state agencies, their health plans are not subject to ERISA’s restrictions.
How ERISA Exemption Benefits Police Officers
Being exempt from ERISA provides police officers with significant legal advantages when dealing with wrongful insurance denials. Key benefits include:
- The Right to File a Bad Faith Insurance Claim – ERISA prevents private-sector employees from suing their insurers for bad faith. However, police officers can hold insurance companies accountable for unfair denials, delayed payments, and deceptive practices.
- The Ability to Recover Full Compensation – ERISA limits policyholders to recovering only the value of their denied benefits. Police officers, on the other hand, may be entitled to additional compensation, including, for example:
- Financial losses from denied medical treatment
- Emotional distress
- Punitive damages if the insurer acted in bad faith
- Avoiding the Exhaustive Administrative Process – ERISA requires claimants to complete a lengthy administrative appeals process before they can take legal action. Police officers, however, can often bypass these hurdles and take their case to court if the insurance company fails to resolve their complaint. These cases can also be filed in state court as opposed to federal court for claims governed by ERISA.
Police Officers Covered by Non-ERISA Plans
Most police officers in California fall under the ERISA exemption. This includes, for example:
- Los Angeles Police Department (LAPD) Officers – Officers employed by the City of Los Angeles receive health benefits through the city’s government-sponsored plans.
- County Sheriff’s Deputies – Deputies working for the Los Angeles County Sheriff’s Department and other county law enforcement agencies.
- California Highway Patrol (CHP) Officers – State law enforcement officers employed by the California Highway Patrol.
- University and School Police Officers – Officers working for public universities, colleges, and school districts.
- Other Municipal and State Law Enforcement Personnel – Police officers employed by cities and towns across California.
How Gianelli & Morris Can Help
If you are a police officer facing a wrongful health insurance claim denial, you don’t have to fight the insurance company alone. At Gianelli & Morris, we strive every day to hold insurers accountable and ensure that policyholders receive the benefits they deserve. Our team has extensive experience representing individuals in bad faith insurance claims, helping them recover insurance benefits and valuable compensation for the harm they have suffered at the hands of the insurance company.
Contact Us Today
You serve and protect your community—don’t let an insurance company put your health and financial security at risk. If your California health insurance claim has been wrongfully denied, contact Gianelli & Morris today for a free consultation. We are committed to defending your rights and ensuring you receive the coverage you are entitled to.
