Orlando Injury Lawyers Applaud Insurer Fine
As Orlando injury lawyers fighting insurance companies for over two decades, we applaud state regulators for fining California's largest health insurance provider $1 million for violating state law, saying an investigation found that the company systematically dropped policyholders after they became sick or pregnant.
Officials with the Department of Managed Health Care said they hoped the fine would prompt changes at Blue Cross of California, and they plan similar investigations into other health insurance providers in the state, the Los Angeles Times reported Friday.
The department's findings could expose Blue Cross to legal liability in dozens of lawsuits filed by consumers who allege their policies were illegally canceled. The investigation found that Blue Cross used computer programs and a dedicated department to cancel the policies of pregnant women and the chronically ill regardless of whether they lied on their applications about pre-existing medical conditions - a standard required by state law.
The report said the legal standard for cancellations is high because such action may put the policyholders' health at risk by making it difficult to obtain care. Policy cancellations also hurt hospitals and physicians by denying them payment for treatment rendered in good faith and often with prior approval by the insurer.
In both personal injury and medical malpractice cases, we often see issues arise that requires interaction with our clients' health insurers. Certainly, when we represent clients who face the lose of health care coverage that is a very serious matter. Insurers must recognize that such action places the enrollee at financial risk for the full amount of billed medical charges and potentially rendering the enrollee uninsurable in the future.
As the state investigation discovered, insurers such as Blue Shield of California and Kaiser Permanente, routinely canceled coverage of individual policyholders whose medical care resulted in large claims, prompting some to lose their homes or suffer other hardships. Of course, we have seen this despicable conduct over the years and have come to expect it. However, for the innocent insured, they find this betrayal both surprising and gut-wrenching.









