Insurance Legal News Articles & Interviews

Santa Clara, CA Despite government entities recognizing Long Covid as a disability, attorneys are litigating against health insurance companies that deny disability benefits to COVID long haulers.

Nashville, TN There was a flurry of reports and studies about five years ago that found routine price gouging in emergency rooms nationwide, and it was worse for the most vulnerable populations – poor and minority patients. It appears that, no matter how advanced medical technology gets, many emergency room patients are left in the dark, and left with an unexpectedly huge ER overcharges bill.

Islip, NY A number of elements go into the calculation of emergency room fees. Apart from the cost of providing care, hospitals must factor in reasonable expectations that some bills will go unpaid and that insurance companies will try to negotiate certain charges down – sometimes because of suspicions of healthcare fraud. The net effect, however, is that patients pay more.

Clear Lake, CA On April 8, the DC Circuit Court, which has jurisdiction over Medicare cases, held that Medicare need not reimburse St. Helena Clear Lake Hospital for the cost of maintaining nonemergency room specialists on call. Without Medicare reimbursement, the cost of maintaining these doctors on call will ultimately be passed along to patients through higher emergency room charges.

Santa Clara, CA If you are a COVID 19 long-hauler and your disability claim has been denied, don’t give up – don’t accept excuses from your insurer. The medical and legal community, state and federal governments (including the CDC) and a recent global survey recognize Long COVID as a disability and insurers will increasingly find it difficult to deny LTD benefits.

Las Vegas, NV (April 26, 2022) A jury awarded $40 million in compensatory damages and $160 million in punitive damages to the family of a Las Vegas man who died after being wrongfully denied a specific type of cancer treatment. Sierra Health and Life, a UnitedHealthCare Company, denied Bill Eskew’s claim for proton beam therapy (PBT). Sandy Eskew, the widow and on behalf of Bill Eskew’ estate, brought a lawsuit against Sierra Health and Life. After a 13-day trial, the jury found Sierra Health and Life had breached its duty of good faith and fair dealing also known as “insurance bad faith.” 

Northridge, CA It’s no surprise that some “long COVID-19” claims are denied by insurance companies: there was even a debate about whether it was real. But long-term disability attorney Brent Dorian Brehm, with Kantor & Kantor LLP has already won “post-COVID-19 syndrome” appeals for his clients. Brehm discusses how best to file a long-COVID LTD claim.

Baton Rouge, LA No sooner has TeamHealth settled a $15 million class action lawsuit brought by physicians than it’s slammed with another class action claiming inappropriate ER billing and systematic overcharges from its central billing office which is controlled in a “cartel-like manner”. 

Knoxville, TN On October 27, 2021, UnitedHealthcare filed a lawsuit against TeamHealth Holdings in the Eastern District of Tennessee. UnitedHealthcare Services v. TeamHealth Holdings, the ER fees lawsuit, charges that TeamHealth routinely overcharged emergency room patients for minor medical needs. UHC, as the administrator for many of those claims, alleges that it overpaid by as much as $100 million. The company claims that TeamHealth’s tactics crossed the line from aggressive profit maximization to outright fraud.

Santa Clara, CA The No Surprises Act, that went into effect January 1, 2022 intends to provide protection against surprise medical bills such out-of-network bills for in-network hospitals and services such as an air ambulance ride (not ground ambulance) to an in-network hospital. But don’t be surprised if you get a surprise bill…