LAWSUITS NEWS & LEGAL INFORMATION
Insurance Legal News Articles & Interviews
February 20, 2019. By Anne Wallace.
Read [ Patients Battle Surprise Emergency Room Charges ]
Washington, DC Dr. Joaquin Lopez ‘s surprise emergency room bill came after he and his insurer had already paid $11,000 toward the cost of emergency gallbladder surgery. For dentist Brad Buckingham, who fell off his bicycle, the shock was a $70,000 bill to repair a broken hip. For Stacey Shapiro, it was a $6,720 emergency room fee to treat sudden spell of low blood sugar.
February 11, 2019. By Jane Mundy.
Read [ Discrepancies in Emergency Room Overcharges Cause Frustration and Financial Woes ]
Scottsdale, AZ: Emergency room care in the US is the highest-priced care a patient can receive. Even a minor condition can set you back thousands of dollars, which in itself can cause health issues—financial problems are stressful. It can get worse: one patient dinged with outrageous emergency room overcharges later discovered that another patient with similar treatment paid a lot less.
January 11, 2019. By Anne Wallace.
Read [ LTD Claimants Win Big as Ninth Circuit Trims “Abuse of Discretion” Standard ]
San Francisco, CA In one of the earliest decisions of 2019, the Ninth Circuit gave plaintiffs in long term denied disability lawsuits a new way to challenge benefit denial decisions. It may turn out to be significant.
January 10, 2019. By Jane Mundy.
Read [ ER Charges: Underserved and Over-Charged thanks to Upcoding ]
Los Angeles, CA: When a nine-year old accidentally had gasoline splashed in her eyes, her mother immediately drove her to the closest hospital emergency room. They were directed to the eyewash station but it was so dirty they couldn’t use it, so Brianna’s mom rinsed her daughter’s eyes at a regular sink. Turns out, they would have been better off using the gas station’s eyewash, which was free. The ER sink cost $1,400: the hospital charged $600 and the ER doctor fee was $800 (for walking into the room, saying Brianna needed an eyewash station and walking out). Upcoding has become common practice, resulting in emergency room overcharges and increased health costs for everyone.
January 8, 2019. By Anne Wallace.
Read [ Unum Disability Insurance Claimant Wins Reinstatement of LTD Benefits ]
Santa Ana, CA On November 20, 2018, the U.S. District Court for the Central District of California handed Pamela Fleming a resounding victory in her Unum disability insurance lawsuit. Unum had been paying her LTD benefits since 2005, after a serious and well-documented neck injury sustained in a car accident. A change in her treating physician and a brief surveillance video led the insurer to re-evaluate her claim and declare that she had recovered. The insurer terminated her benefits. Judge Cormac J. Carney was not impressed and reinstated her benefits due under the policy.
December 17, 2018. By Anne Wallace.
Read [ Jury Awards $25.6 Million in Bad Faith Insurance Lawsuit ]
Oklahoma City, OK In November 2018, a jury awarded nearly $25.6 million to the family of a Oranna Cunningham, a woman who was diagnosed with advanced nasopharyngeal cancer. Her insurer, Aetna, refused to cover the cost of the proton beam therapy recommended by her physician, claiming that it was “experimental or investigational.” After her death, her husband brought a bad faith insurance lawsuit.
December 6, 2018. By Jane Mundy.
Read [ Unum: the Gift of Giving and Taking Away ]
Chicago, IL: Yet another lawsuit was filed in November against First Unum for allegedly denying long-term disability benefits. In the same month, Unum announced to the media that it had donated $300,000 to a high-school girls’ leadership program.
November 16, 2018. By Anne Wallace.
Read [ Fibromyalgia Sufferer Brings LTD Lawsuit against Life Insurance Co. of North America ]
Los Angeles, CA On September 14, 2018 Marisa Finnerty filed a long term denied disability lawsuit against the Life Insurance Company of North America (LINA), alleging that she had been wrongly denied benefits under her employer, Quest Diagnostics’, long term disability and group life insurance plans. Two things stand out about this lawsuit.
November 15, 2018. By Jane Mundy.
Read [ Unum’s Denial of Opioid Overdose Deaths ]
New Orleans, LA: The giant insurance company Unum—also known as First Unum -- typically denies accidental death benefits (as do most other life insurance companies) by excluding in their policy coverage for deaths related to prescription overdose or for medical or surgical treatment of a sickness or disease. But Unum’s denial didn’t sway Judge Martin Feldman this past August.
November 12, 2018. By Jane Mundy.
Read [ United Healthcare Faces Class Action Lawsuit For 'Arbitrary' Therapy Payment Policy ]
Sacramento, CA: Workers in the U.S. who received psychotherapy through their employers’ plans with United Healthcare Insurance Co. and United Behavioral Health (UBH) in California have filed a proposed class action, claiming the insurers have violated mental health laws
- Is a Health Plan Liable for the Negligence of an Unqualified Claims Reviewer? By Anne Wallace (Oct-23-18)
- UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock By Anne Wallace (Oct-15-18)
- Mother with Post-Partum Depression Denied Disability Benefits by Hartford By Jane Mundy (Oct-10-18)
- Prosthetic Denial Lawsuits Filed against UnitedHealth Group and Anthem under ERISA By Jane Mundy (Sep-24-18)
- Amputees Fighting for Insurance Coverage Get Tips from Blue Cross Antitrust Lawsuit By Anne Wallace (Sep-20-18)
- Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman By Anne Wallace (Sep-14-18)
- Dentist Claims Injury, Unum Claims Sickness to Deny By Jane Mundy (Sep-13-18)
- Amputees’ Fight for Insurance Coverage Focuses on ‘Medical Necessity’ of Microprocessor Prosthetics By Anne Wallace (Sep-4-18)
- Aetna Denies Disability – Is there a Doctor in the House? By Jane Mundy (Sep-3-18)
- Lawsuits Brewing over Insurance Denials for “Smart” Prostheses By Anne Wallace (Aug-21-18)
- Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits By Jane Mundy (Aug-14-18)
- Hartford Insurance Denies Disability Benefits and Pays Millions to bail out a town By Jane Mundy (Aug-13-18)
- Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics By Anne Wallace (Aug-6-18)
- Sen. McCaskill Probes Anthem Emergency Room Coverage Denials By Anne Wallace (Jul-28-18)
- Summary Judgment for Lincoln National in Barber v. Lincoln National Life Insurance Company By Anne Wallace (Jul-25-18)
- Anthem Refuses to Cover Emergency Room Care After the Fact By Anne Wallace (Jul-18-18)
- Court Orders Unum Doctor to Reveal How Much He Was Paid for His Opinion By Lori Prapas (Jul-17-18)
- Surveillance Sinks Liberty Mutual Long Term Denied Disability Lawsuits By Anne Wallace (Jul-12-18)
- MetLife Refuses to Disclose Background Claim Processing Principles By Anne Wallace (Jun-28-18)
- Big Law Employee Sues Unum Group for Denial of Benefits By Lori Prapas (Jun-22-18)
- Ninth Circuit Champions Wrongly Denied Disability Claimant By Anne Wallace (Jun-8-18)
- Unum Insurance Lawsuits Gain Momentum By Lori Prapas (May-18-18)
- Fibromyalgia sufferer wins denied disability claim lawsuit against Hartford By Anne Wallace (May-4-18)
- Another Chance after LTD Denial? Arbitrary and Capricious Standard Continues to Crumble in MetLife Lawsuit By Anne Wallace (Apr-25-18)
- Unum: You Win Some, You Lose Some By Gordon Gibb (Mar-26-18)
- Liberty Mutual Administrator Must Consider Evidence of 'Broken Heart' By Anne Wallace (Mar-13-18)
- A Tale of Two Unum Lawsuits By Gordon Gibb (Mar-12-18)
- A New Way for Unum Lawsuit Plaintiffs to Fight Biased Medical Review By Anne Wallace (Mar-5-18)
- Diagnosed with Lyme Disease, Plaintiff is Denied by Unum Disability Insurance By Gordon Gibb (Feb-14-18)
- Unum Sued for Denial of Disability Benefits By Gordon Gibb (Feb-12-18)
- Long Term Disability Denial Letter from Insurer is Not the End of the Road By Brenda Craig (Feb-8-18)
- Class Actions Get Relief for Uninsured and Overbilled Hospital Patients By Brenda Craig (Jan-25-18)
- How to Think Like a Plaintiff in a Unum Lawsuit By Anne Wallace (Jan-24-18)
- Emergency Room Charges and What to Do About Them By Gordon Gibb (Jan-14-18)
- New Year, New Unum Lawsuit By Gordon Gibb (Jan-12-18)
- Denied Disability Claimant Wins when Administrator Blows Deadline By Anne Wallace (Jan-10-18)
- Disabled Pediatrician Sues Unum for Denied Long Term Disability By Gordon Gibb (Dec-17-17)
- Home Warranty Lawsuit Goes to the New Jersey Supreme Court By Gordon Gibb (Dec-14-17)
- LTD Denial: Understanding "Own Occupation" vs "Any Occupation" By Gordon Gibb (Dec-6-17)
- How Unum LTD Denials Forced Statute Of Limitations Ruling Against Victim By Anne Wallace (Dec-1-17)