Insurance – Bad Faith, Claims Handling

HMO provider group of physicians does not provide timely hand surgery. $7.2M. Los Angeles County.

Following a bad hand injury, plaintiff receives referral after referral through his HMO, but no timely surgery.

 

 

Med-mal case against Kaiser goes to trial when arbitration clause is beaten. $28 million gross. Los Angeles County.

Teen loses leg to aggressive cancer when Kaiser delays MRI.  Kaiser Foundation Health Plan is sued for insurance bad faith, but after summary judgment for defense, complaint is amended to include medical negligence against Kaiser's physician group. Plaintiff defeats Kaiser arbitration clause and a second summary judgment motion, and case goes to a jury. 

Plaintiff fails to beat carrier's 998 offer in breach of contract and bad-faith claim. $78,689. San Francisco County.

Carrier offered $100K under CCP 998 to settle a breach of contract and bad-faith claim for alleged failure and delay in paying benefits, but the jury awarded less. The claim arose out of a fire at a commerical business.