How Our Firm’s Cases Have Changed Lives
Our cases have impacted millions of insurance policyholders through forcing insurance companies to change their behavior – including their process of reviewing requests for medically necessary treatment and their medical policies. Some notable achievements include:
- Exposing Aetna’s review practices of medical directors not reviewing medical records before denying treatment through litigation that led to national news and investigations into Aetna by the United States Senate, California Department of Managed Health Care, California Department of Insurance, Colorado state regulators, Washington state regulators and Connecticut state regulators. For more information you can see these articles: Aetna settles suit alleging claim-denying medical director never read patient’s records; Leading Senate Democrats want answers from Aetna CEO; California launches investigation following stunning admission by Aetna medical director; Aetna inquiry widens over ex-medical director’s comments; When insurers require patients to stop treatment
- Forcing Kaiser to stop systemically denying Applied Behavioral Analysis (ABA) and speech therapy to children with autism spectrum disorders (ASD). This decision impacted 45,000 kids with Kaiser insurance and provided a $9,290,000 settlement for class members and autism research. For this case, Scott was given California Lawyer Magazine’s California Attorney Lawyer of the Year (CLAY) award and was a finalist for the 2014 Consumer Attorney of the Year Award from the Consumer Attorneys of California.
- Getting Kaiser to provide over 100,000 California members living with severe mental illness access to medically necessary residential treatment as part of a court-approved class action settlement.
- Recovering roughly $25 million from Anthem Blue Cross and Blue Shield of California based on their misleading California members about the doctors within their networks.
- Exposing how insurance companies systematically pressure hospitals to discharge patients with severe, and often fatal, eating disorders. His case put insurance companies on notice that they can no longer victimize young women without suffering serious consequences. For this case, Scott won Consumer Attorneys of California 2008 Street Fighter of the Year award. This award is given to a lawyer who helped create a more just society by overcoming incredible odds and without regard to profit or personal benefit.
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Our Case Results
Relentlessly Tough, Relentlessly Personal
Scott began representing policyholders instead of insurance companies in 1999 and has consistently sought justice for his clients in ways other firms cannot. Scott is passionate about helping policyholders obtain treatments, coverage, and reimbursement from California insurance companies, including Aetna, Anthem Blue Cross, Blue Shield of California, Health Net, Kaiser Permanente UnitedHealthcare, and other companies providing insurance.
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$17.3 Million
On April 30, 2019, a 39-year-old father was fatally injured when his Kia Optima collided with a disabled Los Angeles County Metropolitan Authority (LACMTA) bus on the I-10 freeway's express lane.
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$14.9 Million
Cowart v. Anthem Blue Cross, et al. Anthem sued for misleading California individual plan members about the doctors in its networks for its ACA (“Obamacare”) plans in 2014.
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$10 Million
General areas addressed: health insurance; treatment and procedure coverage; physician recommendations; critical organ, brain, cancer or spinal cord issues; and out of network coverage issues.
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$9.29 Million
Arce v. Kaiser. Kaiser Permanente sued for denying ABA and speech therapy to children with Autism Spectrum Disorders.
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$8.5 Million
General areas addressed: health insurance; treatment and procedure coverage; physician recommendations; critical organ, brain, cancer or spinal cord issues; and outside of network coverage issues.
