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Blue Shield of California Denied Coverage for Hydrocephalus Medication, Law Offices of Scott Glovsky Lawsuit Alleges

Blog, Insurance, Insurance and Healthcare Denials, Insurance Bad Faith
Blue Shield of California Denied Coverage for Hydrocephalus Medication, Law Offices of Scott Glovsky Lawsuit Alleges

CLAREMONT, Calif., June 14, 2019 — Scott Glovsky of The Law Offices of Scott Glovsky filed a lawsuit in Riverside Superior Court on behalf of Nicole Young against Blue Shield of California for bad faith, unlawful business practices and breach of contract.

Blue Shield contracted to provide Nicole with medically necessary health care in exchange for monthly premium payments. Nicole suffers from a debilitating condition called hydrocephalus. For years Blue Shield covered medication for Nicole’s condition, but then suddenly they began to deny her the same medication. Despite its legal obligation to do so, Blue Shield denied and has not provided and continues to refuse to provide coverage for these medications and she has been forced to either pay out of pocket or go without the medications since these denials. All of these denials resulted
from Blue Shield’s failure to use qualified reviewers to review Nicole’s requests for medication coverage in violation of Health & Safety CodeĀ§ 1367.01 and Blue Shield’s failure to follow its own prior authorization and properly investigate the requests for coverage before denying coverage for the medications.

The complaint can be viewed here.

About The Law Offices of Scott Glovsky

The Law Offices of Scott Glovsky has spent over a decade protecting policyholders from insurance company abuse. In both individual and class actions, the Law Offices of Scott Glovsky has fought for consumers to protect their rights when insurance companies act in bad faith and put their own profits ahead of the rights and interests of their insureds.