Case Results

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. Anthem agrees to reimburse members who paid more out-of-pocket because they received medical services from an out-of-network professional. Uncapped claims fund allows members the opportunity to recover 100% of the out-of-pocket expenses for medical services rendered by an out-of-network professional in 2014.

Confidential. 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.

Arce v. Kaiser. Kaiser Permanente sued for denying ABA and speech therapy to children with Autism Spectrum Disorders. Kaiser agrees to change its policy and stop systemically denying ABA and speech therapy, and agrees to pay 9.29 million to reimburse families with children with ASDs for ABA and speech therapy.

Confidential. 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.

Glick/Chase v. Anthem Blue Cross. Anthem Blue Cross sued for denying ABA and to children with Autism Spectrum Disorders. Anthem agrees to pay 4.65 million to reimburse families with children with ASDs for ABA.

Confidential. General areas addressed: wrongful death; health insurance; insurer-required premature hospital discharge; procedures and policies; nursing home treatments; elder abuse; health insurance coverage; physician recommendations; and discharge policies and procedures.

Confidential. General areas addressed: health insurance; mental health coverage; Mental Health Parity Act; procedures and policies; health insurance coverage; physician recommendations; eating disorders, and discharge policies and procedures.

Confidential. General areas addressed: health insurance; treatments and procedures for special needs child; health insurance coverage; Mental Health Parity Act; physician and medical provider recommendations; and medically necessary treatments and procedures.

Jones v. 3M Company et al. Personal injuries from asbestos exposure caused mesothelioma. Los Angeles case settlements resulted in recovery in excess of $2 million.

Confidential. General areas addressed: health insurance; treatment and procedure coverage; physician recommendations; critical organ, brain, cancer or spinal cord issues; and in or outside of network issues.

Confidential. General areas addressed: health insurance; treatments and procedures for special needs child; mental health parity; health insurance coverage; physician and medical provider recommendations; and medically necessary treatments and procedures.

Gonzales v. Hickman et al. Civil Rights violations against California prison officials resulting in death of correctional officer in Chino, California.