Dynamic Accident Lawyers: Health Net Hit With Bad Faith Lawsuit By UC Irvine Professor

A bad faith insurance lawsuit has been filed by a University of California, Irvine assistant professor who claims the insurance company Health Net refused to cover the cost for a necessary hip surgery.

Plaintiff AnneMarie C. is a 39-year-old mother of three who claims she injured her hip while practicing yoga almost two years ago. AnneMarie alleges that the injury resulted in a labral tear, which caused the shredding of her entire hip capsule.

In an interview with an ABC affiliate in Los Angeles, AnneMarie described the pain she endured due to the injury. She told the news station that her daily lifestyle was dramatically changed by the injury. Before she tore her hip muscle she lived an active life, often running and swimming. According to AnneMarie, after the injury occurred she had to rely on ice packs just to get through the day.

AnnMarie told ABC News that while it was a bad injury, she shouldn’t still be in so much pain. She blames her pain on Health Net, her insurance company for adding to the stress of the experience.

After the injury occurred, AnneMarie saw two in-network physicians who both told her she needed to see a specialist. Unfortunately, the only local specialist was out of network. Both of the physicians recommended she visit the same out of network specialist, but Health Net refused to pay for the surgery.

According to the California bad faith insurance lawsuit, Health Net unreasonably determined that the surgery was not medically necessary, and therefore not covered by the insurance plan.

AnneMarie says that she tried to reason with Health Net, calling the company almost daily. The pain continued to worsen and complications began to occur due to her need to overcompensate in order to protect her hip. The pain also made it difficult for AnneMarie to care for her three children.

Five months after the injury occurred, Health Net reversed its denial of AnneMarie’s claim and approved the hip surgery. Unfortunately for AnneMarie, the approval occurred after her scheduled surgery date so she had to wait for a new date to have the surgery.

When AnneMarie eventually had the surgery, Health Net refused to cover the cost, and Anne Marie was left with more than $200,000 in medicals bills because her policy had expired before the surgery took place.

AnneMarie states that she thought the surgery would occur while she was covered by Health Net, but because she felt so betrayed by the company she let her insurance lapse. According to her California bad faith insurance claim lawsuit, the corrective surgery should have happened a few weeks after the injury rather than over a year later.

If you were denied coverage for a health problem by your insurance company in California, such as Health Net, you may have legal recourse.

Join a Free California Bad Faith Insurance Lawsuit Investigation

A bad faith lawsuit investigation has been launched into allegations that some California insurance companies are refusing to pay valid medical claims or offering to pay far less than the claim is worth. Some of the companies being investigated for potential violations include:

Aetna
Anthem Blue Cross
Blue Cross of California
Blue Shield of California
Cigna
Health Net
Kaiser
Secured Horizons
United Healthcare
WellPoint
Others

If you or a loved one were denied coverage for autism treatment, mental health treatment, plastic surgery skin removal after weight loss, proton therapy for cancer, or some other medically necessary treatment, you may have a legal claim.

Get a Free Case Evaluation Now

We tell you about cash you can claim EVERY WEEK! Sign up for our free newsletter.

Email*
State*
selectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

jQuery(document).ready(function($){gformInitSpinner( 5, ‘http://11284-presscdn-0-40.pagely.netdna-cdn.com/wp-content/plugins/gravityforms/images/spinner.gif’ );jQuery(‘#gform_ajax_frame_5’).load( function(){var contents = jQuery(this).contents().find(‘*’).html();var is_postback = contents.indexOf(‘GF_AJAX_POSTBACK’) >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find(‘#gform_wrapper_5’);var is_confirmation = jQuery(this).contents().find(‘#gform_confirmation_wrapper_5’).length > 0;var is_redirect = contents.indexOf(‘gformRedirect(){‘) >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;if(is_form){jQuery(‘#gform_wrapper_5’).html(form_content.html());setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery(‘#gform_wrapper_5’).offset().top); }, 50 );if(window[‘gformInitDatepicker’]) {gformInitDatepicker();}if(window[‘gformInitPriceFields’]) {gformInitPriceFields();}var current_page = jQuery(‘#gform_source_page_number_5’).val();gformInitSpinner( 5, ‘http://11284-presscdn-0-40.pagely.netdna-cdn.com/wp-content/plugins/gravityforms/images/spinner.gif’ );jQuery(document).trigger(‘gform_page_loaded’, [5, current_page]);window[‘gf_submitting_5’] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find(‘#gforms_confirmation_message_5’).html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery(‘#gform_wrapper_5’).replaceWith(” + confirmation_content + ”);jQuery(document).scrollTop(jQuery(‘#gforms_confirmation_message_5’).offset().top);jQuery(document).trigger(‘gform_confirmation_loaded’, [5]);window[‘gf_submitting_5’] = false;}, 50);}else{jQuery(‘#gform_5’).append(contents);if(window[‘gformRedirect’]) {gformRedirect();}}jQuery(document).trigger(‘gform_post_render’, [5, current_page]);} );} ); if(typeof gf_global == ‘undefined’) var gf_global = {“gf_currency_config”:{“name”:”U.S. Dollar”,”symbol_left”:”$”,”symbol_right”:””,”symbol_padding”:””,”thousand_separator”:”,”,”decimal_separator”:”.”,”decimals”:2},”base_url”:”http:\/\/topclassactions.com\/wp-content\/plugins\/gravityforms”,”number_formats”:[],”spinnerUrl”:”http:\/\/topclassactions.com\/wp-content\/plugins\/gravityforms\/images\/spinner.gif”};jQuery(document).bind(‘gform_post_render’, function(event, formId, currentPage){if(formId == 5) {gformInitChosenFields(‘#input_5_2′,’No results matched’);} } );jQuery(document).bind(‘gform_post_conditional_logic’, function(event, formId, fields, isInit){gformInitChosenFields(‘#input_5_2′,’No results matched’);} ); jQuery(document).ready(function(){jQuery(document).trigger(‘gform_post_render’, [5, 1]) } );

Top Class Actions is a Proud Member of the American Bar Association

american-bar-association