Joseph Romano Law

Parents argued that their daughter suffered brain damage as a result of the negligence of their HMO's. The family attempted to sue the HMO. The HMO argued that it does not make "medical decisions" and that they are protected from lawsuits by a 1974 federal law that regulates employee benefits (ERISA).

Many courts are not accepting the argument that HMO's, which set the guidelines for care, should not have any legal liability. Some courts have held that consumers should be able to sue their health insurance plan. Careful consideration should be given as to whether or not to sue an HMO, given the specific facts and circumstances of your case. Recently, courts in New York, Connecticut, Texas, and Pennsylvania, permitted patients to sue their HMOs for negligence in quality-of-care decisions.