Joseph Romano Law

An individual was involved in a swimming pool accident and suffered quadriplegia. The health care provider requested coverage information from the health insurer. The health insurer provided incorrect and misleading information as to the health insurance coverage. The health insurer denied the requested rehabilitation hospital stay, durable medical equipment (ventilator) and the 24-hour nursing care recommended by the treating doctor. The treating doctor suggested that the family contact an attorney. After reviewing the health insurance policy, I found that there was coverage for the requested services. I filed a bad faith claim against the health insurer for misleading the family and the health care provider concerning the "coverage information".

Bad faith is a principle of law which applies in all states, and essentially can be a valuable weapon against health insurers if they are providing incorrect, incomplete, misleading, or outdated coverage information for the purpose of denying medical treatment or services for an individual.