Anyone sue Anthem?
Has anyone sued Anthem (and possibly UC) for denied claims? Got any lawyer recommendations for me? And yes, I've been in touch with the health care advocate, who has been sympathetic but largely ineffective.
Dec 12, 2021
Has anyone sued Anthem (and possibly UC) for denied claims? Got any lawyer recommendations for me? And yes, I've been in touch with the health care advocate, who has been sympathetic but largely ineffective.
Parent Replies
If your Anthem plan is an HMO I recommend you submit a grievance with the CA Department of Managed Care at https://www.dmhc.ca.gov/FileaComplaint.aspx . I have pursued multiple grievances with them and found their lawyers to be compassionate and incredibly effective. I won all of them. They told me at least 60% of grievances are found in favor of the patient. Good luck.
I have not sued Anthem but I would recommend that you go through the formal Claims Appeals process before hiring an attorney. I have worked for multiple health insurance companies and the Claims Appeals process described here https://mss.anthem.com/california-mmp/benefits/coverage-decisions/appea… is the best route. You may also need to get your health care provider involved to make sure they used the correct procedure codes when they filed your health insurance claim.