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The largest groups representing hospitals and physicians in California have joined the consumer fraud lawsuit against Blue Cross of California, claiming the state's biggest health plan company deceptively and frequently refused to pay them millions for healthcare provided to patients whose policies were canceled later.
As a result of joining the suit, doctors and hospitals are now siding with patients, regulators and consumer advocates who have condemned Blue Cross for canceling patient's policies after they undergo costly medical treatments. These cancellations have resulted in devastating financial losses for many patients.
Blue Cross contends that it only cancels coverage after deciding that enrollees submitted inaccurate or incomplete applications, which would make the patients responsible for paying for their medical care.
Individual Policyholder Issues
The issue with Blue Cross lies with their individual insurance policies. Unlike group coverage provided by an employer, individual applicants who have preexisting medical conditions or other risks may be rejected.
Hundreds of disgruntled former Blue Cross members have filed lawsuits against the insurer and other carriers in the state, accusing them of finding mistakes in the applications after the fact so they could get out of covering the medical bills.
These consumer fraud lawsuits claim that Blue Cross is violating California law by failing to decide whether policyholders merely made a mistake on their applications or intended to lie.
According to state law, insurance carriers are required to reimburse hospitals and physicians for authorized treatment if the carrier determines later that the patient shouldn't have been covered during that time.
Have you been a victim of fraud? Please contact us today to schedule a complimentary case evaluation with a proven consumer fraud attorney.
Consumer fraud class action lawsuits are specifically designed to help individuals who have been similarly aggrieved to pursue a common goal – namely to hold the deceptive business accountable for any damages suffered. Thus, consumers who have been defrauded by a corporation or other entity may file a consumer fraud class action lawsuit on behalf of themselves and others to seek compensation for their shared grievance.
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