Oklahoma Bad Faith Insider

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Latest from Oklahoma Bad Faith Insider

Judge Calls Health Insurance Company’s Proton Therapy Denials “Barbaric”

By Doug Terry on May 18, 2019

As we frequently discuss on this blog, insurance companies owe a duty of good faith and fair dealing to their policyholders. Unfortunately, insurers regularly violate this important duty in a myriad of ways. This is not uncommon. However, it is very uncommon for an insurance company’s actions to be called out as forcefully as they were in an April 29, 2019 order issued by United States District Judge Robert N. Scola, Jr. in Miami, Florida. Judge Scola…

Oklahoma Bad Faith Insider

Aetna Settles California Suit that Led to Insurance Department Investigation

By Doug Terry on April 30, 2019

A high-profile California insurance bad faith lawsuit brought by Gillen Washington and his attorney Scott Glovsky against his health insurance company, Aetna, has now been settled. In this case, first reported on by CNN, evidence emerged in the form of the Aetna-in house doctor’s testimony that Aetna medical directors make decisions on policyholders’ claims without first reading the medical records submitted to Aetna by policyholders and their doctors. When the California Department of Insurance learned…

Oklahoma Bad Faith Insider

Nation’s Largest Health Insurer Punished for “Sloppy Practices”

By Doug Terry on February 17, 2019

United Healthcare (“UHC”), the largest health insurance company in America, was found by the California Department of Insurance to have committed over 900,000 violations of California laws and regulations. As a result, the California Insurance Commissioner imposed $173 million in fines. UHC challenged the fines in court, and in early January the California Supreme Court upheld $91 million of those fines. The remaining $82 million in fines are still pending on appeal. According to a…

Oklahoma Bad Faith Insider

$25.6 Million Verdict Against Aetna in Bad Faith Case

By Doug Terry on November 9, 2018

I am happy to announce we obtained a $25.6 million verdict for our clients Ron and Orrana Cunningham this week in Judge Lisa Davis’ court in Oklahoma County. The case is Cunningham v. Aetna, CJ-2015-2826. It is a non-ERISA health insurance bad faith case. I apologize for the length of this post, but I think this is a story worth telling. I tried this case for 12 days with my former law partners, Justin Meek…

Oklahoma Bad Faith Insider

Insurance Companies Must Investigate Coverage Before Denying It

By Doug Terry on September 9, 2018

Insurance adjusters often don’t know how to properly interpret the language of the very insurance policies their companies sell their policyholders. My experience tells me adjusters often read the insurance policy looking for any arguable as (even outlandish) way to deny coverage. They take language out of context, misapply language to the facts of the claim and generally look harder for reasons to deny than for reasons to pay. This is exactly the opposite of what…

Oklahoma Bad Faith Insider

CEO Pay in US Companies Has Skyrocketed

By Doug Terry on August 20, 2018

A recent story in the Guardian reveals the statistics on how CEO pay at the largest US corporations has skyrocketed over the last few decades. The Guardian story says in 1965, CEO pay was 20 times that of workers. That would mean if a worker made $30,000.00 per year, the CEO would be making about $600,000.00. However, today CEO pay has risen to an average of 312 times that of the average worker. Therefore, if a worker…

Oklahoma Bad Faith Insider

Policyholders Should Not Blindly Accept Coverage Denials

By Doug Terry on August 19, 2018

When an insurance company receives a claim from its policyholder, the first thing the adjuster does is “check coverage.” This means they verify the policy is in force by making sure the premiums have been paid and the policy period is in effect. Then, the adjuster looks at the facts of the claim the policyholder is presenting to determine if the insurance policy language provides coverage for the claim. This may sound simple (and it…

Oklahoma Bad Faith Insider

Claim Handlers’ “Say No First, Ask Questions Later” Attitudes Can be Costly

By Doug Terry on August 9, 2018

There are many people working as claims professionals in the insurance business who strive to do the right thing by the company’s policyholders. When I run into one of them, it is like a breath of fresh air. These folks seem to genuinely care about policyholders and work hard to try to find ways to pay claims. They do not relish denying a policyholder’s claim and do not feel as though they have “won” somehow by denying a claim.…

Oklahoma Bad Faith Insider

Does Using Biased Experts Violate the Duty of Good Faith?

By Doug Terry on June 15, 2018

Insurance companies often hire an “expert” as part of their investigation of a policyholder’s claim. The expert can be a doctor, an engineer, an accident reconstructionist, an accountant, etc. , depending on the type of claim and the issue being investigated. Insurance companies and their lawyers love nothing better than to claim that because they hired and relied on an expert before denying the claim, they cannot be in bad faith. They use the old…

Oklahoma Bad Faith Insider

Health Insurance Company Denying Coverage for ER Visits it Deems Unnecessary After the Fact

By Doug Terry on May 19, 2018

In an excellent recent article in the New York Times, a claim-handling practice by Anthem Blue Cross Blue Shield was brought into the public light. Anthem has begun denying its policyholders’ claims for coverage for emergency room visits if Anthem determines after the fact that the policyholder didn’t really need to go to the emergency room in the first place. Anthem is basing these decisions on what the final diagnosis of the policyholder’s condition turns…

Oklahoma Bad Faith Insider

Your Source on an Insurance Company’s Duty to its Policyholders

Blog Authors

Judge Calls Health Insurance Company’s Proton Therapy Denials “Barbaric”

Aetna Settles California Suit that Led to Insurance Department Investigation

Nation’s Largest Health Insurer Punished for “Sloppy Practices”

$25.6 Million Verdict Against Aetna in Bad Faith Case

Insurance Companies Must Investigate Coverage Before Denying It

CEO Pay in US Companies Has Skyrocketed

Policyholders Should Not Blindly Accept Coverage Denials

Claim Handlers’ “Say No First, Ask Questions Later” Attitudes Can be Costly

Does Using Biased Experts Violate the Duty of Good Faith?

Health Insurance Company Denying Coverage for ER Visits it Deems Unnecessary After the Fact

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