Legal Question in Insurance Law in California

Re: ''Corporate Medical Insurance Provider Fraud''

You raise some interesting issues that cannot even begin to be resolved without further information. For instance, the negligence of the insurer is based on what? Individual doctor medical malpractice? Is the insurer interfering with the doctor acting to meet the standard of care?

Is the subsidiary company breaching their obligations to the employees by failing to provide coverage? Maybe yes if the employees had the expectation when hired that they were to receive benefits.

I would be happy to discuss this matter with you.

805-494-6557

Re: ''Corporate Medical Insurance Provider Fraud''

Sounds like breach of contract. you could sue individually or as a group.

Re: ''Corporate Medical Insurance Provider Fraud''

The terms you used have specialized meanings in insurance

law and so your description of what was promised and

what happened may be in error.

Was the subsidiary to provide insurance, or was the

subsidiary only to provide for health benefits such

as membership in an HMO? It sounds like there is

an employee benefit being granted by the subsidiary

and membership in a PPO/HMO is the means to provide

such for the employees.

Employees who have been malpracticed have separate claims

from those who have not been provided with any

benefits at all.

Federal law (ERISA) may well govern this situation, so what

is necessary is to determine exactly who promised

what - and how they promised it.

As for malpractice, agency principles may apply to

hold enterprises vicariously responsible for the

acts or omissions of others.

Please call me if you want to discuss this since I

think you have an employee benefit plan problem, not

an insurance problem.

Steven Murray

(818) 501-2277

Re: ''Corporate Medical Insurance Provider Fraud''

Based upon the facts you provided it sounds like a Breach of Contract to me, cold also be negligence and/or fraud. Depends on the actual facts and documentation. Whether you could sue individually or jointly would depend upon many factors which are too numerous to name here. You may call me for a free telephone consultation at 818-342-8020 x1