Legal Question in Medical Malpractice in California

Re: malpractice suits

For not administering? No, that is the doctor's job. For not approving coverage for, yes. However, regarding the success of such a case, I would need more facts. Extreme pain in an E.R. setting for example, would need to be treated by the physicians, and the HMO would not likely come into the picture until later. I can see the HMO playing a (negligent) role only in a prolonged pain management scenario.

Re: malpractice suits

An HMO can not be sued. The hospital or physicians can, but the law suit will require proof that the healthcare providers were negligent in the way they administered care and treatment, and also, that as a practical matter the injury was sufficiently serious to make it likely that a jury would award at least $250,000 in damages.