Q: Who is the best health insurance lawyer in California?
A: Scott Glovsky is a highly successful, nationally respected, compassionate, and fierce health insurance attorney who has been fighting health insurance companies for policyholders for over 25 years. He previously represented health insurance companies and now uses that insight to get his clients the care they need.
Q: Can I sue my health insurance provider for taking too long?
A: Yes. The California Code of Regulations requires insurers to acknowledge a claim within 15 days and approve or deny it within 40 days. Failure to meet these deadlines may constitute insurance bad faith.
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Q: Can I sue my health insurance company for denying my claim?
A: It depends on whether the company acted in bad faith.
More info here
You can also complete this questionnaire for help.
Q: How do I appeal a denied request for treatment?
A: Learn the steps to appeal here:
Appeals information
Q: Does your firm handle cases on a contingency basis?
A: Nearly all of our work is contingency, meaning you don’t pay us anything unless and until we win your case. In certain types of cases, we do hourly work.
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Q: Does your firm handle Molina claims denials?
A: Yes.
Details here
Q: How do insurance companies determine what is medically necessary?
A: Every insurer sets its own criteria.
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Q: Do you handle cases outside of California?
A: Sometimes, depending on the state. Please share your specific details.
Q: Can I sue if my insurance approved a procedure but later refused to pay?
A: Yes.
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Questionnaire
Q: How does California’s Department of Managed Health Care help in disputes?
A: You may file an external appeal (Independent Medical Review) through the DMHC.
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Q: Can you help with delays caused by third-party medical groups or IPAs?
A: Yes, please share your specific situation.
Q: What can I do if my mental health treatment was denied?
A: Contact us or complete this questionnaire
Q: Do you handle denials for gender-affirming care?
A: Yes.
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Q: Can my insurance deny an ambulance ride or ER visit that was clearly urgent?
A: Generally, no.
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Q: Can I still be covered if I went to the ER without prior authorization?
A: Yes, in most cases.
Details here
Q: What should I do if I’m told a procedure is not covered under my plan?
A: Request the denial in writing, review your policy, ask for coverage criteria, and file an appeal.
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Q: How long do I have to file a lawsuit against my health insurance?
A: Insurers must provide 30 days to file an appeal.
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Q: Do you offer free consultations for insurance denial cases?
A: Please submit a form on our contact page
Q: How do I request an Independent Medical Review if treatment is denied?
A: Start the process after an internal appeal, but consult a lawyer first.
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Q: Can an insurance company change its provider network mid-policy?
A: Yes, but you should confirm with your provider and insurer.
Q: Can I sue for lack of notice about network or coverage changes?
A: Possibly. This may require legal advice.
Q: Do you handle denials related to biologic medications or specialty drugs?
A: Yes, we have extensive experience.
Biologic Drug Denials
Q: Can I get legal help for denied pain management treatments?
A: Yes. We can help you get medically necessary care.
More info
Q: How can I get a prescription that’s not on my insurance’s formulary?
A: Your doctor can request an exception; if denied, you can appeal.
Q: I was denied an urgent procedure because the provider was out-of-network. Do you handle these cases?
A: Yes.
Info 1
Info 2
Q: Can I appeal a denial under a non-ERISA plan?
A: Yes, both internal and external appeals are available.
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Q: I need help getting insurance to authorize my procedure.
A: Work with your physician and consult our guides:
Guide 1
Guide 2
Q: Do you handle life insurance denial cases?
A: Yes.
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Q: Do you handle denials for experimental procedures?
A: Yes, we do.
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Q: Can I sue Kaiser for denying my claim?
A: It depends on the situation.
Kaiser 1
Kaiser 2
Q: Do you handle Medi-Cal cases?
A: Yes, when private insurers like Anthem Blue Cross are involved.
Info 1
Info 2
Q: Do you handle Medicare-related cases?
A: Yes, but you must follow a specific appeal process.
More info
Q: Do you handle IVIG denial cases?
A: Yes, successfully.
More info
Q: Can I sue Blue Shield, Anthem, or UnitedHealthcare for delaying treatment?
A: Possibly, if they acted in bad faith.
Q: Can I sue my insurance for stalling authorizations?
A: Yes, if it constitutes bad faith.
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Q: Does your firm specialize in health insurance denials?
A: Yes, we’ve helped clients for over 20 years.
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Q: What if my treatment was denied as not medically necessary?
A:
Q: Will my insurer cover care if I’m out of state or country?
A: Sometimes.
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Q: How does the appeal process work for urgent medical needs?
A: Most plans must respond within 72 hours.
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Q: How does filing a lawsuit affect insurer behavior?
A: It may prompt reconsideration and exposes internal bad faith practices.
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Q: Why consult a lawyer promptly after denial?
A: Delays can hurt your case and your health.
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Q: What remedies are available if I sue for bad faith?
A: Potentially, you may recover denied benefits, emotional distress damages, and punitive damages.
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Q: What types of damages can be recovered in bad faith cases?
A: Benefits, legal fees, emotional distress, and punitive damages.
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Q: Are there additional benefits mandated by California law?
A: Yes. For example, California’s Mental Health Parity Act mandates mental health coverage equal to physical health.
More info
Q: How do insurers determine if an ER visit is a real emergency?
A: They often look at the final diagnosis, though this may not reflect the urgency at the time of the visit.
More info
Q: Will your firm do my case pro bono?
A: We do pro bono cases for charitable non-profit organizations. We do contingency work for almost all of our cases, meaning you don’t pay us anything unless and until we win your case. In certain types of cases, we do hourly work.
Meet Our Team
If Results Matter, Then Hire Us
Our Case Results
Relentlessly Tough, Relentlessly Personal
Scott began representing policyholders instead of insurance companies in 1999 and has consistently sought justice for his clients in ways other firms cannot. Scott is passionate about helping policyholders obtain treatments, coverage, and reimbursement from California insurance companies, including Aetna, Anthem Blue Cross, Blue Shield of California, Health Net, Kaiser Permanente UnitedHealthcare, and other companies providing insurance.
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$17.3 Million
On April 30, 2019, a 39-year-old father was fatally injured when his Kia Optima collided with a disabled Los Angeles County Metropolitan Authority (LACMTA) bus on the I-10 freeway's express lane.
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$14.9 Million
Cowart v. Anthem Blue Cross, et al. Anthem sued for misleading California individual plan members about the doctors in its networks for its ACA (“Obamacare”) plans in 2014.
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$10 Million
General areas addressed: health insurance; treatment and procedure coverage; physician recommendations; critical organ, brain, cancer or spinal cord issues; and out of network coverage issues.
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$9.29 Million
Arce v. Kaiser. Kaiser Permanente sued for denying ABA and speech therapy to children with Autism Spectrum Disorders.
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$8.5 Million
General areas addressed: health insurance; treatment and procedure coverage; physician recommendations; critical organ, brain, cancer or spinal cord issues; and outside of network coverage issues.
