In a recent interview, attorney Bob Scott, a partner with the Advocate Law Group who has also practiced law in the insurance industry for over 30 years, told us that he applauds the regulatory settlement as a whole because Anthem Blue Cross is being required to reinstate insurance coverage for California insurance consumers. However, he says that it’s important for people who don’t understand their rights to investigate their individual rights – which this regulatory settlement has not allowed them to do – to seek independent counsel with the skill set to help them do that. He explained:

If they’ve had previous medical expenses, they can either, 1) get $1,000 without doing anything – but would waive all their rights, 2) go through an arbitration proceeding – but would give up their rights to a jury trial, or 3) actually litigate the matter.

For example, if somebody had a lot of medical bills, suffered horrible emotional distress, lost their insurance, had people hounding them for bill payments and were financially upset – then those people deserve a hell of a lot more than $1,000. Anyone in that kind of setting also deserves more than some arbitration provision. You need to have your own case and go after them. Here’s a very unique setting where the carrier is essentially saying, ‘We know we’re responsible.’ It’s really just a question of how bad you’ve been damaged.

How badly have you been damaged?

Scott, who has handled a number of bad faith insurance cases against Blue Cross over the past 30 years, – many of which were generated by similar situations where significant bills needed to be addressed – says that there are many types of damages that could be recovered in this situation. He explained, “Damages could include unpaid medical bills, being harassed and dunned by creditors, having judgments taken against them or having their credit rating decrease as a result. That would be the test.”

Deciding which route to follow

Deciding which route to follow is a personal choice, according to Scott. He says that if someone only lost their insurance and didn’t have much of a loss in the way of damages – something he would find hard to believe after fighting against insurance companies for over 30 years – then they could just opt for the $1,000 payment. However, he also believes that if someone does have significant damages, then those need to be reviewed externally by an independent lawyer who can determine what rights they might have.

The other option, according to Scott, would be the arbitration provision. However, he thinks that the rights you give up in choosing that option are greater than the rewards you might receive. He says, “Why give up your right to a jury trial when we know Anthem Blue Cross is wrong? They’ve kind of admitted that they were wrong, even if they haven’t done so on the record.”

Scott told us that Anthem Blue Cross will soon be sending out notices of the settlement. If you would like to discuss your situation and evaluate your options, contact an experienced bad faith insurance attorney. Consultations are free, without obligation and are strictly confidential.