 Dear Friends:
The Office of the Los Angeles City Attorney has launched a law enforcement investigation into potentially unfair business practices by health plans and health insurers, particularly with respect to their improper denial of claims for coverage made by consumers, or their cancellation of consumers’ coverage altogether.
Recent news reports indicate that certain companies in the health insurance industry may be engaging in business practices that violate numerous civil consumer protection, and possibly even criminal, laws. Such practices are devastating to consumers who are led to believe that they have health coverage, only to have that coverage suddenly denied after they are diagnosed with serious medical conditions. Additionally, these business practices may victimize health care providers, such as doctors and hospitals, who reportedly have been denied payment for medical services provided to patients under the reasonable belief that the patients were fully insured.
If you have information regarding what you believe are unlawful, fraudulent or unfair business practices of a health plan or health insurer, we request your assistance in this investigation.
If you believe your health insurer has wrongfully denied or delayed your claim and/or canceled your coverage, we urge you to provide us with a description of your complaint.
If you are a health care provider who has had payment withheld, payment delayed or has been retroactively denied payment for services rendered under a health plan or insurance policy, we welcome your assistance in this investigation, to the extent consistent with your legal and ethical obligations to maintain patient confidentiality.
If you have other information relevant to this investigation, we welcome your assistance, as well.
Please click on the appropriate complaint form to tell us what you know about these practices.
Thank you for your interest in our investigation.
Sincerely,

Rocky Delgadillo
City Attorney |