What to Do If You Have Problems
Can I recover damages from my health plan when it does not live up to the promises in the health plan’s brochure?
It may be difficult. Most of the information in your health plan’s brochure is considered to be general marketing—which is sometimes called “puffery”—as opposed to legally enforceable promises.
In one case some people sued their health plan over the health plan’s brochure that claimed that the health plan would provide “high standards” of medical service. The patients did not receive what they considered a high standard of medical care. The patients lost their lawsuit because the court decided that the health plan brochure was puffery and not a contract to provide a certain type of medical care.
Although the patients lost in that case, it is possible that if a health plan provided more specific details about the care provided to patients, you might be able to win in a case against a health plan, such as when a health plan specifically promised access to medical specialists that it did not provide.
>>What options do I have when my health plan refuses to cover the treatment I need?
>>Can I recover damages from my health plan when it does not live up the promises in the health plan’s brochure?
>>Is the health plan legally responsible if I am injured because of a doctor’s mistake?
>>How can I recover from my health plan for negligence?
>>What is respondeat superior?
>>What is apparent authority?
>>What is corporate negligence liability?