The Law and Your Health

What to Do If You Have Problems

Is the health plan legally responsible if I am injured because of a doctor’s mistake?

One of the biggest questions surrounding health plans is whether the health plan or the doctor is responsible for the actions of its doctors when you are injured. The law is not settled, yet nearly every state is trying to come up with an answer.

In California, the law states that your health plan is responsible for its actions and your doctor is responsible for his or her actions. In other words, you cannot necessarily recover from your health plan when your doctor makes a mistake. Another California law, though, states that in some cases you could recover from the health plan when your doctor is negligent and you are injured. Exactly when this could happen, however, is not clear at this point.

In some cases you may be able to recover from the health plan for not checking the credentials of its doctors (see later question and answer).

As more cases move through the courts this area of law will become clearer.

>>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?


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