Category Archives: Health & Life Insurance Bad Faith

In November 2011, we posted about a new filing against Pan American Life Insurance Company. The suit was filed on behalf of a policyholder who had been denied medical treatment for skin cancer. The medical evidence and the opinions of her doctors supported the claims, yet her insurer wrongfully denied care and treatment.

There have been updates to this case. Tragically, our client passed away in January from cancer. The wrongful denials by Pan American Life Insurance, and resulting lack of medical treatment, ultimately led to her death.

The case has recently been re-filed in Houston after a dismissal in New Orleans due to a venue argument. The policy was purchased by a couple living in Honduras but the parent company is based in New Orleans. All medical treatment and procedures were to be performed in Harris County causing jurisdiction to fall under Texas law.

In the original filing, the plaintiffs were attempting to reverse the wrongful denial in order to pursue medical treatment. In the subsequent filing in Harris County, the damages have shifted as the plaintiff has died as a result of the insurance company’s misconduct.

To add to the issues, and compounding the effect of the insurance company’s misconduct, health care providers whose services were sought by the plaintiff under the pretext Pan American Life Insurance would pay the cost, enlisted the services of Specialized Collections to begin harassing the plaintiffs for the debts owed. A grieving family is now faced with financial ruin, in addition to the tragic loss of a loved one. All of this could have been avoided had Pan American Life simply honored its responsibilities.

Pan American Life Insurance’s actions had dire consequences. Our client sought medical treatment in Houston, one of the best medical cities in the world, with the expectation of being cured. Instead, her insurance company created roadblocks and bars to her treatment, and abandoned her and her family. Doyle stands behind this family to see justice served against an insurance company who chose profit margins over fulfilling their duty to a policyholder.

On December 22, 2011, Doyle Dennis Avery LLP filed suit in the 151st District Court of Harris County, Texas, against Pan American Life Insurance Company (“Pan American”) and its third-party claims administrator for their bad faith denial of health insurance benefits.  Since the time of filing, litigation has endured numerous procedural delays due to defendants’ attempts to escape proper venue.

In the Summer of 2011, our client was diagnosed with cutaneous melanoma in her lower abdomen. Following this disheartening finding of cancer, she sought treatment with medical professionals in Houston, Texas, and made a claim for benefits with Pan American. The insurance company, assisted by a third party administrator, fraudulently delayed the claimant’s health insurance claim while rejecting the opinions of her doctors and the evidence that she presented to support her claim. Sadly, our client lost her battle with cancer in 2012. The wrongful denials and resulting lack of medical treatment ultimately led to this tragedy.

Pan American, along with the claims administrator, are from Louisiana, and sought to remove the case to Federal Court asserting that there was complete diversity. However, the insurance lawyers of Doyle Dennis Avery LLP also held Specialized Collection Systems, Inc., liable, as this Texas collections agency threatened and harassed our client for outstanding debts that Pan American is legally obligated to pay. The defendants’ responded with motions asserting Specialized Collection was improperly joined in this cause, but after a year’s time, the courts ruled otherwise .

A federal district court in Houston held that the defendants’ failed to demonstrate that joinder of Specialized Collection was improper and remanded the case back to the 151st District Court of Harris County, Texas.

The health insurance bad faith lawyers of Doyle Dennis Avery LLP will proudly continue fighting for this client and her family in seeking justice for the bad faith actions of Pan American and the various entities which assisted their improper actions.