Doyle Files Suit Against Pan American Life

On December 22, 2011, Doyle filed suit against Pan American Life Insurance Company (PALIC) and its third-party claims adminsitrator for their bad faith denial of a health insurance claim earlier this year.  After making a claim on her insurance for treatment of her recently diagnosed cancer, Pan American continued to deny the claimant’s health insurance claim, in contravention of the opinions of her doctors and the evidence that she presented to support her claim.

Doyle is proud to assist this claimant in seeking justice for the bad faith actions of Pan American.

Lawsuit Involving Pan American Life Insurance Update

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.

Doyle Files Negligence and Breach of Contract Lawsuit against Central United Life Insurance

Doyle has filed suit against Central United Life Insurance on behalf of a policyholder whose cancer treatment was denied. The policyholder had purchased a cancer insurance policy long before her diagnosis of breast cancer and continued to pay the premiums during her treatment and recovery.

Upon receiving the policyholder’s claim for benefits, Central United failed to assign her claim to an adjuster and failed to even research or request any information reasonably required to adequately investigate her claim further. The company did not conduct a reasonable and objective investigation of the facts of the claim. Further, Central United ignored medical evidence, including records from the treating doctors, and failed to collect or analyze other evidence related to the claim for insurance benefits.

In 2011, the company completely denied the claim for insurance benefits under a policy which expressly provided comprehensive coverage in the event of a cancer diagnosis. The plaintiff had maintained the policy in full force and effect by timely payment of insurance premiums for more than a decade.

Central United violated the Texas Insurance Code by refusing to pay the claim without conducting a reasonable investigation with respect to the claim. This conduct also breached the duty to deal fairly and in good faith with the policyholder. Central United acted fraudulently in denying the coverage benefits.

Doyle stands behind this policyholder in their fight against an insurance company’s bad behavior and failure to honor their financial obligation.

Bad Faith Health Insurance Suit against Pan American Life Insurance Remanded Back to Proper Jurisdiction, Harris County

On December 22, 2011, Doyle 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 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 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.

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