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Doyle Files Suit Against BCBS Texas For Wrongful Denial

Doyle has filed another suit against Blue Cross/Blue Shield Texas for wrongfully denying emergency medical care to a pregnant policyholder. The suit alleges BC/BS Texas refused payment for an emergency c- section delivery, necessary to save the life of both mother and child, on the ground that maternity care was not covered under the policy.

The plaintiff became pregnant, with a due date in June 2012. On June 23, 2012, she was admitted to a medical center in Austin for scheduled induced delivery. During the delivery, the plaintiff’s medical providers observed complications which endangered the health and lives of her and her unborn child. The physicians determined that it would be necessary to perform an emergency Cesarean section operation in order to save the lives and health of both the plaintiff and her unborn child.

BC/BS Texas has repeatedly issued a denial of payment for all medical services rendered in connection with the emergency medical procedures. BC/BS Texas maintained its denial even though the plaintiff continued to present evidence demonstrating that her claim for coverage was expressly provided for by the Policy and despite the input of the Texas Department of Insurance, which submitted inquiries on behalf of the plaintiff to BC/BS Texas.

BC/BS Texas was sanctioned by the Texas Department of Insurance in that case for the same exact misconduct. Unfortunately and despite being told their denial was inappropriate, BC/BS Texas engaged in the same improper denial behavior toward yet another Texas policyholder and mother.

Doyle remains committed to helping both plaintiffs pursue justice against this insurance company’s serial misconduct and breach of its obligations.