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The basics of California Appeals — two not-so-simple rules

Success on appeal in California depends on many things — the facts that underlie your case, the legal positions you can take in light of the state of the law, your skill in selecting and presenting the issues to the appellate court in a persuasive… Read More
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Categories: Articles & Briefs

10 Common mistakes that trial lawyers make that can lead to appellate disaster, and how to avoid them

Getting a case from the pleading stage through trial can be like trying to walk through a minefield. There are always procedural traps lurking to snare the unwary trial lawyer. Here are 10 easy, and distressingly common mistakes for a trial lawyer to… Read More
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Categories: Articles & Briefs

Can HMOs be sued for "Bad Faith Insurance?" (Yes.)

In most cases, the providers decide what is covered and what is not covered, without any input from the HMO. (Although in most cases, the member can appeal the decision to the HMO.) The HMO is, in essence, nothing more than a middleman. So, can you s… Read More
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Categories: Articles & Briefs

Common reasons that plans deny care and what you can do about it

Most plans — whether HMOs or insured plans, deny care for one of four reasons:
  • The patient went “out of plan” to receive care, instead of following the plan’s rules and seeing a provider who has a contract with the plan;
<… Read More
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Categories: Articles & Briefs

What is the difference between “health insurance,” a “health-care service plan,” and a “health-maintenance organization (“HMO”)?

A health-care service plan is the same as an HMO. The California Health & Safety Code calls these plans “health care service plans,” while the Federal Health Maintenance Organization Act calls them HMOs. Sometimes, it makes more sense to call… Read More
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Categories: Articles & Briefs

HMO FAQs: Can I sue my HMO for bad faith?

What makes an HMO an HMO is that the policyholder (usually called a subscriber or member) pays the HMO a premium in exchange for a promise of health coverage provided by the HMO. Some HMOs provide the coverage directly; others enter… Read More
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Categories: Articles & Briefs

HMO FAQS: MHO vs PPO - How HMOs Operate and Make Money

The key difference between an HMO and an insurer is that HMOs provide the promised coverage to the member (either directly or indirectly) while traditional insurance simply pays for care that the policyholder has obtained, after the care was rendered… Read More
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Categories: Articles & Briefs

How to Read an Insurance Policy

The law requires that insurance policies be drafted in clear language. But anyone who has tried to read an insurance policy knows that they are seldom clear and that they are almost always difficult to read and understand. Determining what the policy… Read More
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Categories: Articles & Briefs

HMO FAQs: Are HMOs really all bad? Why are there so many HMO horror stories?

HMOs make more money by not providing care to patients. The medical group or doctor working with an HMO is paid a fixed amount each month, whether or not care is provided. Therefore the most profitable situation for the HMO is when no care is provide… Read More
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Categories: Articles & Briefs

Why do HMOs have such a bad reputation?

In the pursuit of profit, HMOs have negotiated ever-declining rates with their providers. As a result, many medical groups and hospitals have gone bankrup… Read More
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Categories: Articles & Briefs

Appellate Passion: Jeffrey Ehrlich has helped set precedent, but he’s proudest of getting one man out of prison.
Los Angeles & San Francisco Daily Journal,
Monday, May 21, 2018

Read more about the Ray Jennings Case

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News

Success on appeal in California depends on many things — the facts that underlie your case, the legal positions you can take in light of the state of the law, your skill in selecting and presenting the issues to the appellate court in a persuasive… Read More
Getting a case from the pleading stage through trial can be like trying to walk through a minefield. There are always procedural traps lurking to snare the unwary trial lawyer. Here are 10 easy, and distressingly common mistakes for a trial lawyer to… Read More
In most cases, the providers decide what is covered and what is not covered, without any input from the HMO. (Although in most cases, the member can appeal the decision to the HMO.) The HMO is, in essence, nothing more than a middleman. So, can you s… Read More

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