Tag: Eating Disorder Claims

In-Network versus Out-of-Network: What you need to know when selecting a medical provider

One of the first questions we ask clients calling about the denial of medical benefits is whether the provider (i.e. hospital, treatment center, doctor) was an in-network or ­out-of-network provider. Some insurers use different terms such as participating provider or contracted provider. These terms all mean that the insurance company, or its claims administrator, has […]

Trumpcare will cut mental health care and substance addiction treatment for 1.3 million people

Trumpcare, the Republicans’ proposed plan to replace the Affordable Care Act (ACA) — also known as “Obamacare” — will cut mental health and addiction treatment for 1.3 million people, just as the country is struggling to cope with an epidemic of opiate addiction. The Washington Post reported on March 9, 2017, that House Republicans admitted under questioning […]

Top 7 Benefits of the Affordable Care Act…Some of Which May Soon Disappear.

As health care litigators, we are often asked about the benefits of the Affordable Care Act (“ACA” aka Obamacare). The bottom line is that more people have received more comprehensive coverage through the Affordable Care Act because of the following measures: No preexisting exclusion. Health plans can no longer charge more or deny coverage to […]

If you have insurance, you need to know about the “notice-prejudice” rule!

Every insurance policy requires that you give notice of your claim for benefits to the company before benefits can be paid.  It doesn’t matter if the claim is for medical services, disability benefits, life insurance, fire, flood, theft, etc. Obviously, notice and information about your claim is necessary before the insurance conpany can process and pay the claim. Policies […]

Mental illness is nothing to be ashamed of, but stigma and bias shame us all. – Bill Clinton

Eating disorders are a serious public health concern in the United States and around the world. At least 30 million people in the United States will suffer from an eating disorder at some point in their life. And eating disorders don’t just impact women.  Approximately 10 million men in the United States will face an eating […]

Your Insurance Claim Will Probably Be Denied!

On January 13, 2017, the Los Angeles Times published a column entitled Healthcare insurance hell: If at first your claim is denied, try, try again The article describes on insured’s extreme difficulty in obtaining approval for treatments of her multiple autoimmune disorders that cause chronic pain, migraines, extreme dizziness and debilitating chronic fatigue. As the […]

Kantor & Kantor Wins 2014 Best Business Award

Kantor and Kantor LLP was nominated and has now been awarded the 2015 Best of Business Award for the Small Business category.

The Small Business Community Association has been dedicated to empowering and recognizing small business owners who make a difference in their respective communities since 2006.

We are honored to accept this award and grateful that our firm is recognized in this way.

We at Kantor & Kantor strive to help individuals get the insurance coverage to which they are entitled. If you or someone you know has been denied health, life, or disability insurance, call Kantor & Kantor today for a free consultation on 888-569-6013. We care and we can help.

Four Kantor & Kantor Attorneys make the California Super Lawyers List for 2014

Kantor & Kantor is honored to announce the selection of four attorneys from the firm for the 2015 Southern California Super Lawyers list. Inclusion in this list is reserved for attorneys who exhibit distinct excellence in their practice.

Super Lawyers, a prominent attorney rating service, identifies exceptional lawyers from more than 70 practice areas. The selected attorneys have attained substantial peer recognition and widespread professional achievement. The extensive and multiphase process used to determine 2014 California Super Lawyers relies on peer nominations, evaluations, and independent research.

All four lawyers were selected for their successes in representing people denied disability – particularly those with disabling conditions such as eating disorders, autoimmune diseases, Alzheimer’s, Parkinson’s, Multiple Sclerosis, cancer and mental illness – as well as assisting people recover benefits under long-term care, health and life insurance policies. This recognition and honor demonstrates the talent, dedication, and diligence of these attorneys; all of which they utilize to obtain the insurance benefits to which their clients are entitled.

Glenn Kantor, a founding partner in Kantor & Kantor, LLP, has spent nearly his entire 25 year legal career representing Plaintiff’s in Health, Life, Disability & Long Term Care insurance disputes. His firm has become one of Southern California’s preeminent firms in this area of the law. Kantor was also at the forefront of litigation arising out of the Northridge earthquake. In 2001, Kantor successfully argued Vu v. Prudential before the California Supreme Court. The opinion in Vu v. Prudential has become a seminal case significantly expanding the protections offered insureds under California law.

Since 2007, Kantor has annually been named a “Southern California Super Lawyer” in the area of health, life, disability, and long term care insurance disputes. For the past seven years in a row, Kantor has supervised more litigation involving employer provided health, life, and disability benefits than has any other attorney in the State of California.

Lisa Kantor, a Los Angeles lawyer and partner in Kantor & Kantor LLP, represents people denied health benefits for treatment of both physical and mental illnesses. Most recently, Kantor has focused her efforts litigating insurance company denials of coverage for residential treatment of eating disorders. Kantor & Kantor is the only law firm in the country with a distinct eating disorder practice staffed with lawyers and other professionals experienced in the specific needs of people who have been denied benefits for eating disorder treatment.

Lisa Kantor sues health plans that refuse coverage, or agree to pay for treatment for a short period of time, forcing patients to be discharged before their health is restored. In 2007, she won the first published eating disorder decision in California in which the court applied the state’s mental health parity law to beneficiaries who sought treatment outside California. In August 2012, she won the first federal court ruling that determined health plans must pay for all medically necessary treatment for mental illnesses, including residential treatment.

For her achievements, Ms. Kantor was named a Top Woman Lawyer by the Los Angeles Daily Journal and an Attorney of the Year by the San Francisco Recorder. She received a “Special Recognition” award from the International Association of Eating Disorders Professionals Foundation and a California Women Lawyers’ Woman of Distinction Award. Kantor was recently named one of the Top Women Attorneys by Super Lawyers 2015 and has been recognized as a Southern California Super Lawyer since 2009.

Corinne Chandler has practiced law for over 30 years and has over 25 years of experience litigating life and disability disputes. Ms. Chandler’s current practice is devoted to representing insreds in actions involving life, disability and long term care insurance benefits. She has litigated close to 500 such disputes and has obtained dozens of trial and appellate decisions in favor of insureds, recovering insurance benefits.

Ms. Chandler has been named a Super Lawyer every year since 2010 in the field of ERISA litigation and was also named a “Top Women Attorney in Southern California” by Super Lawyers in 2012, 2013 and 2014. She has frequently lectured on insurance claims litigation to industry groups and attorneys. She received a B.A. Degree from St. Mary’s College, Notre Dame, Indiana and her J.D. Degree from De Paul University, College of Law. She has received licenses to practice law in Illinois and California and is admitted to all courts in the State of California.

Since 1984, Alan Kassan has focused his practice almost exclusively on representing plaintiffs in actions to recover damages against insurance companies and other defendants, and he has handled hundreds of these cases. His practice is now dedicated to helping people obtain benefits for Life, Disability, Long Term Care, and Health insurance, under both the Federal law of ERISA and under state insurance bad faith law. Mr. Kassan has lectured to various organizations on the subject of ERISA welfare plan benefit claims, and has recently recovered over $2 million in unpaid life insurance benefits for various clients. Mr. Kassan also serves on the Board of Trustees for the San Fernando Valley Bar Association, and has been named a Southern California Super Lawyer since 2013 in the field of ERISA litigation.

For more on Kantor & Kantor’s California Super Lawyers, see http://digital.superlawyers.com/superlawyers/socal2013?pg=81&search_term=kantor&doc_id=-1&search_term=kantor#pg81

For more about what we do, visit our website, insurance law blog, and Facebook pages here and here.

Kantor & Kantor Awarded 2014 Best of Business Award

Congratulations to Kantor and Kantor LLP who won the Small Business Community Association 2015 Best of Business Award for the Small Business category.

We are honored to have our work recognized in this way. Our attorneys and support staff work tirelessly to help those in our community get the benefits paid to which they are entitled. Medical Insurance, Disability Insurance, Long-term Care Insurance and Life Insurance are paramount to the health and longevity of those in our community. When Insurance companies fail to honor their contractual obligations to pay benefits under these policies, it is a detriment to our community.

We are grateful that our clients trust us and know that we get their benefits paid so they can continue to live healthy, fulfilling lives.

Congratulations Kantor & Kantor!

Senator Patrick Kennedy and Public Respond to Anthem’s Behavior in CBS’ 60 minutes segment, ‘Denied’

On Sunday December 14, 2014, CBS’ 60 minutes reported on the tragic and avoidable death of 15 year old Katherine West. http://www.cbsnews.com/news/mental-illness-health-care-insurance-60-minutes/.

Katherine suffered from a severe eating disorder and major depression. She was admitted to Veritas Collaborative Eating Disorder Treatment Center (“Veritas”) in October 2013. Katherine was an insured under an Anthem health insurance plan. Initially, Anthem authorized her treatment. Six weeks later, however, despite protests from the treatment team which included a psychiatrist, a pediatrician, a psychologist, a dietitian, nurses and numerous other eating disorder professionals, Dr. Timothy Jack, a psychiatrist working for Anthem, who never met Katherine, denied any further treatment for her on the basis that it was not medically necessary. Her treatment team warned Dr. Jack that Katherine was not yet ready to discharge and that the likelihood of her purging again was extremely high. Dr. Jack and Anthem ignored this warning.

Unable to pay for Katherine’s continued treatment, which cost upwards of $1000 per day, Katherine’s parents were left with no choice but to take her home. Six days later, Katherine’s mother Nancy found her dead in her bed. She had died of heart failure due to complications from her purging which resumed after she left Veritas.

The 60 minutes segment highlighted that this unfair, and rather unbelievable practice of insurance companies. This is something that we, at Kantor & Kantor see day after day. Partner Lisa Kantor specializes in fighting for appropriate treatment for those suffering from eating disorders. http://www.prweb.com/releases/2014/12/prweb12395807.htm

On December 16, 2014, following the 60 minutes segment, former Senator Patrick Kennedy spoke about the tragedies that arise when insurance companies wrongfully deny patients the mental health treatment that they need. https://www.thekennedyforum.org/news/patrick-kennedy-responds-to-60-minutes-segment-on-mental-health.

Members of the Parity Implementation Coalition applauded the segment in a press release issued yesterday. http://www.prweb.com/releases/2014/12/prweb12396991.htm.

Andrew Sperling, Director of Federal Advocacy for the National Alliance on Mental Illness also came out in support of the segment: “Our members stand with the millions of individuals and families who face insurance discrimination as a result of living with a mental or addictive disorder.”

Outraged, the public has taken to social media to condemn Dr. Jack and Anthem. While Dr. Jack’s actions are reprehensible, his compensation from Anthem, estimated at roughly $25,000 per month and a denial rate for treatment of 92% suggests that he doing exactly what he is paid to do.

Some 24 million people, or 7.6% of the United States population, suffer from an eating disorder. As highlighted by this story, eating disorders kill. In fact, eating disorders have the highest mortality rate of any mental disorder. http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/.

If you or someone close to you is suffering from an eating disorder, we encourage you to seek help immediately. If you or someone you know are having trouble getting your insurance company to pay for your treatments or other benefits, call us for a free consultation. 800-569-6013