Florida Insurance Blog

Florida Insurance Blog

Providing Insight Into Florida Insurance Law and Litigation

Mark A. Nation is Board Certified in Civil Trial Law, and also in Business Litigation Law by the Florida Bar. Although there are about 100,000 attorneys in Florida, less than 100 hold these two Board Certifications...MORE

Category Archives: Health Benefits

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Lawsuit Filed for Health Insurance Benefits

Posted in Health Benefits
My client was injured in an automobile accident.  After exhausting his PIP benefits, he was advised he needed neck and back surgery.  My client paid $25,000 to his surgeon and the surgery center for his surgery.  He submitted the surgery charges to his health insurer for reimbursement. Instead of paying the bills, the health insurer… Continue Reading

1St DCA Defines “Usual and Customary” Charges for Emergency Services Billed to an HMO

Posted in HMO
Baker County Medical Services operates a rural, not-for-profit hospital, and provides emergency medical services to patients.  Aetna Health Management and Humana Medical Plan are HMOs which provide health benefits to some of BCMS’s emergency room patients.  BCMS does not have a contract with Aetna or Humana.  As a result, when Aetna and Humana’s subscribers receive emergency medical… Continue Reading

Victory in Claim for Health Benefits Against Blue Cross and Blue Shield of Florida

Posted in Health Benefits, Liens Health Insurance / Erisa
Federico A. was involved in a serious car accident and as a result suffered extensive physical injuries. He was transported to the hospital for several emergency surgeries. The hospital promptly submitted his medical bills to his PPO health insurance company, Blue Cross and Blue Shield of Florida, for payment. The treatment had been rendered by… Continue Reading

Suit Filed Seeking Emergency Evacuation Benefits Under a Travel Insurance Policy

Posted in Health Benefits
Our client was traveling in the Middle East when she fell and suffered a serious injury. She was treated at a local hospital but required medical evacuation back to the United States. Before her trip, our client purchased a travel insurance policy before leaving on her trip. The policy provided for emergency evacuation benefits up to $50,000.00. The… Continue Reading

Mega Life Sued for Health Benefits

Posted in Health Benefits
I recently filed suit against Mega Life (again) to help my client recover health insurance benefits. This company has been sued many, many times for failing to pay health benefits. In fact, Mega Life’s parent company, HealthMarkets, Inc., recently received a $20,000,000 fine from 29 states as a result of a 3 year multi-state investigation which found… Continue Reading

Nation Law Firm Victorious in Significantly Reducing Health Insurance Lien

Posted in Health Benefits, Liens Health Insurance / Erisa
Many times, when a lawyer for a personal injury victim settles his or her client’s personal injury case, the health insurer will ask for a significant portion of the settlement for reimbursement of expenses which it incurred in paying for health care. This is known as "subrogration" or a "right of reimbursement."  Repeatedly, I have… Continue Reading