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What to do when a medical insurance company denies your claim?

Fremont, CA |

I had plastic surgery on my nose in 2007. I was not able to see the full results until November 2009, at which time I told the surgeon I was not happy with the results. I wrote a letter of intent to sue to the Dr. and his liability company responded (after a short “investigation”) stating that the “treatment was within the standard of care.”

A lawyer will not take this since the damages are not worth enough for them. I want to reach some type of settlement so I figured my next step would be to file a complaint with the medical board, as well as a complaint against the liability company for lack of good faith in the investigation. However, I do not know if this will work, so anything that can help me get something out of this horrible situation would be greatly appreciated.

Attorney Answers 2


  1. You are wasting your time. No medical liability insurer will take your claim seriously unless you are represented by a lawyer.A complaint with the medical board may make you feel better but is not going to get you compensated.Such complaints should not be used as leverage for malpractice claims. By the way, if your surgery was in 2007, you may be coming up against a statute of limitations, or past it by now. I am not active in CA but if I recall correctly the statute of limitations for medical malpractive is no more than three years.


  2. Medical claims are a very specialized field of personal injury law. Before you can proceed with such a claim, you would first need to get a medical opinion that the surgeon did not meet the standard of care required.
    The surgery being in 2007, I believe you may have exceeded the statute of limitations. I do not handle medical cases, so I cannot answer that question.

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