Feb 06, 2012

Case Results

DISCLAIMER: Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case.

Hernandez v. Prudential Ins. Co. of America

The Firm prevailed in a second case challenging the ability of a health insurer to withhold medical necessity criteria, Hernandez v. The Prudential Ins. Co. of America, 2001 U.S. Dist. LEXIS 15231 (D. Utah 2001). The court followed much of the rationale of the Teen Help opinion and required Prudential to produce its criteria for evaluating medical necessity as well as the names and qualifications of the reviewers of the claim and their written opinions or evaluations.

Awarded: Second Decision Requiring Production of Medical Necessity Criteria