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Health Insurance and HMO Claims With the growth of managed care in providing health insurance benefits to Americans over the past 20 years, HMO members and health insurance policyholders have found that vital decisions about whether medical treatment for themselves and their families will be paid for are made by lay person managers more interested in holding down costs than providing the coverage the policyholder purchased. Several of Sorling's trial lawyers have extensive knowledge of the insurance and HMO industries' use of the terms "medically necessary," "experimental," "investigational," "for research purposes," and other exclusions to deny coverage and indemnification for claims for treatment of cancer, primary amyloidosis myeloma, and other diseases with new drugs, high dose chemotherapy (HDC), bone marrow transplant (BMT), and peripheral stem cell rescue (PSCR). Sorling attorneys have filed numerous lawsuits in Illinois and the midwest for policyholders against their insurance companies for fraud in the drafting and sale of the insurance policy and the intentional infliction of emotional distress. These attorneys have also prosecuted lawsuits against insurance companies in Illinois and the midwest for their refusal to fully indemnify their policyholders or pay their treating physicians the usual and customary charge (U&C) for medical services in the area in which they were provided. The firm has extensive knowledge of the claims practices of health insurance companies. Its attorneys have successfully represented policyholders in claims against various insurance companies. These attorneys have also successfully litigated and settled claims by employees against insurance companies and employee benefit plans in federal court under the Employee Retirement Income Security Act (ERISA). With the passage of federal and state HMO reform legislation, many wronged policyholders will be able to file suit in Illinois courts for the denial of health insurance claims. Sorling attorneys already have extensive experience in prosecuting and defending such lawsuits. The attorneys involved in these cases are committed to the aggressive prosecution of these claims so that their clients can obtain indemnification, coverage, and fair compensation for their injuries. Sorling attorneys who practice in this area include:
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