Unwarranted delay and confusion in processing requests for coverage may give rise to liability for negligence on the part of a health maintenance organization, a Manhattan Supreme Court justice has ruled in what is apparently a case of first impression.
New York County Supreme Court Justice Herman Cahn yesterday allowed negligence and gross negligence claims to go forward against an HMO over its claims-administration practices in the case of a beneficiary seeking in-patient treatment for chemical dependency.
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