Sue hospital for delay surgery?

Question

Ok here is the story.

June of 2007 I tore my rotator cuff in my shoulder. My previous doctors tried to let "time" heal it, even without getting a MRI done. By December 07 I was still in pain, he ordered a MRI and the MRI shown a tear in the shoulder and it needed surgery.

The problem comes at the begining of 08, I switched health care providers, and went with Kaiser. I had a copy of my MRI, and my previous doctors letter and such of what he told me.

Kaiser did nothing including taking away my pain medication telling me "they didnt want to take the chance of me hurting it again." Well after 6 months of still constant pain, Kaiser ordered me to get another MRI, the MRI confirmed all the information that was given to them 6 months prior. The doctor ordered surgery in June, it is now about to roll into September, and I still have no surgery date.

I have been fighting with my employer about keeping my job, since it was a off the job injury, but the injury would of been healed, had Kaiser either listened to the advice when I gave it to them, or had ordered a MRI themselves at the begining of the year, since I was told it was about a 6 month recovery time.

Im wondering, if I do in fact lose my job, could I sue Kaiser for some kind of Malpractice for loss of wages?

Answer 1

Unfortunately, insurance companies can't be charged with malpractice. Only physicians and other health care providers can be.

Are you eligible for FMLA through your job?  That would protect you from being fired for missing too much work due to an injury or illness.

In the meantime, be more aggressive with Kaiser about getting your surgery completed.  Remember, the insurance company has nothing to gain by doing it...also, you can report them to your state insurance commissioner if you feel as though the insurance company is being negligent.  Sometimes, a letter from the insurance commissioner will force them to speed it along...

Good luck!

Answer 2

You wouldn't win. They would have too many reason why they waited. They probably wouldn't be big reasons but enough to win. Typical medical insurance company.

Answer 3

Actually, I think the first doctor would be the one you need to sue....

The problem you are going to run into is that your injury happened while you were covered by a different insurance company, and when you signed up with Kaiser you had a pre-existing condition.