Is it possible to sue Kaiser? Policyholders are not permitted to sue Kaiser directly and instead have to go through a process called arbitration (resolving the issue outside of court). By being a part of the Kaiser healthcare system, you are bound by a contract requiring you to go through arbitration. How Does The Arbitration Process Work? When you file a claim against Kaiser, the claim is arbitrated by the Office of the Independent Administrator. You and your attorney must submit a demand for arbitration. In this demand, you must include the following: 1. A statement describing your injury and why Kaiser is responsible; 2. How much compensation you’re seeking; 3. Your name, phone number, address, and the same information for your attorney; AND 4. The names of all people you believe are responsible for your injury. The administrator is required to send each party a list of 12 randomly generated arbitrators to choose from. Each party then has 20 days to decide and reply with their choice. The administrator will then select an arbitrator based on the selections of the parties involved. Within 60 days, the arbitrator is required to hold an arbitration management conference. At this meeting, deadlines are set for mandatory settlement meetings and the arbitration hearing date is scheduled. If the parties are not able to come to an agreement, the arbitrator will hold a trial. The goal of this arbitration is to have the case resolved within 18 months from the time the demand letter is received.
如果想起诉KAISER, 需要找专门打KAISER官司的律师，自己可以在网上搜索，有很多相关的网站和报道。 KAISER有一千两百多万member，是美国最大的HMO医疗机构，too big to fail, 是医疗行业的巨无霸，一般人想要打赢Kaiser 的官司，难度比较大。 As of 2022, Kaiser Permanente had 12.6 million health plan members, 216,776 employees, 23,597 physicians, 63,847 nurses, 39 medical centers, and 724 medical facilities.[13][14][1] As of December 31, 2022, the nonprofit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported an operating loss of $1.3 billion in net income on $95.4 billion in operating revenues. Mandatory arbitration In order to contain costs, Kaiser requires an agreement by planholders to submit patient malpractice claims to arbitration rather than litigating through the court system. This has triggered some opposition.[89] Wilfredo Engalla is a notable case. In 1991, Engalla died of lung cancer nearly five months after submitting a written demand for arbitration. The California Supreme Court found[90] that Kaiser had a financial incentive to wait until after Engalla died; his spouse could recover $500,000 from Kaiser if the case was arbitrated while he was alive, but only $250,000 after he died. The Foundation for Taxpayer and Consumer Rights contends that Kaiser continues to oppose HMO arbitration reform.[91] Watchdogs have accused Kaiser of abusing the power imbalance inherent in the arbitration system. Kaiser engages in many cases whereas a customer will usually engage in just one and Kaiser can reject any arbitrator unilaterally, thus they can select company-friendly arbitrators over those that rule in favor of customers. As a large organization, Kaiser can also afford to spend much more on lawyers and orators than the customer, giving them more advantages. In response to criticisms, Kaiser established an Office of Independent Administrators (OIA) in 1999 to oversee the arbitration process. The degree to which this office is actually independent has been questioned.[92][third-party source needed] Patients and consumer interest groups sporadically attempt to bring lawsuits against Kaiser Permanente. Recent lawsuits include Gary Rushford''s 1999 attempt to use proof of a physician lie to overturn an arbitration decision.[93] In one case, Kaiser attempted to significantly expand the scope of its arbitration agreements by arguing it should be able to force nonsignatories to its member contracts into arbitration, merely because those third parties had allegedly caused an injury to a Kaiser member which Kaiser had then allegedly exacerbated through its medical malpractice. The California Court of Appeal for the First District did not accept that argument: "Absent a written agreement—or a preexisting relationship or authority to contract for another that might substitute for an arbitration agreement—courts sitting in equity may not compel third party nonsignatories to arbitrate their disputes."[94] https://en.wikipedia.org/wiki/Kaiser_Permanente
Is it possible to sue Kaiser?
Policyholders are not permitted to sue Kaiser directly and instead have to go through a process called arbitration (resolving the issue outside of court). By being a part of the Kaiser healthcare system, you are bound by a contract requiring you to go through arbitration.
How Does The Arbitration Process Work?
When you file a claim against Kaiser, the claim is arbitrated by the Office of the Independent Administrator. You and your attorney must submit a demand for arbitration. In this demand, you must include the following:
1. A statement describing your injury and why Kaiser is responsible; 2. How much compensation you’re seeking; 3. Your name, phone number, address, and the same information for your attorney; AND 4. The names of all people you believe are responsible for your injury.
The administrator is required to send each party a list of 12 randomly generated arbitrators to choose from. Each party then has 20 days to decide and reply with their choice. The administrator will then select an arbitrator based on the selections of the parties involved. Within 60 days, the arbitrator is required to hold an arbitration management conference. At this meeting, deadlines are set for mandatory settlement meetings and the arbitration hearing date is scheduled.
If the parties are not able to come to an agreement, the arbitrator will hold a trial. The goal of this arbitration is to have the case resolved within 18 months from the time the demand letter is received.
如果想起诉KAISER, 需要找专门打KAISER官司的律师，自己可以在网上搜索，有很多相关的网站和报道。
KAISER有一千两百多万member，是美国最大的HMO医疗机构，too big to fail, 是医疗行业的巨无霸，一般人想要打赢Kaiser 的官司，难度比较大。
As of 2022, Kaiser Permanente had 12.6 million health plan members, 216,776 employees, 23,597 physicians, 63,847 nurses, 39 medical centers, and 724 medical facilities.[13][14][1] As of December 31, 2022, the nonprofit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported an operating loss of $1.3 billion in net income on $95.4 billion in operating revenues.
Mandatory arbitration
In order to contain costs, Kaiser requires an agreement by planholders to submit patient malpractice claims to arbitration rather than litigating through the court system. This has triggered some opposition.[89]
Wilfredo Engalla is a notable case. In 1991, Engalla died of lung cancer nearly five months after submitting a written demand for arbitration. The California Supreme Court found[90] that Kaiser had a financial incentive to wait until after Engalla died; his spouse could recover $500,000 from Kaiser if the case was arbitrated while he was alive, but only $250,000 after he died. The Foundation for Taxpayer and Consumer Rights contends that Kaiser continues to oppose HMO arbitration reform.[91]
Watchdogs have accused Kaiser of abusing the power imbalance inherent in the arbitration system. Kaiser engages in many cases whereas a customer will usually engage in just one and Kaiser can reject any arbitrator unilaterally, thus they can select company-friendly arbitrators over those that rule in favor of customers. As a large organization, Kaiser can also afford to spend much more on lawyers and orators than the customer, giving them more advantages. In response to criticisms, Kaiser established an Office of Independent Administrators (OIA) in 1999 to oversee the arbitration process. The degree to which this office is actually independent has been questioned.[92][third-party source needed]
Patients and consumer interest groups sporadically attempt to bring lawsuits against Kaiser Permanente. Recent lawsuits include Gary Rushford''s 1999 attempt to use proof of a physician lie to overturn an arbitration decision.[93] In one case, Kaiser attempted to significantly expand the scope of its arbitration agreements by arguing it should be able to force nonsignatories to its member contracts into arbitration, merely because those third parties had allegedly caused an injury to a Kaiser member which Kaiser had then allegedly exacerbated through its medical malpractice. The California Court of Appeal for the First District did not accept that argument: "Absent a written agreement—or a preexisting relationship or authority to contract for another that might substitute for an arbitration agreement—courts sitting in equity may not compel third party nonsignatories to arbitrate their disputes."[94]
https://en.wikipedia.org/wiki/Kaiser_Permanente