Laws vary from state to state, but in some states a health insurance carrier, health maintenance organization, or other managed care entity for a health care plan has the duty to exercise ordinary care when making health care treatment decisions and is liable for damages for harm to an insured or enrollee proximately caused by its failure to exercise such ordinary care.

This liability may be created by a specific state statute or by the state's common law (court opinions or case law) under a negligence theory for breach of the standard of care (reasonableness).

In Idaho, health insurance carriers, health maintenance organizations, and other managed care entities are expected to adhere to a standard of ordinary care when making health care treatment decisions. While Idaho does not have a specific statute that explicitly imposes this duty, the principle is generally derived from common law under negligence theories. This means that if such an entity fails to exercise ordinary care, resulting in harm to an insured or enrollee, it could potentially be held liable for damages. The determination of liability would typically involve assessing whether the managed care entity breached the standard of care (reasonableness) expected in the industry and whether this breach was the proximate cause of the harm suffered by the insured or enrollee. As with any legal matter, the specifics of each case can vary, and an attorney would be able to provide advice based on the current state of the law and the particular facts of a situation.