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Health care

negligence by health insurer

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 Kansas, 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 Kansas does not have a specific statute that explicitly imposes this duty, the principle is generally derived from common law under negligence theories. If a managed care entity fails to exercise ordinary care, resulting in harm to an insured or enrollee, it can be held liable for damages. The determination of liability would typically involve assessing whether the entity's actions were reasonable and consistent with the standard of care expected in the industry. This would be evaluated on a case-by-case basis, taking into account the specifics of the situation and the professional standards applicable at the time of the treatment decision.

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Health care

negligence by health insurer

As a LegalFix Member You Will Be an Important Client of Local Law Firms

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Kansas State Code

Kansas State Code

Health care

negligence by health insurer

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