Select your state

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 North Carolina, health insurance carriers, health maintenance organizations (HMOs), and other managed care entities are expected to adhere to a standard of ordinary care when making health care treatment decisions. While North Carolina does not have a specific statute that explicitly imposes this duty, the principle is derived from common law under the theory of negligence. This means that these entities could be held liable for damages if they fail to exercise ordinary care and such failure proximately causes harm to an insured or enrollee. The determination of liability would typically be made through the courts, where the standard of care and the entity's adherence to that standard would be assessed based on the specifics of the case.

Legal Articles

State Statutes

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

For about 82¢ a day you can have a LegalFix Legal Plan that includes initial consultations with an attorney at no additional charge—and additional legal services at reduced rates—all from top law firms in your state. Don't wait—be prepared for life's inevitable legal challenges, starting today.

And ask your employer, credit union, or membership group to offer LegalFix for even better pricing.

Health care

negligence by health insurer

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

Articles

North-Carolina State Code

North-Carolina State Code

Health care

negligence by health insurer

Articles