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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 Tennessee, health insurance carriers, health maintenance organizations, and other managed care entities are expected to adhere to a standard of ordinary care when making decisions about health care treatments. If they fail to exercise this level of care and their actions or inactions proximately cause harm to an insured or enrollee, they can be held liable for damages. This liability can arise from specific state statutes or from Tennessee's common law under a negligence theory, which would assess whether the managed care entity breached a reasonable standard of care. It is important for these entities to be aware of their duties and for patients to understand their rights under Tennessee law regarding health care treatment decisions made by their insurance providers.

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Health care

negligence by health insurer

Individual & Family Legal Plan

Articles

Tennessee State Code

Tennessee State Code

Health care

negligence by health insurer

Articles