Health Net, Associations Set To Begin Legal Battle Over Coverage Wednesday

The First District Court of Appeal in San Francisco on Wednesday will consider a "legal battle" involving Thousand Oaks-based health insurer Health Net's plan to terminate health policies for several associations, including the San Francisco Trial Lawyers Association and the Organization of Women Architects and Design Professionals, the San Francisco Chronicle reports.

Health Net maintains that the associations do not have at least 1,000 members, the legal threshold required for insurers to renew coverage for professional organizations, according to the Chronicle. Health Net spokesperson Brad Kieffer said, "The trial lawyers are seeking a special exception we believe is prohibited by state regulations."

The lawyers association, which in 2003 won a preliminary injunction in the case that required Health Net to continue coverage, contends that its HMO contract contains language that does not allow Health Net to end coverage unless the company provides "good cause." The lawyers association, which has 500 to 600 members, is one of a few groups to offer health coverage to its members, the Chronicle reports.

Terrence Coleman, lead attorney for the case and a member of the lawyers association, said that Health Net "has taken the position they can disregard what was written in their policy. Their policy does not allow them to cancel out this coverage."

He added, "If Health Net's position is accepted, no one in this state can rely on anything that is promised by their insurance company and their policy. If they can disregard their contracts, we have no protections whatsoever."

The court is expected to make a decision within 90 days of Wednesday's hearing (Colliver, San Francisco Chronicle, 10/11).