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In the event you are planning on contacting any attorney regarding medical malpractice, negligence, wrongful death or anything non emergency related please:

  • Gather your medical records - Order them immediately from Kaiser following your states request for medical records procedures.  Instructions and sample forms are at: http://www.harp.org/recordmethod.htm
  • Do not tell Kaiser or let them know what your intentions are.  You may be taking a chance of having your medical records altered by Kaiser Medical Legal Department before you receive them if you do.
  • Calmly and with as little emotion as possible write out a concise statement of what took place.  If possible also write out a timeline. 
  • Your first question to any attorney should be:  Do you or have you ever represented an HMO?  If the answer is yes then ask questions about the attorney's involvement with the HMO to satisfy yourself that if you hire him/her you will feel comfortable with the arrangement.
  • Realize that all victims of the Kaiser system feel that their case is unique and will be the one that will make change.  The truth is that only by having all cases made public will any change be made.  The Kaiser arbitration system will not as a rule make this information available to the general public.
  • Read: How To Survive A Kaiser Arbitration.  This page is not well written but it certainly presents the truth.  Make sure you go into this with open eyes.  A Kaiser Arbitration costs more money than a conventional court proceeding.  Whether the client foots the bill or the attorney initially it is rare to do much more than recoup your expenses.  True justice in this form of legal proceeding is rare.  No one can bring back your health or a loved one's life.  This is a closed civil proceeding that probably will never see the light of day - realize that from the start.
  •  The hardest part as a victim of medical negligence or malpractice or as a survivor of a loved one wrongfully killed is being told that a persons financial worth is based upon their potential earning capacity.  If you are very young and die or if you are elderly that is not very much money.  It is not fair nor is it morally correct but it is what the law says and none of us can do anything about that.
The following is extremely important as Kaiser hopes that you will not learn about it.

A Calif. appellate court has ruled that a mandatory arbitration agreement is not binding on adult children suing for 
wrongful death of a parent. 
The case is Buchner v. Tamarin, Calif. 2d Appellate Distr. #B149385 
Who WILL be bound by the patient's agreement to arbitrate? 
1. an agent can bind a principal - 
2. spouses can bind each other - 
3. a parent can bind a Minor child. 
If you have Kaiser insurance  through your employer, it is an ERISA plan, and effective January 1 of this year, 2003, you cannot be forced into arbitration. 

Government at all levels and Church employees are not subject to ERISA. 

 New regulations make it clear that ERISA plans may not require mandatory arbitration.  However, Kaiser is likely to ignore these regulations and refer to the contractual provisions that require arbitration, so it is important that you be very clear about your ERISA rights so that you can enforce them. 

The Department of Labor can clarify any questions about under ERISA plans. Their hotline is 866-275-7922 

The specific regulation section is 29 CFR 2560.503-1: 

(c) Group health plans. 
The claims procedures of a group health plan will be deemed to be reasonable only if, in addition to complying with the requirements of paragraph (b) of this section- 
. . . 
    (4) The claims procedures do not contain any provision for the mandatory arbitration of adverse benefit determinations, except to the extent that the plan or procedures provide that: 
        (i) The arbitration is conducted as one of the two appeals described in paragraph (c)(2) of this section and in accordance with the requirements  applicable to such appeals; and 
        (ii) The claimant is not precluded from challenging the decision under section 502(a) of the Act or other applicable law.

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