Kaiser Refuses Treatment to Car Accident Victim, He Claims
SANTA ANA, Calif. (CN) – Kaiser refused to treat a man who was hurt in a car accident, he claims in Orange County Superior Court.
Randal Sharp sued Kaiser Permanente Insurance company on Tuesday, April 5.
Sharp says he had Kaiser insurance through his employer, Nan Inc., when he came to the Placentia Linda Hospital emergency room after he was in a car accident.
“Plaintiff’s x-rays revealed wide-spread spinal degenerative disc disease, along with other anomalies, not attributable to the MVA [motor vehicle accident],” the complaint states.
The complaint does not specify how long after the car accident he sought treatment.
Though he presented his treatment claim to Kaiser five times, Sharp says, it “denied coverage and refused payments.”
“Unable to work and determined to be 73 percent disabled per the Oswestry scale, plaintiff has been rendered destitute; had to commence much delayed treatment through Cal. DHCS; has had to endure associated pain for two years prior to getting treatment he otherwise should have obtained per the policy with defendant; and, only now, is finally on track to get multiple surgeries to both the lower back and neck, to include multilevel discectomies and vertebrae fusions,” the complaint states.
The Oswestry Disability Index is used by doctors to estimate a person’s degree of disability and quality of life based on lower back pain. A score between 60 and 80 percent is considered "crippling pain," according to the scale.
Sharp claims that Kaiser acted in bad faith when it denied his policy benefits for no reason other than learning the extent of his medical problems “and their prospective economic cost.”
Thanks to Kaiser’s fraudulent business practices, Sharp says, he suffered severe emotional distress, fear of dying, anguish, horror, grief, anxiety, humiliation, and physical suffering.
He seeks $1 million in damages for breach of contract, unfair competition, and negligent infliction of emotional distress.
He is representing himself.