Gianelli & Morris

Gianelli & Morris Los Angeles Insurance Attorney The law firm of Gianelli and Morris has been proudly serving California Policyholders since 1979.

We recognize that submitting claims through insurance companies can be difficult enough, let alone when your claim is later delayed, underpaid or even denied. In events such as these, it’s important to have the support to confront the insurance company and see that your claim is given its due attention. Whether the insurance company is stalling on your claim or if the investigation they performed

was inadequate, these can be remedied with the proper legal representation. Over the last 34 years our firm has earned a reputation as effective litigators in insurance disputes. If you are in the Los Angeles area and are seeking assistance with an insurance claim that is clearly not being properly addressed or has been capriciously dismissed, contact our offices right away to discuss your rights.

An HMO is supposed to coordinate your care. But what happens when the P*P needs a referral, the specialist needs prior a...
09/01/2026

An HMO is supposed to coordinate your care. But what happens when the P*P needs a referral, the specialist needs prior authorization, the medical group needs more records, and the health plan keeps sending the request back?

Our latest article examines how each layer of the HMO system can create another opportunity for delay or denial, and when these actions raise serious legal and insurance bad faith concerns.

Learn how HMO referrals, prior authorization, capitation and cost containment can delay care and when an HMO denial may constitute bad faith.

Your doctor says the medical group denied the treatment. The medical group says it was the health plan. The health plan ...
08/19/2026

Your doctor says the medical group denied the treatment. The medical group says it was the health plan. The health plan says it was delegated. Meanwhile, you still need the care. Our new guide explains the complicated layers of Medi-Cal managed care, including the roles of DHCS, managed care plans, medical groups, primary care physicians, specialists, and delegated entities.

Learn what happens when care is denied, why delegation does not necessarily eliminate a health plan's responsibilities, and what appeal and review options may be available to Medi-Cal members.

Learn who is responsible when Medi-Cal managed care denies care and how health plans, medical groups, DHCS and delegated entities fit into the process.

Anthem Blue Cross was fined $15 million by California's DMHC for longstanding problems handling member grievances and ap...
08/15/2026

Anthem Blue Cross was fined $15 million by California's DMHC for longstanding problems handling member grievances and appeals. But what does that actually mean for patients who have had care denied or delayed? Our latest article examines the enforcement action, why grievance rights matter, and why a regulatory penalty paid to the state is not the same as compensation for the patient who suffered the harm.

Anthem was fined $15 million by the DMHC over grievance failures. Learn what the penalty means for California patients facing wrongful denials.

A new generation of weight-loss drugs is changing the treatment of obesity, but will health insurers keep up? Our latest...
08/07/2026

A new generation of weight-loss drugs is changing the treatment of obesity, but will health insurers keep up? Our latest post explores Eli Lilly's newly approved Foundayo, the promising investigational drug retatrutide, California DMHC data showing dozens of overturned Zepbound denials, and when insurance companies may cross the line into bad faith by wrongfully denying medically necessary treatment.

Learn how insurers are handling coverage for Foundayo, Zepbound, and future obesity drugs, and when denials may lead to bad faith claims & punitive damages.

Has your health insurer denied coverage for a new or specialty medication? From GLP-1 weight-loss drugs and targeted can...
07/30/2026

Has your health insurer denied coverage for a new or specialty medication? From GLP-1 weight-loss drugs and targeted cancer therapies to biologics for autoimmune diseases, insurers often challenge coverage for high-cost medications. Our latest article explains common reasons for these denials, when they may cross the line into insurance bad faith, and the legal remedies that may be available.

Learn why insurers deny specialty medications, including GLP-1, cancer, and biologic drugs, and when those denials may constitute bad faith.

Can your health insurer refuse to pay for out-of-network medical care? Not always. California law contains important pro...
07/24/2026

Can your health insurer refuse to pay for out-of-network medical care? Not always. California law contains important protections that require health plans to cover certain out-of-network services as if they were provided in-network, including many emergency services and situations involving inadequate provider networks.

Our latest article explains these rules, highlights real California enforcement actions and court decisions, and discusses when an out-of-network dispute may become insurance bad faith. Read the article to better understand your rights.

California insurance bad faith attorneys Gianelli & Morris discuss when the law requires insurers to cover out-of-network care & policyholder rights after denials.

Why does Anthem Blue Cross account for more California DMHC enforcement actions than any other health plan? Join us as t...
07/13/2026

Why does Anthem Blue Cross account for more California DMHC enforcement actions than any other health plan? Join us as take a look at the numbers behind the enforcement database and explain why policyholders may need to pursue insurance bad faith claims to recover for the full extent of their losses.

California insurance bad faith attorneys Gianelli & Morris discuss why Anthem faces more DMHC enforcement actions than any other California health plan.

Did your health insurer deny treatment as "not medically necessary" or "experimental"? California's Independent Medical ...
07/09/2026

Did your health insurer deny treatment as "not medically necessary" or "experimental"? California's Independent Medical Review (IMR) process allows independent medical experts—not the insurance company—to evaluate certain coverage denials. And the numbers show that many insurer decisions are ultimately overturned.

Insurance bad faith attorneys Gianelli & Morris explain how California's Independent Medical Review process works & how IMRs overturn wrongful health denials.

What does it actually take to prove insurance bad faith in California? Our latest article breaks down the essential elem...
07/07/2026

What does it actually take to prove insurance bad faith in California? Our latest article breaks down the essential elements of a bad faith claim, including the insurer's duty of good faith, unreasonable claim handling practices, available damages, and common examples involving health and life insurance denials.

California insurance lawyers Gianelli & Morris explain key elements of a insurance bad faith claim & how policyholders can pursue remedies for wrongful denials.

Anthem got hit with three enforcement matters from California’s insurance regulator in May, amounting to $140,000 in pen...
07/01/2026

Anthem got hit with three enforcement matters from California’s insurance regulator in May, amounting to $140,000 in penalties. Sadly, these are the same types of fines and violations leveled against Anthem month after month, while policyholders are forced to fight for the benefits they are entitled to.

Learn about some recent DMHC enforcement actions against Anthem for its failures to process claims and provide benefits correctly under California legal requirements.

California insurance lawyers Gianelli & Morris discuss DMHC enforcement actions against Anthem in May, causing $140,000 fines for violating laws & regulations.

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