Kaiser Malpractice Attorney
The Kaiser Foundation Health Plan is the largest provider of health services in California, with about 1 in 4 insured Californians covered by Kaiser. Most Kaiser members are enrolled through their employer, although some are direct enrollees and others are placed with Kaiser through the state's Medi-Cal program.
Kaiser is divided into three separate entities: the Kaiser Foundation Health Plan, the Kaiser Foundation Hospitals, Inc., and the Permanente Medical Group. The Health Plan is like other health insurance plans that collect premiums and pay for the medical services provided to its members. However, unlike other health plans like Blue Cross or Aetna, Kaiser Health maintains an exclusive contract with the Kaiser Hospitals for hospital care and the Permanente Medical Group for physician care. Both the Kaiser Foundation Health Plan and the Kaiser Foundation Hospitals, Inc. are non-profit corporations, but the Permanente Medical Group is a for-profit entity where its physician members share in the profit at the end of the year. In Northern California, the Permanente Medical Group is a corporation with physicians as employees. In Southern California, the Permanente Medical Group is a partnership with both physician partners and other physicians as employees.
The main difference between a medical malpractice and negligence case against Kaiser and a medical malpractice and negligence case against any other physician or hospital in California, is the fact that as part of the Kaiser Health Plan contract for insurance, all Kaiser members agree to waive their right to sue Kaiser in court before a judge and jury, and instead they agree, in advance, to submit all disputes over medical care to an arbitration system, which is outside of the court system in California. As a result of abuses by Kaiser with their arbitration system several years ago, Kaiser agreed to set up a system in which the selection of a neutral arbitrator is made by a semi-independent administrator who provides the attorney for Kaiser and the attorney for the plaintiff with a list of 12 names (selected from a list of about 200 retired judges and other attorneys in each of Southern and Northern California). Each side can then strike four names and rank the remaining eight, and from this ranked list, a single neutral arbitrator is selected. Each side then has the right to select a party arbitrator if they wish, or go with a single arbitrator who decides all issues in the case. The decision of the arbitrator is then binding and not subject to appeal.
Other than the method of deciding the issues of the case (including liability and damages), the evidence required and the law controlling the case is the same between a jury trial and an arbitration, including the limit on non-economic damages and the use of periodic payments to fund an award for future economic damages. However, Kaiser uses their arbitration system, because over the years the awards in arbitration cases have been substantially less than what would have been obtained from a jury verdict.
Between 1999 and 2007, there have been 366 cases where there has been a monetary award in favor of a plaintiff in a Kaiser case. The average award was around $500,000 and there have been only seven Kaiser cases where an arbitrator has awarded more than $2 million to the plaintiff.
During this same time, The Law Offices of Bruce G. Fagel & Associates has settled numerous cases involving Kaiser patients for between $3.5 million and $5 million each. For more information, click here to watch a brief video regarding Kaiser lawsuits featuring Dr. Fagel.