Kaiser Permanente in Southern California
Kaiser Permanente is one of the largest healthcare companies in the United States. In total, Kaiser provides health insurance and healthcare services to more than 12 million members across the country. Kaiser employs almost 90,000 physicians and nurses in 39 hospitals and more than 700 medical offices in nine states. Headquartered in Oakland, California, Kaiser maintains its largest market in the Golden State, insuring and providing care to millions of Californians.
Kaiser’s model essentially operates as a fully inclusive, one-stop shop: the company provides insurance and health care to its members, and its care includes more than doctors who you visit only when you’re sick.
Kaiser Permanente Locations in Los Angeles
While Kaiser operates more than 200 locations in the Los Angeles metropolitan area, some of the largest Kaiser hospitals include:
Los Angeles Medical Center
4867 W Sunset Blvd.
Los Angeles, CA 90027
West Los Angeles Medical Center
6041 Cadillac Ave.
Los Angeles, CA 90034
Baldwin Park Medical Center
1011 Baldwin Park Boulevard
Baldwin Park, CA 91706
Downey Medical Center
9333 Imperial Highway
Downey, CA 90242
Panorama City Medical Center
13651 Willard Street
Panorama City, CA 91402
South Bay Medical Center
25825 S. Vermont Avenue
Harbor City, CA 90710
Woodland Hills Medical Center
5601 De Soto Avenue
Woodland Hills, CA 91367
Kaiser Permanente Medical Malpractice Arbitration
Kaiser dictates that its members are required to be seen by Kaiser doctors in Kaiser hospitals, and treated by Permanente Medical Group doctors. Kaiser members accept that term of the deal when they sign on to the Kaiser plan. However, one lesser-known aspect of Kaiser health plans is that they contain a mandatory arbitration clause.
Arbitration clauses require that any dispute arising from the contract is handled in a private arbitration instead of a lawsuit being filed in court. Kaiser’s HMO plans require that all claims – including medical malpractice, importantly – are arbitrated privately.
What is arbitration?
Arbitration functions similarly to a trial but is conducted entirely in private, not in a court of law. Instead of a judge, an arbitrator decides issues in the case and resolves any issues relating to evidence or facts.
In most arbitrations, the law and procedure are applied in the same way as they would be in a court. Each side calls witnesses, presents evidence, questions witnesses, and makes arguments about how the matter should be resolved. In some arbitrations, one arbitrator hears the case, and in others, a panel of multiple arbitrators hears the case.
When an arbitration ends, the arbitrator’s decision is binding on the parties. It is enforceable in the same way that a judgment from a court would be. It is not appealable.
Why does Kaiser require arbitration?
Arbitration is preferred by many companies because it enables things to stay private. In Kaiser’s case, arbitration is helpful because it enables malpractice claims to be kept in the dark, protecting the company and its reputation from any bad publicity.
In a Kaiser HMO plan, a member signs a contract with Kaiser (their insurance agreement), and then Kaiser requires the member to see Kaiser doctors. By keeping a member’s healthcare entirely within Kaiser networks, the Kaiser plan exerts more control over a member’s healthcare situation than an ordinary insurance plan could.
How do Kaiser arbitrations work?
Kaiser arbitrations are conducted by the Office of the Independent Administrator (OIA), an independent entity set up to arbitrate claims between Kaiser and its California members. OIA arbitrations use California law, California evidence rules, and California rules of procedure.
After a Kaiser arbitration claim is filed, the case is assigned to an arbitrator. If the amount of damages claimed is $200,000 or less, one arbitrator is assigned.
Kaiser arbitration decisions cannot be appealed. In a lawsuit, filing an appeal is always an option for recourse if you believe a judge or jury has made a mistake. Such is not the case in a Kaiser arbitration, as the decisions are final. Even if a Kaiser arbitration makes a mistake, the decision remains in place, as no opportunities for appeal exist.
In a malpractice claim involving Kaiser Permanente, you should ensure that you consult with a Los Angeles Kaiser Medical Malpractice Attorney who is experienced in handling Kaiser arbitration claims, and who has the reputation, resources, and knowledge to ensure that your claim succeeds the first and only time it will be decided.
California Medical Malpractice Arbitration Claims
Even though Kaiser arbitration looks very different from a lawsuit conducted in a court, arbitrators apply California law in the same way that a California judge or jury would. Thus, California law on medical malpractice is equally applicable to Kaiser malpractice arbitrations.
Signs of Medical Malpractice
Unfortunately, not all medical malpractice victims may be aware that they have suffered from medical malpractice injuries until well after a procedure is performed or a diagnosis is made. General warning signs of medical malpractice include:
- Unexpected complications from a procedure or surgery
- Behavior by your healthcare provider that seems reckless, negligent, or suspicious
- Communication issues with your healthcare provider or hospital
- An injury that persists through treatment, and a second opinion that is radically different than an initial diagnosis
If you believe that a healthcare provider hasn’t followed a standard of care, resulting in you becoming injured, you should consult with a Los Angeles Kaiser Medical Malpractice Attorney to assess whether you may have a claim for medical malpractice.
Common Types of Medical Malpractice
Certain types of medical malpractice are more common than others. Each of these types of medical malpractice cases could be heard in a Kaiser arbitration proceeding:
- Misdiagnosis of cancer, infection, complication, or chronic illnesses
- Surgical errors leading to complications
- Anesthesia errors
- Medication errors and wrongful prescribing practices
- Birth injuries causing long-lasting physical harm to newborns
- Delayed diagnosis causing a worsened prognosis
Damages in Medical Malpractice Arbitration Cases
The law governing damages that can be recovered in a Kaiser arbitration is the same as the law governing medical malpractice lawsuits in California courts. In California, the amount of recoverable damages depends on the type of damages sought.
Economic damages compensate a victim for expenses paid or future expenses that the victim may incur – medical bills, lost wages, loss of earning potential, and other costs associated with the injury are the most common forms of economic damages. California law places no cap on economic damages, and the same is true in Kaiser arbitrations.
Non-economic damages are designed to compensate the victim for their pain and suffering. In a standard malpractice case, the cap on non-economic damages is currently $350,000 (as of 2022) and will increase by $40,000 each year until reaching $750,000. In a wrongful death case (brought on behalf of a deceased patient’s family), the damages cap is currently $500,000 (as of 2022) and will increase by $50,000 each year until reaching $1 million.
A Kaiser medical malpractice claimant today can recover an unlimited amount of economic damages, and $390,000 in non-economic damages.
Contact a Los Angeles Kaiser Medical Malpractice Attorney
Because Kaiser Permanente malpractice arbitrations are so different from standard malpractice lawsuits, you should consult with an experienced Kaiser attorney when deciding whether to file a claim. An experienced Kaiser malpractice attorney will know of the arbitrators deciding your case and can adjust your case’s strategy accordingly.
Most importantly, Kaiser arbitrations are final. If the arbitrator’s decision isn’t in your favor, there are no opportunities for appeal, so it is critical that your claim succeeds the first time around. With no room for error, you should not risk having your case handled by an inexperienced attorney.
Contact our office today to set up a free consultation on your Los Angeles Kaiser medical malpractice claim.
