What is the standard of review and approval of a health care benefit claim by a specific insurance carrier?
California, United States of America
The following excerpt is from People v. Pierce, 251 Cal.Rptr.3d 140, 38 Cal.App.5th 321 (Cal. App. 2019):
People v. Gillard (1997) 57 Cal.App.4th 136, 151, 66 Cal.Rptr.2d 790.) A specific insurance carrier's internal standards and policies for reviewing and approving health care benefit claims may have some probative value in determining what statement, representation,
[251 Cal.Rptr.3d 154]
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