Anthem Blue Cross Coverage Denial Lawyers in California

Was Your Health Insurance Claim Unfairly Denied?

Kershaw Talley Barlow is actively investigating potential claims from policyholders throughout California who have experienced wrongful coverage denials from Anthem Blue Cross or Blue Shield of California.

Anthem Blue Cross has faced mounting scrutiny over how it handles policyholder claims. Now, a growing number of policyholders across California—many of them state and public agency employees—are stepping forward to seek accountability and compensation for unfair delays and denials of coverage. 

If your health insurance claim was unfairly denied or delayed, we want to help. 

Kershaw Talley Barlow is a nationally recognized civil trial practice that’s recovered over $1 billion in compensation for clients nationwide. Our award-winning attorneys know how to take on major insurers that put profits over people, and how to protect the rights of policyholders who’ve been treated poorly. 

Learn more about your rights and options. Call (916) 520-6639 or contact us online for a FREE consultation.

Why Anthem Blue Cross Coverage Denials Happen

Anthem Blue Cross (formerly Blue Cross of California), part of the nationwide Blue Cross Blue Shield network, has faced significant scrutiny for how it handles policyholder claims. 

In recent years, California regulators have fined Anthem millions of dollars for improperly denying medically necessary care and mishandling consumer complaints. Investigative reports have further exposed systemic issues in Anthem’s claim review process, including heavy reliance on automated algorithms and insufficient review by qualified medical professionals.

Complaints from California state and public agency employees—a large segment of Anthem’s policyholders—have also highlighted a troubling pattern of delays and denials for preventive and life-saving care.

As a result, many Anthem policyholders are left without essential medical care or forced to pay out-of-pocket for treatments that should be covered. Denials can take many forms, including:

• Claims labeled "not medically necessary": Anthem frequently disputes the medical necessity of critical procedures, screenings, and treatments—even those recommended by physicians.
• Breast cancer screening denials: Particularly for dense breast tissue screenings like MRIs or ultrasounds, despite California law mandating coverage.
• Experimental or investigational denials: Essential treatments wrongly denied under the claim they're experimental.
• Out-of-network provider denials: Disputes over network coverage that leave patients financially burdened.
• Administrative errors and unjustified delays: Procedural mistakes or unexplained delays resulting in denied claims.

Anthem Cases We’re Investigating

We help California policyholders fight back against unfair denials from Anthem Blue Cross and Blue Shield involving:

• Medical necessity disputes
• Breast cancer screenings (MRI, ultrasound)
• Cancer treatment coverage
• Surgical procedure denials
• Chronic condition treatment
• Mental health coverage denials
• Out-of-network coverage disputes
• Prescription drug coverage
• Emergency treatment coverage denials
• Experimental or investigational treatment claims

If your situation isn't specifically listed, we still strongly encourage you to contact us. Every case is unique, and we specialize in evaluating complex and challenging denials.

Do I Have a Case Against Anthem Blue Cross?

As a California policyholder, you have important legal rights under both state law and your insurance contract. Insurers like Anthem are required to:

• Provide clear, timely communication about claim decisions.
• Process claims and appeals in good faith—not for the purpose of delay or wrongful denial.
• Provide coverage for medically necessary treatments and screenings, including those explicitly protected under California law.
• Comply with mandated timelines and procedural protections in handling appeals.

When You May Have a Case

You may have grounds for legal action if your situation involves any of the following:

• Anthem denied or delayed coverage for any medically necessary treatment, procedure, or screening recommended by your healthcare provider.
• Your denial involved critical diagnostic screenings, such as breast cancer imaging (MRI, ultrasound), despite medical necessity.
• Anthem classified necessary treatments as "experimental" or "investigational" without adequate justification.
• You experienced denials based on network disputes or administrative issues.
• You've suffered health consequences, delays in care, or financial hardship due to unjustified denials.

If your situation fits one of the scenarios above, here are some options you may have:

• You can file an internal appeal with Anthem to contest the denial.
• If the appeal is unsuccessful—or if bad faith or legal violations occurred—you may have the right to pursue a civil lawsuit seeking damages.
• In some cases, Anthem’s conduct may support a claim for insurance bad faith, which could entitle you to additional damages beyond the original claim.

The best way to determine your eligibility for a claim is to speak directly with our attorneys. We offer FREE, confidential consultations and are currently representing Anthem policyholders across California.

Why Work With an Attorney for an Anthem Denial?

Insurance denial cases are complex. Anthem, and all large insurers, retain teams of attorneys and claims professionals whose goal is to protect the company’s bottom line. Without experienced legal counsel, it can be extremely difficult to:

• Interpret and challenge denial letters
• Gather the right medical evidence to prove “medical necessity”
• Navigate the appeals process effectively
• Build a strong case for insurance bad faith damages
• Maximize your potential financial recovery

Even if you’ve already filed an appeal or received a denial letter, it’s not too late to pursue legal action. Insurers often rely on complex procedures to discourage policyholders from continuing the fight. Our attorneys can help you navigate the process, understand your rights, and pursue the full compensation you deserve.

Steps You Can Take Now

If you’ve received a coverage denial from Anthem Blue Cross or Blue Shield of California:

1. Keep all written correspondence: Save denial letters, appeal responses, and emails.
2. Document conversations: Write down the names and dates of any calls with Anthem representatives.
3. Preserve medical records: Retain copies of all medical recommendations, diagnoses, and doctor’s letters.
4. Consult an attorney: Even if you’ve already filed an appeal, legal action may still be an option.

The sooner you contact an experienced attorney, the better. We can evaluate your situation and help protect your rights.

Call For a FREE Consultation: (916) 520-6639

Kershaw Talley Barlow is one of California’s most respected trial firms, known for taking on powerful corporations—and winning. We’ve recovered over $1 billion for clients nationwide and have extensive experience in complex insurance litigation.

If Anthem Blue Cross or Blue Shield of California denied your rightful medical coverage, we want to hear from you. Call (916) 520-6639 or contact us online for a FREE consultation.