FOR IMMEDIATE RELEASE: Family Files Suit Against Health Net to Receive Life-Saving Care for their Disabled Son
NOVEMBER 7, 2005
OAKLAND, Calif. (November 7, 2005) – San Francisco bad faith insurance, today filed a lawsuit in Alameda County on behalf of Mark and Kimberly Zembsch against Health Net, Inc., calling for the end to a long and tedious trail of refusals by the HMO to get their son Jack the urgent and critical care he needs to survive.
Four-year old Jack Zembsch suffers from Metatropic Dysplasia (MD), a rare and dangerous form of dwarfism characterized by soft vertebrae and a badly deformed spine. Jack’s parents, Mark and Kim Zembsch of Moraga, say their son’s vertebrae are like “soggy graham crackers.” As a result of this condition, Jack’s spine is twisting at severe and abnormal angles as he grows, damaging internal organs that have too little room to grow and threatening to cause paralysis or severe permanent pain. He is expected to undergo 10 to 20 surgeries over his lifetime. Without adequate care from a specialist, the prognosis for Jack is life-long pain, paralysis or even death.
Jack’s father, Mark, is a deputy city attorney for the City of Berkeley and has full health care coverage through Health Net of California. Doctors first diagnosed Jack’s condition when he was just an infant. Health Net assured the Zembsch’s that Jack would receive all the treatment he would need. However, despite repeated referrals by Health Net physicians to Dr. William Mackenzie, a Delaware orthopedic surgeon who is the only recognized expert in Jack’s disease in the country, Health Net insisted that Jack receive treatment from local physicians. After making five formal requests for treatment in the last 14 months, the Zembsch’s say they have little choice but to turn their case over to the court system, and hope it’s enough to save Jack’s life.
The lawsuit calls for Health Net to designate Dr. William Mackenzie of Delaware as the standing referral specialist for Jack’s treatment, and for Health Net to pay all of Jack’s medical costs in the future. The suit will also ask for punitive damages in order to stop Health Net from treating its members in this fashion.
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Pillsbury & Coleman, LLP is a San Francisco Bay Area law firm with more than 30 years experience representing policyholders in claims against insurance companies, specializing in coverage disputes and bad faith litigation. Pillsbury & Coleman represents individuals with health, disability and life insurance claims, and businesses and individuals with liability and property insurance claims. Pillsbury & Coleman has represented all types of insureds from individuals and small businesses to large corporations and governmental entities. To date the firm has secured well over $500 million in verdicts and settlements on behalf of its clients. For more information, please visit www.pillsburylevinson.com.
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