It's a standard sentiment, held by a nontrivial number of people, and succinctly summarized by the phrase: "F***ing Kaiser." (For a slightly longer diatribe with additional obscenities, see here. Thank you, Helen Hunt.)
That feeling typically arises out of a view that Kaiser -- alongside other HMOs, or insurance companies in general -- often put profits over people, and withhold benefits even when they are obviously due. For an HMO like Kaiser, the most common setting in this regard is when they refuse to provide necessary medical care to a subscriber even when it is obviously (or at least allegedly) due.
Today's Ninth Circuit opinion arises in a different setting, but very much to the same effect.
Ya-Xia Liu worked for Kaiser for over two decades. She got cancer in 2021. She took a leave of absence from work, and battled the disease for a year. But in 2022, she began to lose the fight, and was admitted to Kaiser as a patient on March 19. She was dying, needed 24-hour care, and ultimately succumbed to the disease on March 29, 2022.
Because she worked for Kaiser for 20-plus years, she had a 401(k) plan that was worth over $675,000. She was entitled to roll that over as a lump sum, and on March 26, 2022, she submitted an online request that Kaiser send the entire $675,000+ to E*Trade, and naming her sister (Sherry Liu) as her beneficiary. Ya-Xia knew she was about to die. She wanted her sister to have her money. She did everything she needed to do to make sure that happened.
Unbeknownst to Ya-Xia, however -- or any other employee outside of the benefits office, for that matter -- Kaiser had an internal policy that it always sought to "confirm" any request for a rollover. Although Kaiser admitted that Ya-Xia filled out her request properly, Kaiser refused to pay, saying that because Ya-Xia died before she could "confirm" the rollover request, the sister wasn't entitled to the $675,000+.
The sister sued, and Kaiser still refused to pay. The district court -- Judge Martínez-Olguín, in the Northern District of California -- agreed with Kaiser, and dismissed the lawsuit on the pleadings.
Thankfully so.
Can you come up with arguments as to why Kaiser shouldn't have to pay the $675,000? Sure. Creative lawyers can indeed do so. They can even, on occasion, be persuasive. As they were initially here.
But it's precisely cases like this one that make many people hate insurance companies. Or Kaiser in particular.
And I absolutely do not blame them.
Just pay the woman her stinking money. It's not yours, Kaiser. Give the dead woman's sister the cash to which she was entitled for her 20-plus years of service.
And if you elect not to do so, don't complain when people think about you the way that many in fact do.
