Denial of Benefits
Anthem Denial of Claims for Prosthesis Settlement
Anthem, Inc. and Anthem UM Services, Inc. are settling a class action alleging that the companies or an Anthem subsidiary improperly denied claims relating to certain prostheses. The complaint alleged that the companies denied pre-authorization requests and post-service claims for microprocessor-controlled knee or foot-ankle prostheses as being “investigational” and “not medically necessary.” Anthem has now Read more
Insurance Companies Refusal to Cover Covid-19 Business Losses Class Action
The defendants in this class action are a long list of insurance companies, including Certain Underwriters at Lloyd’s, London, Westchester Surplus Lines Insurance Company, HDI Global Insurance Company, and others. These companies insured businesses for Business Income, Extra Expense, and Civil Authority coverage which the complaint alleges should cover losses to a group called the Read more
USAA Casualty Offset for UIM Coverage New Mexico Class Action
If you have uninsured/underinsured motorist (UIM) coverage as part of your insurance policy, are you always entitled to receive its benefits? The complaint for this class action alleges that USAA Casualty Insurance Company offers UIM coverage that is essentially illusory and/or misleading, because USAA offsets the amount by the amount of the underinsured motorist’s coverage. Read more
Blue Cross Denial of Coverage for Mental Health Treatment Class Action
This class action concerns parity—the requirement that mental health treatment be addressed in an equal manner to physical illness, under the federal Mental Health Parity and Addiction Equity Act. The case brings suit against insurer Blue Cross and Blue Shield of Texas for its denial of benefits for the plaintiff’s son at a residential treatment Read more
Allied Universal Benefits to Domestic Partners Massachusetts Class Action
Who may be included in a domestic partnership? This unusual pro-se class action brings suit against Allied Universal and its subsidiary Universal Protection Service, LLC, alleging that Allied Universal must extend employee medical insurance benefits to all three wives of a Muslim man if they can be registered as domestic partners. The company insists that Read more
BCBS of New Mexico Improper Denials of Care New Mexico Class Action
Health insurance companies may refuse to authorize novel or unproven treatments, or procedures that don’t meet their guidelines. However, the complaint for this class action alleges that Blue Cross and Blue Shield of New Mexico, a company of Health Care Service Corporation, routinely refuses patients services and forces them to go through appeal processes, to Read more
Aetna Denies Insureds L-ADR Surgery Class Action
At issue in this class action are certain policies of the health insurance offered by Aetna Life Insurance Company. The complaint alleges that Aetna will not pay for its insureds to have lumbar artificial disc replacement (L-ADR) surgery, alleging that it is “experimental and investigational.” But the complaint claims that this is not true, that Read more
Standard Life, Protective Life Designation Notice Requirements California Class Action
People who are elderly or sick may have difficulty keeping up with bills and other necessities for a stable life, and may need help from a third party. The complaint for this class action alleges that Standard Life Insurance Company and Protective Life Insurance Company do not provide the annual notices required under California law Read more
World Nomads Travel Insurance No Payouts for Covid-19 Losses Class Action
One of the issues arising out of Covid-19 has been whether insurance companies must make payouts for Covid-related losses. This class action bring suit against three travel insurance companies, World Nomads, Inc., Trip Mate, Inc., and Nationwide Mutual Insurance Company, for refusing to make payouts for trips cancelled, delayed, or interrupted due to the pandemic. Read more
Sentinel Insurance No Payouts for Covid-19 Business Losses Class Action
Sentinel Insurance Companies, Limited offers insurance policies, including for commercial all-risk insurance. But the complaint for this class action alleges that Sentinel has breached its contracts because it is refusing to pay out to compensate policyholders for business losses incurred because of Covid-19 closures. Read more