Denial of Benefits

Aetna Denial of Benefits for Wilderness Therapy ERISA Class Action

Two minors were denied coverage under their fathers’ Aetna health benefit plans for mental health and substance use programs, the complaint for this class action says, because of the plans had improper exclusions for licensed wilderness therapy programs and licensed residential treatment centers. Both plans are covered under the Employee Retirement Income and Security Act  Read more

Centene Health Insurance Companies Refuse to Pay for Hepatitis C Treatment Class Action

How would you feel if you developed an often-fatal liver disease? Now imagine that a cure became available—but your insurer refused to pay for it until the damage to your liver was irreparable? That’s the case with new hepatitis C drugs and Centene Corporation, says the complaint for this class action. The company’s health insurance  Read more

Knight Transportation “Independent Contractor” Drivers ERISA Class Action

Plaintiff Ronnie Stevenson works for Knight Transportation, Inc. as a truck driver. Knight insists he’s not an “employee” but an “independent contractor,” yet the complaint for this class action alleges that the only difference between Knight’s “employee” truck drivers and its “independent contractor” truck drivers is that the employees receive benefits and the others do  Read more

USAA Denial/Reduction of Med Pay Insurance Benefits Montana Class Action

The complaint for this class action claims that insurer USAA hired another company to “review” medical claims submitted to it for Med Pay benefits and that that company used unfair systems to refuse, reduce, or deny claims for benefits for injured people. Some of the bills, the complaint contends, are refused via “coding errors, sham  Read more

Neiman Marcus Health Plan Mental Health Parity ERISA Class Action

According to the complaint, three-year-old FA has autism spectrum disorder (ASD) and needs Neurodevelopmental Therapy (NDT) and Applied Behavior Analysis (ABA) therapy. Unfortunately, the complaint alleges that the health plan he’s on covers only speech, occupational, and physical therapy for “non-chronic conditions, and acute illnesses and injuries” but does not cover those same services for  Read more

Anthem Denial of Benefits for Microprocessor Controlled Prostheses Class Action

Defendant Anthem is one of the largest health insurers in the US, and defendant Anthem UM is its claims administrator. The two companies together develop Medical Policies and make decisions on which claims are approved and which are denied. One of their policies is the denial of claims for microprocessor-controlled lower limb prosthesis, the complaint  Read more