Health Insurance

Xerox Changes in Health Benefits for Retirees Class Action

Benefits for retired persons are crucially important; elderly people can no longer simply get another job or earn more money to pay for price increases. The complaint for this class action alleges that Xerox Corporation and its Plan Administrator Committee reneged on promises about its medical and dental plans for retired employees. Xerox at one  Read more

Medicare Advantage Insurers Primary Payers for Accident Expenses Class Action

This is one of a number of recent class actions brought by Medicare-related entities, trying to recover payments that insurance companies offering Medicare Advantage allegedly should have paid. The complaint claims that the insurance companies “have systematically and uniformly failed to honor their primary payer obligations under the Medicare Secondary Payer provisions of the Social  Read more

Allstate Primary Payer for Accidents Under Medicare Advantage Class Action

This class action brings suit against two related insurance companies, claiming they did not fulfill their obligations as primary insurers in the Medicare Advantage (MA) program. Allstate Insurance Company and Allstate Fire and Casualty, the complaint alleges, did not pay medical expenses involving injuries in a car accident. Medicare and MA Plans therefore had to  Read more

Amica Mutual Medicare Advantage Accident Claims Class Action

This class action against Amica Mutual Insurance Company in its role as a Medicare Advantage insurer. The complaint alleges that Amica has refused to pay accident-related medical expenses, despite their role as primary payers for those enrolled under Medicare Advantage (MA) plans. This leaves Medicare, which was supposed to be the secondary payer, to pay  Read more

United Health Plans “Cross-Plan Offsetting” ERISA Class Action

Healthcare plans are governed by a law popularly known as ERISA, the Employee Retirement Income Security Act. This class action brings suit against a number of companies in the United Health group for something called “cross-plan offsetting,” in which the companies use the assets of one plan to offset losses in another.  Read more

Anthem Blue Cross Refusal to Pay Settlement

Anthem Blue Cross is settling a class action alleging that it refused to pay for treatment for co-morbid diagnoses because it had classified their claims as being for substance abuse only. The co-morbid diagnoses included schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, obsessive-compulsive disorder, pervasive development disorder or autism, anorexia nervosa, or  Read more

Cigna, Viant Conspiracy to Negotiate Insurance Payments Class Action

Behavioral health problems, such as drug or alcohol addiction, can be difficult and expensive to treat. In this class action, the complaint alleges that Cigna Behavioral Health, Inc. and Viant, Inc. have “systematically undervalued and underpaid” claims, requiring insureds to pay excessive out-of-pocket charges.  Read more

Blue Cross Blue Shield Denial of Proton Beam Radiation Therapy Class Action

Insurance companies have the power to decide what kinds of tests and treatments patients receive. The complaint for this class action claims that Proton Beam Radiation Therapy (PBRT) was delayed or denied for cancer patients by Blue Cross Blue Shield of Florida, Inc. (BCBS), claiming it was not an established treatment.  Read more

United Behavioral Health Guidelines and Rejected Claims Class Action

United Behavioral Health (UBH) “administers mental health and substance use disorder benefits for commercial welfare benefit plans,” says the complaint for this class action. But, according to the complaint, UBH’s guidelines for accepting or rejecting treatment under those plans have been flawed and were rejected in a previous class action. This class action seeks to  Read more

United Healthcare Dropping Providers Without Explanation Class Action

This class action, brought against entities in the UnitedHealthcare group of companies, concerns contracts for a Medicare Advantage (MA) insurance plan. The plaintiffs say they are being dropped as providers without being given any reason and that the process violates MA Regulations and the companies’ provider manual.  Read more