Health Benefits

Back to Insights

Court rejects finding on claimant’s mental health insurance benefits

There has been a growing number of rulings relating to health insurance denials involving mental health treatment. A recent example is Jamie F v. Unitedhealthcare Insur. Co., 2020 WL 4249200 (N.D. Cal., July 23), which involved a claimant who had a long history of being treated for several mental illnesses including anorexia nervosa, depression, anxiety, obsessive-compulsive […]

Recent trends in transgender healthcare law

Protecting LGBTQ rights is of great importance for this country, and the legal issues related to transgender healthcare can be particularly complicated. Many employer-sponsored healthcare plans now explicitly cover transgender-related healthcare. Part of the reason is likely economic. According to the Williams Institute, there are currently just under 1.4 million Americans who identify as transgender, […]

Behavioral health ruling supports benefit claim appeals

Litigating health benefit claim denials is extremely challenging for plaintiffs. Especially under the Employee Retirement Income Security Act — where many cases are decided under the arbitrary and capricious standard of review that upholds an insurance claim denial so long as the basis for the claim decision is viewed as reasonable by a court —overturning […]

Why do health insurers deny claims?

When you are ill and a doctor recommends a course of treatment, you naturally assume that your health insurer will reimburse the cost.  That is not always the case, though, and it is not uncommon for benefits to be denied, especially if the costs are high.  Examples of types of claims that are frequently denied […]

Mental health coverage required under 2008 parity act

Increasing awareness of federal requirements for equal health insurance coverage of mental and physical conditions has led to a spate of litigation relating to health insurance denials. In Christine S. v. Blue Cross Blue Shield of New Mexico, 2019 WL 6974772 (D. Utah, Dec. 19, 2019), the issue was whether the plaintiff pleaded a valid […]