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Case Against Health Insurer for Denial of Substance Abuse Treatment Coverage Survives Motion to Dismiss

Case Against Health Insurer for Denial of Substance Abuse Treatment Coverage Survives Motion to Dismiss

Health your username March 12, 2021 On Thursday, Judge Jane Magnus-Stinson of the Southern District of Indiana issued a mixed ruling in a case challenging a benefit denial by defendants Golden Rule Insurance Company, Savvysherpa Administrative Services LLC, and United Healthcare Services Inc. (collectively, Golden Rule). The plaintiff seeks to represent a class of insureds who were denied coverage for urine drug tests because Golden Rule deemed them not “medically necessary” to treat substance abuse. The court’s opinion explains that on Feb. 1, 2013, the plaintiff, his wife, and son entered into a health insurance contract with Golden Rule. The plaintiff’s son was diagnosed with depression, anxiety, and other disorders, as well as an opiate use disorder at different times in his teenage years.

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