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Health Insurer Prevails During Early Stage of Insured's Denial of Benefits Class Action


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5 days ago
On Monday, defendant-administrator Health Care Service Corp. (HCSC) secured the dismissal of a lawsuit brought by the beneficiary of an employer-sponsored health insurance plan. The Northern District of Illinois class-action was filed after HCSC denied coverage for residential treatment that the plaintiff’s daughter received for behavioral health conditions in 2018.
The court explained that pursuant to the plaintiff’s second amended complaint, HCSC’s denial was the consequence of “improperly narrow residential treatment guidelines that HCSC continues to employ in making benefits determinations,” in violation of the Employment Retirement Income Security Act of 1974 (ERISA). The plaintiff seeks to certify a class consisting of “any member of a health plan governed by ERISA whose request for coverage of residential treatment services for a behavioral health disorder was denied by HCSC,” wholly or partl ....

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GOP governors trigger mask showdown with White House


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