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October 17, 2019

Utah Judge Finds Standing for Individual Plaintiff in UnitedHealthcare Mental Health Treatment Suit

On October 9, Judge Dee Benson (D, Utah) refused to dismiss a suit against UnitedHealthcare where the insurance giant is accused of violating ERISA when it failed to pay for mental health treatment for a minor. In Tony M. v. UnitedHealthcare Ins. Co., No. 2:19-cv-00165 (D. Utah), an individual plaintiff alleged UnitedHealthcare improperly denied coverage for the plan participant's minor child's treatment at Elk River, a mental health facility. The patient allegedly had exhibited "violent and sexually aggressive behavior." The plan participant appealed the denial of coverage, arguing that it was a medical necessity covered under ERISA. UnitedHealthcare alleged that the plan participant and his son suffered no injury, but the judge found that the plaintiffs had an identifiable injury that was "fairly traceable" to the denial of coverage.

Despite finding standing, the judge agreed to stay the proceedings until a related class action was resolved or the class was decertified. While neither the plan participant nor his child are named plaintiffs in the class action, the child is still a member of the certified class.