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Case: Health Care & Benefits/Benefits Denial (D. Utah)

Feb. 21, 2020, 4:51 PM

A federal district court in Utah denied AvMed Inc.'s motion to dismiss an employee’s ERISA action for denial of benefits for his minor child’s treatment at an inpatient facility. The employee sufficiently alleged that AvMed violated the terms of its plan by failing to comply with ERISA’s claims processing procedures, and by denying medically necessary treatment benefits, the court held. But the employee didn’t adequately allege that AvMed violated the Mental Health Parity and Addiction Equity Act, according to the court, because the complaint lacked factual support for its assertion that AvMed treated this claim differently than claims for treatment...

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