Case: Health Care & Benefits/Benefits Denial & Fiduciary Duties (N.D. Cal.)

A federal district court in California denied an employee’s motion for judgment in this ERISA action for recovery of benefits and breach of fiduciary duty, and granted judgment in favor of Blue Shield of California, TriNet Blue Shield, and Maximus Federal Services Inc. The employee sought reimbursement from Blue Shield and TriNet for two residential treatment programs for a minor child with behavioral issues and mental health diagnoses, including oppositional defiant disorder, attention deficit hyperactivity disorder, Asperger Syndrome, and autism, and claimed that Maxiumus breached its fiduciary duty in its review of the claim denial. The court found that Blue ...