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Case: Health & Welfare Benefits/Mental Health (D. Conn.)

Nov. 6, 2019, 5:48 PM

Oxford Health Insurance acted arbitrarily and capriciously when it denied coverage for a 16-year-old’s residential mental health treatment, the District of Connecticut ruled Nov. 5. The denial of residential treatment for anorexia nervosa was based on whether the teen needed residential care for “acute” symptoms, a standard imposed by plan administrator United Behavioral Health Services, and one that conflicted with the Oxford plan’s definition of medically necessary treatment, the court said. The case is S.B. v. Oxford Health Ins., Inc., 2019 BL 424126, D. Conn., No. 3:17-cv-1485 (MPS), 11/5/19

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