United Healthcare Must Reassess Residential Treatment Denials

United Healthcare Insurance Co. violated the Employee Retirement Income Security Act in its processing of a Morgan Stanley employee’s benefits claim denials, the Tenth Circuit ruled.

United Healthcare, through its claims administrator, “deprived plaintiffs of the meaningful dialogue that ERISA mandates between benefit claimants and the plan administrators deciding those benefits claims,” the court said, citing procedural irregularities and inconsistent claim denials.

David P. and his teenage daughter L.P. sought to recover healthcare benefits under a health plan David obtained through Morgan Stanley Medical Plan. L.P. was a beneficiary who went through a year-long mental health and substance abuse treatment ...