SAN FRANCISCO – Two Alameda County residents allege their insurer wrongfully denied coverage for treatment claiming that it was not medically necessary.
Mahlon D. and Emily D. filed a complaint on Dec. 19, in the U.S. District Court for the Northern District of California against
Cigna Health and Life Insurance Co. and Does 1 through 10
citing the Employee Retirement Income Security Act.
According to the complaint, the plaintiffs allege that Emily D., Mahlon D.'s daughter, suffered damages from being denied coverage for her ongoing treatment at a residential treatment facility. The plaintiffs holds Cigna Health and Life Insurance Co. and Does 1 through 10 responsible because the defendants allegedly initially paid for coverage for plaintiff Emily D.'s, treatment but denied any further coverage moving forward despite having sufficient medical records to support her claim that the treatment was still necessary.
The plaintiffs seek interest, statutory penalties, all legal fees and any other relief as the court deems just. They are represented by David M. Lilienstein and Jessica M. Cho of DL Law Group in San Francisco.
U.S. District Court for the Northern District of California Case number 3:16-cv-07230-JSC