LOS ANGELES – A Los Angeles woman alleges her insurers failed to properly and adequately investigate the merits of her claims for treatment for an eating disorder.
Jacqueline A. filed a complaint on June 12 in the U.S. District Court for the Central District of California against the Motion Picture Industry Health Plan and Optumhealth Behavioral Solutions of California Inc. alleging violation of the Employee Retirement Income Security Act.
According to the complaint, the plaintiff was admitted to residential treatment center Hope of the Sierras in July 2014 for treatment of an eating disorder. The suit states the defendants denied benefits for this treatment on the basis that it was not medically necessary.
The suit also states she was admitted to partial hospitalization treatment in November 2014 at Valenta for her eating disorder and that the defendants again also denied benefits.
The plaintiff holds Motion Picture Industry Health Plan and Optumhealth Behavioral Solutions of California Inc. responsible because the defendants allegedly refused to provide medical benefits to the plaintiff despite knowing she was entitled to such benefits.
The plaintiff seeks payment of health care benefits due to the plaintiff, all legal fees, interest, and any other relief as the court deems just. She is represented by Lisa S. Kantor and Elizabeth K. Green of Kantor & Kantor LLP in Northridge.
U.S. District Court for the Central District of California case number 2:17-cv-04333-JAK-JEM