SAN FRANCISCO – A California woman alleges her insurance company wrongfully denied treatment for her daughter.
Suzanne Stone filed a complaint on March 4 in the U.S. District Court for the Northern District of California against Dexcom Benefits Plan and U.S. Behavioral Health Plan, California, doing business as OptumHealth Behavioral Solutions of California, citing violation of the Employment Retirement Income Security Act.
According to the complaint, the plaintiff alleges that between July 2014 and September 2014, her daughter was diagnosed with an eating disorder and was treated at a facility in Denver, Colorado. Initially, the plaintiff sought authorization for her daughter's treatment and was verified that it was covered under the plan, the suit states. After the treatment, the defendants stated that plaintiff's plan did not cover nonemergency treatments in a non-California facility. The plaintiff holds the defendants responsible because they allegedly denied coverage of treatment for her daughter despite multiple appeal attempts.
The plaintiff seeks the following: health benefits, interest, legal fees and any other relief as the court deems just and proper. She is represented by Lisa S. Kantor and Elizabeth K. Green of Kantor & Kantor LLP in Northridge.
U.S. District Court for the Northern District of California Case number 4:16-cv-01100-KAW