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NORTHERN CALIFORNIA RECORD

Friday, March 29, 2024

Woman alleges coverage of treatment was denied by insurance companies

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SAN FRANCISCO – A Los Angeles County woman alleges that her insurance company denied claims for mental health treatment.


A plaintiff only identified as Laura B. filed a complaint on March 31 in the U.S. District Court Northern District of California against United Health Group Co., Optumhealth Behavioral Solutions Inc. and Does 1 through 10, citing violation of the Employee Retirement Income Security Act.

According to the complaint, the plaintiff alleges she suffers from major depressive disorder, generalized anxiety disorder and post-partum depression and has been unable to work since 2013. The suit states in January 2015, she sought residential treatment at the Balance Treatment Center and was forced to pay for her treatment from her own personal funds because the defendants denied claims relating to treatment there. The plaintiff holds United Health Group Co., Optumhealth Behavioral Solutions Inc., and Does 1 through 10 responsible because the defendants allegedly denied the plaintiff's benefit claims and failed to provide plaintiff copies of her policy and claims file, thus hindering plaintiff from providing a full appeal of this claim denial.

The plaintiff seeks a declaration that the defendants violated the terms of the plan, order the defendant to pay health benefits plus interest for every benefit payment through the date of judgment at the rate of 9 percent compounded, other penalties, all legal fees and any other relief as this court deems just. She is 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-01639

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