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Family Medical Care Plan Autism Treatments Class Action Settlement Overview:
- Who: A $1.7 million class action settlement between union medical plan holders and providers National Electrical Contractors Association and the International Brotherhood of Electrical Workers has been approved.
- Why: Plaintiffs claimed the unions’ medical plan discriminated against planholders with autism or other developmental disorders.
- Where: The class action settlement was approved in Washington federal court.
A federal judge in Seattle has approved a $1.7 million class action settlement to resolve claims that a union health care plan was unwilling to cover treatment for autism and other developmental disorders.
Plaintiffs, parents of children with autism who went by KT and WT in their class action lawsuit, claimed the medical plan provided by the National Electrical Contractors Association and the International Brotherhood of Electrical Workers was discriminatory.
US District Judge James L. Robert recently ruled that the proposed $1.7 million class action settlement was “fair, reasonable, and in the best interests of the class,” according to the order.
“Although the class had a strong likelihood of success, the key legal issues in the case had not been adjudicated, such that there was risk in proceeding with the litigation,” Robert said.
Insurer Denies Claims for Autism Treatments, Claims Class Action
KT and WT filed the class action lawsuit in 2017, alleging that the union plan — called the NECA/IBEW Family Medical Care Plan — failed to cover autism treatment for their son, DT, reports Law360.
Plaintiffs claimed the NECA/IBEW Family Medical Care Plan covered their son’s initial diagnosis, but was then unwilling to cover any follow-up medical treatment for his condition.
Further, KT and WT alleged the unions were guilty of breach of fiduciary duty and sought to recover benefits under the Employee Retirement Income Security Act, reports Law360.
The settlement agreement will provide $850,000 for attorneys fees and $25,000 for D.T., while more than $277,900 will be distributed among the remaining Class Members.
Settlement funds are meant to reimburse Class Members for applied behavior analysis and neurodevelopment therapies that the health plan refused to cover, as well as any cost incurred by those who had to use a separate insurance.
A similar class action lawsuit was filed against Kaiser this month over allegations the company’s health plans fail to provide adequate coverage for members who use a wheelchair.
Has your health care provider ever refused to cover mental health or autism-related treatment? Let us know in the comments!
The plaintiffs are represented by Richard E. Spoonemore, Eleanor Hamburger, and Daniel S. Gross of Sirianni Youtz Spoonemore Hamburger PLLC.
The NECA/IBEW Family Medical Care Plan Class Action Lawsuit is D.T., et al. v. NECA/IBEW Family Medical Care Plan, et al., Case No. 2:17-cv-00004, in the U.S. District Court for the Western District of Washington.
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One thought on Insurer Who Denied Autism Treatments Pays $1.7M Class Action Settlement to Policy Holders
Yes ! And it was through a union benefit, Bc of Cal PPO PLAN