Christina Spicer  |  January 14, 2019

Category: Insurance

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wilderness therapyPlaintiffs have managed to secure a settlement for their class action lawsuit alleging that Regence BlueShield and Cambia Health Solutions failed to provide wilderness therapy coverage.

Lead plaintiffs, including parents of a teen who used wilderness therapy to combat depression, claimed that their daughter’s treatment met the definition of therapy covered under their insurance policies, but the companies improperly denied coverage.

“This case is in the relatively early stages of litigation,” states the plaintiffs’ notice of the settlement agreement. “In December 2018, the parties reached a provisional settlement of Plaintiff’s claims…which provides for dismissal of Plaintiff’s claims with prejudice.”

Regence BlueShield and Cambia Health Solutions lost a bid to dismiss the wilderness therapy coverage class action lawsuit in August 2018.

The insurers argued that because the wilderness therapy took place mainly outside and not within a facility, it was not covered by their policies.

A federal judge disagreed, ruling that the terms of coverage were not as restrictive as argued by Regence and Cambia.

Subsequently, the insurers have preliminarily agreed to settle the wilderness therapy coverage class action lawsuit with regards to the plaintiffs’ claims.

The plaintiffs have asked for a waiver of pre-certification notice to Class Members and, in fact, the settlement agreement is contingent upon this waiver.

“No pre-­certification notice of settlement is required to be provided to members of the putative class here because the putative class members are unlikely to have relied on the filing of the class action, the statute of limitations has been tolled during the pendency of the litigation and putative class members’ claims would be dismissed without prejudice under the settlement,” noted the plaintiffs.

Class Members include those insured under certain Regence health insurance plans who also participated in an outdoor or wilderness behavioral healthcare program for a mental health condition.

Under the terms of the settlement, Class Members’ claims would be dismissed, but without prejudice – meaning others affected by the denial of wilderness therapy coverage could take legal action against the insurers.

According to the wilderness therapy class action lawsuit, the teen participated in an Evoke Therapy Program to treat depression.

Despite being categorized as a wilderness therapy treatment facility, the insurers allegedly refused to provide wilderness therapy coverage under the teen’s parent’s policy.

In addition to violating the terms of their insurance policy, the teen’s parents, who filed the wilderness therapy class action lawsuit on her behalf, alleged the Regence and Cambia violated the Mental Health Parity and Addition Equity Act of 2008.

Top Class Actions will post updates to this class action settlement as they become available. For the latest updates, keep checking TopClassActions.com or sign up for our free newsletter. You can also receive notifications when this article is updated by using your free Top Class Actions account and clicking the “Follow Article” button at the top of the post.

The patient and her parents are represented by Eleanor Hamburger and Richard E. Spoonemore of Sirianni Youtz Spoonemore Hamburger and Jordan Lewis of Jordan Lewis PA.

The Regence BlueShield, Cambia Health Solutions Wilderness Therapy Coverage Class Action Lawsuit is A.Z., et al. v. Regence BlueShield, et al., Case No. 2:17-cv-01292, in the U.S. District Court for the Western District of Washington.

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5 thoughts onHealth Insurers Agree to Wilderness Therapy Class Action Settlement

  1. Elle Cay says:

    I would love to connect with you informed people. I have had 2 kids in treatment, 1 wilderness and 1 RTC, and Regence won’t cover any of it. The wilderness denial was “we don’t cover wilderness therapy.” The RTC denial is based on the facility not doing a urinalysis within 48 hours of admittance (she has no history of substance abuse). Because of that direct service omission, Regence says that the state-licensed RTC doesn’t qualify as an RTC in Regence terms, so claim can be done at that level of care.

  2. lisa says:

    My Daughter was in a Residental treatment center in Utah many girls came from Wilderness Programs. We did not. Horizon Blue Cross Blue shield only paid for 5 months she was there for 15. we’ve appealed 3x 250K out of pocked would love info

  3. Jeanette Daniels says:

    Add me please

  4. Tamara N Knight says:

    Add me

  5. Norman Emanuel Booze' says:

    Yes, Add me to the claims

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