SEATTLE--(BUSINESS WIRE)--Attorney Advertising -- Keller Rohrback L.L.P. is currently investigating whether a recent court ruling could allow additional people enrolled in healthcare plans administered by UnitedHealthcare Insurance Company, an affiliate of UnitedHealth Group Inc. (NYSE:UNH), to bring claims for failing to pay them the full amount they were owed for healthcare services.
The ruling is part of a larger healthcare trend. Consumers are increasingly aware of health costs, and take steps to obtain the benefits and services that they pay for and were promised. As researchers at the Robert Wood Johnson Foundation recently found, consumers now often know, “practically to the penny,” what they spend on premiums, deductibles, and co-pays each month.
The ruling came in November 2014, as part of an ongoing lawsuit against UnitedHealthcare. That lawsuit focuses on the payment of benefits to people who are eligible for Medicare but also have secondary coverage through a private employer- or union-sponsored health plan. Keller Rohrback brought the suit on behalf of Marianne Gates, a participant in a plan administered by UnitedHealthcare.
In the November 2014 ruling, following a favorable opinion for Ms. Gates in the Second Circuit Court of Appeals, Judge Katherine B. Forrest of the U.S. District Court in Manhattan rejected UnitedHealthcare’s misinterpretation of its healthcare plan, under which participants may have received impermissibly low reimbursements for medical services.
“The court ruled that UnitedHealthcare has been misconstruing the plan’s terms,” said attorney David Preminger. “UnitedHealthcare’s faulty interpretation caused it to reimburse participants at a lower level than it should have. Under federal law, plan beneficiaries may be able to claim the rest of the reimbursements they should have been receiving all along.”
The ruling could affect anyone who is enrolled in a plan administered by UnitedHealthcare (in particular Choice Plus Plans or HDHP HSA Plans), is eligible for or enrolled in Medicare, and who has received services from a healthcare provider who has opted out of Medicare. If you have any questions about whether you or someone you know has a potential claim, please contact paralegal Phil Lewis at 800-776-6044 or via email at email@example.com. You can learn more about Keller Rohrback’s pension and healthcare-plan litigation here. The lawsuit in which the recent ruling was made is titled Gates v. United Healthcare Insurance Co., No. 11-cv-3487 (S.D.N.Y.).
Keller Rohrback is one of America’s leading law firms handling employee benefit litigation. The firm is committed to helping employees and retirees protect their benefits. Our attorneys have extensive experience litigating cases involving welfare benefit plans and defined-contribution and defined-benefit pension plans. In addition, Keller Rohrback is recognized as one of the premier firms litigating breach of fiduciary duty claims against employers for losses to 401(k) plans caused by imprudent investment in company stock.