Cincinnati, Ohio patient protection attorney reviews mental health treatment denial claims and insurance bad faith lawsuits for injured plaintiffs nationwide
In the toughest time of one’s life, they may have to battle an unscrupulous insurance company. It’s not what anyone wants. Yet thousands of Americans have to fight back when insurance companies fail to cover important treatments, life-threatening mental conditions or addictions.
Oftentimes, mental health treatment denial cases involve those battling addiction. Opioid addiction requires extensive treatment, and when insurance companies fail to cover patients and claims are denied, the addicted are forced out and left to their own devices. There is a mental health and drug crisis in the U.S., and in 2017 alone, around 47,000 Americans died by suicide and 70,000 from drug overdoses.
How can insurance companies deny coverage? The Mental Health Parity and Addiction Equity Act requires insurers to provide coverage for mental health and medical treatments. But insurers are still denying claims, and limiting coverage.
Mental Health Insurance Claims & Denied Coverage
Americans are now taking action against insurance companies when they recognize unlawful or unethical treatment. In one high-profile case of late, a plaintiff took United Behavioral Health, a unit of UnitedHealth Group, to court when they declined to cover a longer stay at an addiction treatment center, and he later died of an overdose. Even though his addiction specialist wanted him to stay at the center, the insurance would not cover him.
Addiction treatment and mental health claims have long been denied or limited by insurers and claimants are fighting back with legal action. Families are seeing their loved ones die or overdose because insurance companies fail to cover treatment.
Before the case mentioned above, United Behavioral Health was already the target of a class action lawsuit alleging that it improperly denied coverage for certain treatments. In fact in March 2019, a judge found United Behavioral Health liable for denying benefits, saying the insurer was more concerned with profits than the well-being of its clients.
Health Insurance Coverage Denial & Denied Claims
Health insurers are not always following federal law, which requires parity in the reimbursement for mental health and addiction. The laws still exist but sometimes it is necessary to take a large insurer to court, and often long after the damage is done.
Insurance companies find ways to delay payouts, limit coverage, deny treatments and underpay claims. Attorneys and Ohio consumer safety advocates are now heading initiatives to improve compliance with the law.
A federal report published in February 2019 concluded that the parity law increased the use of outpatient addiction treatment and the frequency of visits.
But patients and plaintiffs say insurers use subtle methods to deny coverage and claims. For instance, they may use providers or clinicians who won’t take new patients or are no longer in an insurer’s network. Or they require confusing or unending paperwork before they provide coverage.
Some patients say they can’t even find those covered under their plan’s mental health segment because the clinicians cannot be found. And so, mental health treatment denial or an absence of coverage has resulted in injury, suicide, overdose and death. Those may have coverage on paper, but in reality, it is pretty sparse.
Thus, patient safety attorneys are holding insurers responsible for their actions. Industry practices may have to change if enough lawsuits are filed and punitive damages hurt the company. Unfortunately, that may be the only incentive for an insurer to act within the law.
Mental Health Laws & Ohio Coverage Denial Claims
The Labor Department oversees health plans covering 156 million people, but the standards set forth are not as clear, and further, holding insurance companies liable requires individual lawsuits. Even if a mental health and addiction crisis is gripping America, the insurers still have power behind them. Contact an attorney to investigate mental health treatment denial claims.
Law enforcement varies from state to state, and the sums of violations are small enough where insurers are not worried about penalties. Denials of care are not limited to UnitedHealth. Other insurers are following the same protocol.
Aetna settled with Massachusetts over allegations of inaccurate network directories. Other lawsuits have been filed nationwide. New York’s attorney general settled with Beacon Health over allegations of mental health treatment denials and substance abuse claims.
Ohio Insurer Lawsuits & Mental Health Treatment Denial
There have been failures in the mental health system in recent years and suicide and overdose rates have increased at an alarming rate. Insurance bad faith and limited coverage have contributed to this crisis, and plaintiffs can come forward to make the system better in the future.
The Lyon Firm is dedicated to representing victims of insurance bad faith and denied coverage. We work to protect patients and Ohio consumers in the face of corporate greed and unlawful treatment of clients.
If you or a loved one has suffered due to mental health treatment denial or limited insurance coverage, and have questions about the legal remedies available to improve quality of life and medical care in Ohio, contact The Lyon Firm at (800) 513-2403.
You will speak directly with Mr. Lyon, a consumer protection attorney, and he will help you answer critical questions regarding insurance bad faith lawsuits.