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Landmark Settlement with Health Insurers in NJ Eating Disorder Litigation

Nagel Rice stands at the forefront of protecting and enhancing the rights of Eating Disorder patients by settling two class action lawsuits asserting that health insurers were wrongfully denying claims for coverage of eating disorder treatment. On November 24, 2008 Nagel Rice filed papers seeking preliminary approval of a settlement agreement with Horizon Blue Cross Blue Shield of New Jersey in the case known as Drazin v. Horizon et al. This settlement, which still needs to be approved by the Court, will result in payments to a settlement class consisting of members insured by fully funded Horizon insurance plans covered by the New Jersey Parity Act. Under the settlement Horizon will reprocess claims previously denied on behalf of over 500 individuals included in the class, grant parity status for eating disorders going forward and offer a change in the appeals procedure so that patients will have the right to have an eating disorder specialist review claims denied on the grounds of medical necessity. It is estimated that the reforms going forward may impact more than a million insured and will have an approximate value of $20 Million.

On November 18, 2008, the federal district court in New Jersey granted final approval to a similar settlement reached in DeVito v. Aetna and certified a settlement class consisting of members insured by fully funded Aetna insurance plans covered by the New Jersey Parity Act. Under that settlement agreement, Aetna will reprocess claims previously denied on behalf of 119 individuals included in the class, grant parity status for eating disorders going forward, and offer an appeals procedure so that patients may have an eating disorder specialist review claims denied on the grounds of medical necessity.

Click here to read New Jersey Law Journal Article
"Insurer Settles Class Action Seeking Health Coverage for Eating Disorders"

Click here to read New Jersey Law Journal Article
"Judge Approves Settlement of Suit Against Aetna Over Coverage for Eating Disorders"

Click here to read News 4 Article
"Teen Bares Her Battle with Anorexia, How She Won"

Click here to read The Star Ledger
"Insurer will cover claims for anorexia"


The attorneys at Nagel Rice, LLP represent clients in Essex County, Newark, Paterson and throughout the state of New Jersey in a wide range of matters including personal injury, automobile accidents, brain injuries, medical malpractice, business litigation and class action cases.



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© 2014 Nagel Rice LLP | Disclaimer | Personal Injury News
Roseland Office: 103 Eisenhower Parkway, Roseland, NJ 07068
| Phone: 973-618-0400
New York Office: 230 Park Avenue, Suite 1000 , New York, NY 10169
| Phone: 212-551-1465

Practice Areas | Attorneys | Firm News | Verdicts & Settlements | Medical Malpractice | Personal Injury | Litigation | Class Action

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