Zuckerman Spaeder Wins Class Certification in Lawsuit Tied to Landmark Wit Mental Health Case
Zuckerman Spaeder LLP has obtained another important mental health ruling, with the U.S. District Court for the Northern District of California granting class certification in a lawsuit against United Behavioral Health (UBH). The lawsuit seeks relief for individuals whose claims were rejected by UBH as it continued to use coverage guidelines that were later found to be illegal.
In March 2019, the same California court ruled on Wit v. United Behavioral Health, finding that UBH’s systematic denial of tens of thousands of behavioral health claims violated its fiduciary responsibilities under the Employee Retirement Income Security Act (ERISA). Due to the limitation of the class period in Wit, it was possible for UBH to use the same guidelines throughout the remainder of 2017. The resulting denial of additional claims that calendar year prompted a new Zuckerman Spaeder lawsuit.
“Despite an unequivocal ruling against its flawed behavioral health coverage guidelines, UBH continues to fight every effort to provide justice for those it has harmed,” said Zuckerman Spaeder partner D. Brian Hufford. “In handing the insurer another defeat and certifying this new class, the court has brought thousands of patients one step closer to getting the relief they deserve.”
Following the lead of Chief Magistrate Judge Spero, who presided over the Wit trial, California Chief District Court Judge Richard Seeborg certified the new class (Mary Jones, et al., v. United Behavioral Health) early this month. His ruling rejected all of UBH’s arguments as to why Wit should not be followed and, significantly, considered and dismissed UBH’s argument that the Supreme Court’s decision in Tholes v. U.S. Bank N.A had changed the law with regard to standing.
In a November 2020 ruling, Judge Spero provided the plaintiffs in Wit with the full extent of relief available under the law. UBH was ordered to reprocess the claims in question, reform its handling of behavioral health claims, and improve employee training. The court also ordered the appointment of a Special Master to oversee the reprocessing and reforms.
“Because of Wit and other recent cases, insurers’ handling of behavioral health claims is under more scrutiny than ever before,” said Zuckerman Spaeder partner Caroline Reynolds. “But many companies to continue to dodge their legal responsibilities and it’s going to require vigilance and constant legal pressure to achieve fundamental change.”
Under the direction of Mr. Hufford, partners Jason S. Cowart and Caroline E. Reynolds, Zuckerman Spaeder has achieved several other class certifications, delivered multiple settlements, and is pursuing additional mental health-related lawsuits against insurers. The mental health effort is part of a national practice representing patients and health care providers in disputes with health insurance companies. The firm’s cases have received high-level support from former U.S. Representative Patrick Kennedy and the U.S. Department of Labor, which has filed four amicus briefs supporting Zuckerman Spaeder cases in the Second, Third, Fifth, and Eighth Circuit Courts of Appeals, with the firm obtaining successful decisions each time.