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Text of Seventh Circuit Case Allowing ERISA Claim for Benefits Against Wisconsin Health Insurers Over Chiropractic Coverage (PDF)
U.S. Court of Appeals for the Seventh Circuit Link to more items from this source
July 29, 2013
The three-judge panel determined that ERISA did not preclude the bringing of suit under ERISA section 1132(a)(1)(B) by several employer-sponsored health plan participants directly against six health insurance companies rather than the employers, when the plans are "insurance-based" and the insurance companies "decided all eligibility questions and owes the benefits." The participant claimed the insurance policies illegally applied co-payment requirements to chiropractic care under Wisconsin law. The court examined the Wisconsin law and found the policies were in conformance, however, so the district court's denial of the claim was affirmed. A claim for breach of fiduciary duty under ERISA was rejected as being inapplicable to the insurance companies. [Larson v. UnitedHealthcare Insurance Company, et al., No. 12-1256 (7th Cir. July 26, 2013)]

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