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Friday, April 16, 2010

Michigan Insurance Case

This time, the insurance industry takes a hit from the judiciary instead of the legislature. The National Law Journal reports:

Blue Cross Blue Shield of Michigan may have finally settled a historic autism lawsuit for $1 million this week, but it still has a big plaintiff on its back: a judge.

On Tuesday, a Detroit federal judge gave final approval to the insurance company's $1 million settlement with more than 100 families seeking coverage for autism treatments. A separate, similar suit remains pending against the insurance giant -- this one brought by Oakland County Circuit Court Judge Cheryl Matthews.

Matthews, who has a son with autism spectrum disorder, filed her suit against Blue Cross last July in Michigan state court, about one month after the insurance company initially announced its settlement in the Johns v. Blue Cross class action.

Under Tuesday’s settlement, Blue Cross agreed to cover what is known as applied behavioral therapy (ABA) treatments, but only for patients who had received the treatments at Beaumont Hospital in Royal Oak, Mich. Matthews' son received his ABA treatments at another facility in Southfield, Mich., and Blue Cross, her lawsuit contends, has wrongfully refused to cover them.