NEW ORLEANS – An Orleans Parish woman alleges her insurer wrongfully denied preauthorized coverage for her dependent.
Valerie Besthoff filed a complaint in the U.S. District Court for the Eastern District of Louisiana against Louisiana Health Service and Indemnity Co., doing business as Blue Cross and Blue Shield of Louisiana; and Magellan Healthcare Inc. citing the Employee Retirement Income Security Act.
According to the complaint, the plaintiff's daughter is considered a dependent under the terms of her insurance plan. The plaintiff alleges that from April 21, 2015, through Oct. 31, 2015, her daughter's medical providers submitted requests for payment for preauthorized heath care treatments, which the defendants have denied. The plaintiff alleges she has had to pay for the medical treatment.
The plaintiff holds Louisiana Health Service and Indemnity Co., doing business as Blue Cross and Blue Shield of Louisiana; and Magellan Healthcare Inc. responsible because the defendants allegedly refused to reimburse the plaintiff and failed to furnish the plaintiff with complete documents concerning the plan and its reason for denial of medical benefits within 30 days of her request.
The plaintiff requests a trial by jury and seeks judgment against defendants for all reimbursable medical benefits, statutory penalties in an amount to be determined at trial, interest, attorney's fees and other relief the court deems just and proper. She is represented by James J. Bolner Jr. of Montgomery Barnett LLP in New Orleans.
U.S. District Court for the Eastern District of Louisiana Case number 16-cv-12967