NY court decides unions can sue health insurers
In an important judgement for many union members before exorbitant out-of-pocket medical costs, a federal judge has the right followed by four unions to sue to protect their members.
New York State United Teachers and three other unions have recently joined a lawsuit against United Healthcare Corp. for improper management of the Empire plan, one of the largest public employee health plans in the country.
In the action, the unions claim UHC wrong reduced reimbursement to the Empire subscribers plan for health services from out-of-network operators.
UHC moved to dismiss the unions actions and claimed that they had no standing to sue on behalf of individual members and that any claims should be administratively or in arbitration.
But in August, a federal judge rejected every claim of UHC and came to the conclusion that the unions “have standing to sue on a representational basis capacity.”
The court noted that the unions had fully meets the requirements of the law for an association to sue to protect their members and notes, “two volumes of exhibits on the experiences of 38 (union members) have allegedly been negatively affected. ”
Taking a stand
“This decision is of vital importance because it confirms the ability of unions to a level that if their members rights are violated,” said Brian D. Hufford, a partner with Pomerantz Haudek Block Grossman & Gross LLP, New York City law firm hired by The four unions.
The court also rejected UHC assertion that it had “state immunity”, finding that it was not an “arm of the state”, but merely a private company hired to provide services to public employees. Similarly, the Court rejected UHC’s assertion that the claims should be included in the arbitration.
“Suffering a major illness or an operation is traumatic enough without facing a medical bill that would have been covered by your insurance company,” said NYSUT Executive Vice President Alan Lubin. “Some of our members - especially suffering from serious diseases such as cancer and heart disease - were stuck with thousands of dollars in unexpected medical bills.”
NYSUT entered the plea last November, together with the public service employees Association, the organization of executives and employees visible and the New York State Police Investigators Association.
The first legal action by the American Medical Association that the fees UHC has systematically paid less than the 80 percent reimbursement for out-of-network medical services in the General Assembly of the health insurance.
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