$1.4M-Plus United Behavioral Health Settlement Aims to Resolve Lawsuit Over Denial of Mental Health Treatment Coverage

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A more than $1.4 million settlement has been reached that, if approved by the court, will resolve a proposed class action lawsuit over United Behavioral Health’s allegedly illegal denial of coverage for mental health and substance abuse treatment services it considered to be “experimental, investigational or unproven.”

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The proposed class action settlement covers a class of 349 people covered under ERISA-governed healthcare plans administered or insured by United Behavioral Health whose requests for coverage for mental health and substance abuse treatment services received at a licensed residential treatment center were denied in total based on its determination that a component of the program is experimental, investigational or unproven.

The lawsuit against United Behavioral Health was initially filed in May 2021 by a man who sought coverage for his son’s mental health and substance abuse treatment at an Arizona facility. According to the class action suit, the insurer denied the plaintiff’s claim for coverage based on its view that a part of the treatment center’s program, equine therapy, was considered to be “unproven.” The case contended that United Behavioral Health, by issuing such blanket denials of coverage, violated the Mental Health Parity and Addiction Equity Act.

The plaintiff filed an unopposed motion and memo detailing the terms of the settlement agreement with United Behavioral Health on December 18, 2024. The parties now await preliminary approval of the terms of the deal from United States District Judge David N. Hurd.

If the $1,415,000 United Behavioral Health settlement is initially approved by the court, class members will not need to take any action to receive a payout, the agreement says.

Related Reading: Class Action Claims United Behavioral Health Violated Parity Act by Excluding Mental Health Treatment from Coverage

According to the plaintiff’s memo, individual payment amounts will be based on the category a class member fits into—“experimental,” “multiple” or “wilderness.”

Per the document, consumers are members of the “experimental” group if their dependents were treated at residential treatment programs, and if United Behavioral Health raised only the contention that the program was investigational, experimental or unproven. The eight class members who fit this definition may each receive approximately $19,000, the memo states.

Individuals whose dependents were treated at residential treatment programs and for whom the insurer raised multiple reasons for denial—including a contention that the program was investigational, experimental or unproven—are part of the “multiple” category, the memo shares. There are 46 class members in this group, and each may receive an estimated $9,500 payment, the document adds.

Finally, those whose dependents were treated at wilderness programs and for whom United Behavioral Health denied the claim are part of the “wilderness” group, of which there are 292 members, the memo relays. These individuals may each receive approximately $950, with the three consumers whose dependents attended two wilderness programs receiving double that amount, the document says.

According to the agreement, class members’ group designations will appear on the settlement notice they can expect to receive by mail within 60 days following preliminary approval of the deal.

Did you know that some class action settlements require no proof to submit a claim? Check out the latest open class action settlements.