D.K. v. United Behavioral Health

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D.K. v. United Behavioral Health (U.S. Dist. Ct. for the Dist. of Utah, case no. 2:17-CV-01328-DAK, June 22, 2010.  Judge Dale A. Kimball granted Plaintiff’s Motion for Summary Judgment on the ERISA Recovery of benefits action because Defendant’s denials were arbitrary and capricious.  Plaintiff’s Motion for Summary Judgment was denied. In the ruling, the Judge found several reasons supporting United’s breach of fiduciary duty (e.g., treatment that is determined not medically necessary does not automatically default to custodial care, United failed to adequately consider the treating physician opinions, United’s denial letters failed to contain sufficient citations and documentation, and United’s denial letters were inconsistent).

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