Emch v. Community Insurance Company (dba Anthem Blue Cross and Blue Shield)

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  • Decided in the U.S. District Court for the Southern District of Ohio, Western Division, October 25, 2019 (Case No. 1:17-cv-00856).
  • Plaintiff’s son with schizophrenia was denied payment for residential care based on a plan exclusion. Defendant argues that Ohio Parity Act does not contain an express or implied right of action.  The Court disagreed noting that the state law requires that health insurance policies cover the “diagnosis and treatment of biologically based mental illnesses on the same terms and conditions as, and shall provide benefits no less extensive than, those provided under the policy of sickness and accident insurance for the treatment and diagnosis of all other physical disease and disorders.”
  • Defendant’s motion to dismiss under Rule 12(b)(6) was denied, but Defendant’s motion to strike jury demand was granted.

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