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Hendricks v. Aetna Life Ins. Co., No. CV 19-06840-CJC(MRWx), 2021 WL 2497950 (C.D. Cal. June 11, 2021) (Judge Cormac J. Carney).

As modern medicine advances, so do health care costs. Health insurers have an incentive to keep those costs down, and one way to do that is to deny claims for benefits by classifying expensive new treatments as “experimental and investigational.”

This case involves plaintiffs’ benefit claims for lumbar artificial disc replacement (“ADR”), a new alternative to traditional spinal fusion. Lumbar ADR has shown promise because it has the potential to provide improved flexibility and mobility to patients with spinal problems. The FDA has approved at least two lumbar disc replacement products, in 2004 and 2006.
Continue Reading Court Certifies Class Action Challenging Aetna’s Benefit Denials for Lumbar Artificial Disc Replacement

Good morning, ERISA Watchers!  Now that USA has just won its fourth FIFA Women’s World Cup title, I’m bringing you more good news in this week’s notable decision:  Cunningham, et al. v. Wawa, Inc., et al., No. 2:18-cv-03355-PD (E.D. Pa. July 2, 2019).  In Cunningham, the court granted Plaintiffs’ motion to certify a class of Employee Stock Ownership Plan (“ESOP”) participants.  In their ten-count complaint, Plaintiffs claim that Defendant Wawa violated ERISA in several ways by amending the ESOP in a manner which took away their right to hold Wawa stock through age 68 and forced them to sell their shares at an unfair price.  Plaintiffs moved to certify a class and two subclasses of over one thousand participants who were adversely impacted by the amendments.  
Continue Reading Court Holds that Detrimental Reliance Is Not Needed for Class-Wide Relief and Certifies ESOP Class