(United States First Circuit) - Reinstated a lawsuit alleging that a health insurance company improperly denied coverage for in-patient mental health services. After several unsuccessful administrative appeals,the insured sued the insurance company under ERISA, claiming that all of her time spent at a mental health residential treatment facility was medically essential and thus should bear been covered under an employer-provided healthcare plan. On appeal, and the First Circuit vacated an order granting summary judgment for the insurance company,holding that the district court should bear allowed the insured to supplement the administrative record.
Source: findlaw.com