RIGHT-TO-SUE: Labor Department Moves In Support
The federal government "for the first time" has submitted a court filing "argu[ing] that patients shouldn't be precluded from suing for damages under state insurance laws for denials of treatment." The Department of Labor filed an amicus brief in the Supreme Court Friday in the case Unum Life Insurance of America v. John E. Ward, "which centers on whether [the Employee Retirement and Income Security Act] overrides state laws on disability insurance claims." The Wall Street Journal reports that the move represents "a new venue" in the Clinton administration's attempts to "make it easier for consumers" to sue HMOs. The filing also represents a significant shift in stance for the federal government; until now the Labor Department officially supported a 1987 Supreme Court decision limiting damages as specified under ERISA to the value of the denied benefit, "not punitive damages or lost wages or damages for pain and suffering." Jamie Court, director of Consumers for Quality Care, said, "This is the first time that a federal agency has said to a court that it must defer to state insurance codes provisions allowing for damages for injured consumers in ERISA- covered plans that aren't self-funded." The filing only concerns health insurance plans purchased by employers for employees, not "self-funded" plans. The Wall Street Journal reports that consumer advocates said "the department's new position could have a major impact not only on future court decisions, but also on state legislatures trying to find ways to make it easier for patients to sue their health plans for treatment delays or denials" (McGinley, 12/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.