IAA claimed that one of its employees informed a member of Callagy Law of the one-year time limit imposed by the terms of Challenge Printing's plan. for the same injury for which she received treatment from Dr. Spine retained Callagy Law to challenge a denial of benefits for the provision of anesthesia services to N.G. Callagy Law also represented Spine Orthopedics Sports (Spine) in a suit against IAA and Challenge Printing. Mirza retained Callagy Law to represent him in his civil action against IAA and Challenge Printing. None of the denials issued by IAA, including the August 12 letter, mentioned that Challenge Printing's plan imposed a one-year limitation for judicial review of final determinations.ĭr. Mirza a letter stating that he had exhausted the internal review process and that he was allowed to bring a civil action under ERISA § 502(a) if he was not content with its final decision. Mirza filed a claim with Insurance Administrator of America (IAA), the plan administrator. N.G., an employee of The Challenge Printing Company of the Carolinas (Challenge Printing), received treatment for a herniated disc and assigned her benefits under Challenge Printing's ERISA plan to her treating physician, Dr. Court of Appeals for the Third Circuit overturned a grant of summary judgment denying an ERISA beneficiary the right to seek judicial review because the beneficiary failed to challenge the denial within the plan-imposed deadline for civil actions.
If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group. This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. Managed Care Lawsuit Watch - November 2015
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