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Expert Analysis

Behavioral Health Ruling Supports Benefit Claim Appeals

By Mark DeBofsky ( March 17, 2020, 12:21 PM EDT) -- Litigating health benefit claim denials is extremely challenging for plaintiffs. Especially under the Employee Retirement Income Security Act — where many cases are decided under the arbitrary and capricious standard of review that upholds an insurance claim denial so long as the basis for the claim decision is viewed as reasonable by a court — overturning claim denials is often near impossible....

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