PHILADELPHIA, Aug. 22, 2012 /PRNewswire/ -- A federal court in Philadelphia yesterday granted class action status to a lawsuit brought by the parents of an autistic child against CIGNA Corporation and related CIGNA entities for their policy of denying insurance coverage for an autism treatment known as Applied Behavior Analysis (ABA) therapy. In their lawsuit, the plaintiff, Kristopher Churchill and Luis Rolando, allege that the CIGNA companies have a nationwide policy of classifying ABA as experimental, and therefore they do not provide insurance coverage for this therapy. The plaintiffs claim that the classification of ABA as experimental and the denial of insurance coverage for ABA violates federal laws governing insurance plans. The court's order today means that the case will proceed as a nationwide class action on behalf of all families having children with autism who were denied coverage by CIGNA for ABA therapy.
According to the lawsuit, ABA is a well recognized and scientifically valid form of autism treatment for children. Numerous authorities and organizations have supported using ABA to treat autism. For example, the use of ABA for treating autism has been endorsed by the U.S. Surgeon General and the National Institute of Mental Health. The American Academy of Pediatrics has said that the effectiveness of ABA "has been well documented through 5 decades of research." Currently, 31 states mandate insurance coverage for ABA-type autism treatments.
In the Court's Order entered yesterday, Judge Juan R. Sanchez held that the following subclass shall be certified pursuant to FRCP 23(b)(3):
All individuals who, on or after November 24, 2006, (1) were enrolled in a plan administered by a CIGNA Defendant, or insured under health insurance coverage offered by CIGNA Defendant in connection with a plan, and (2) are currently enrolled in a CIGNA-affiliated plan, and (3) who, on or after November 24, 2006, made a claim or make a claim for Applied Behavior Analysis and/or Early Intensive behavioral Treatment for Autism Spectrum Disorder which was denied on the grounds that such treatment is deemed by a CIGNA Defendant to be investigative or experimental.
Churchill and Rolando are represented by Gerard Mantese, Brian Saxe, and John J. Conway of Michigan. Mantese and Conway are counsel in several cases seeking insurance coverage for ABA therapy. In 2010, Mantese and Conway obtained final approval of a class action against Blue Cross Blue Shield of Michigan requiring payment of $1 million in claims for ABA. They are also currently counsel for several military beneficiaries seeking coverage of ABA from the military's Tricare insurer. On July 26, 2012, a federal court in Washington D.C. granted summary judgment ordering that ABA Therapy be provided to military beneficiaries in that case.
Contact information for Churchill's attorneys follows:
Gerard Mantese, Esq.
Brian Saxe, Esq.
Mantese Honigman Rossman and Williamson, P.C.
1361 E. Big Beaver Road
Troy, Michigan 48083
John J. Conway, Esq.
John J. Conway, P.C.
26622 Woodward Avenue, Suite 225
Royal Oak, MI 48067
SOURCE Mantese Honigman Rossman and Williamson