Federal Court Refuses To Dismiss Challenge To Plan Administrator’s Use Of Automated Algorithm For Benefit Decisions
A California federal district court has declined a plan administrator's motion to dismiss a class action lawsuit for wrongful denial of benefits and breach of fiduciary duty. The plaintiffs, a group of participants in various employer-sponsored health plans, blame the administrator's use of an automated algorithm to make decisions on participants' benefits claims as the basis for their lawsuit. The plan participants pointed to examples of benefits claims that they allege the plan should [...]