DETROIT, July 1 The father of an autistic child has fileda class action lawsuit against Blue Cross Blue Shield of Michigan, and it wasset for hearing by Judge Sean Cox in Federal Court. Mr. Chris Johns allegesthat the insurer has wrongfully refused coverage for his child's therapy andcare. The suit alleges that Blue Cross is required to provide coverage for thecare under the terms of its policy, but that it has not done so in bad faithand in violation of the federal ERISA statute.
The suit seeks certification of a class of people who have been refusedcoverage by Blue Cross for their autistic children, as well as damages and aninjunction requiring Blue Cross to provide coverage for the care in thefuture. The plaintiff is represented by the law firms of John J. Conway, P.C.and Mantese and Rossman, P.C. Blue Cross apparently takes the position thatsuch care is experimental even though it is provided by such prestigiousfacilities as Beaumont Hospital. The case was assigned to the Honorable SeanCox, in the Eastern District of Michigan, and Judge Cox issued an orderyesterday, setting the matter for a hearing on August 21.
Attorney, John J. Conway said, "The law is clear that this treatment isnot experimental, but is mainstream, scientifically validated, and beingprovided by prestigious institutions such as Beaumont Hospital, and we lookforward to establishing this in a judicial forum through testimony andaffidavits of professionals in this arena." Conway referenced an expert'saffidavit already submitted to the court, which states, "Intensive behavioralintervention for children with autism is the standard of care and isappropriate for the therapeutic management of autism."
A motion to certify the class is pending and will be heard by the court onAugust 21, 2008, at 3 p.m.
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SOURCE Legal Media, LLC