Legal Opinion

K.D. v. Harvard Pilgrim Health Care, Inc.

District Court, D. Massachusetts

Decided March 27, 2023No. 1:20-cv-11964Unknown

1Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS K.D., ) ) Plaintiff, ) ) v. ) CIVIL ACTION ) NO. 20-11964-DPW HARVARD PILGRIM HEALTH CARE, INC., ) HARVARD PILGRIM – LAHEY HEALTH ) SELECT HMO, AND LAHEY CLINIC ) FOUNDATION, INC., ) ) Defendants. ) MEMORANDUM AND ORDER March 27, 2023 K.D. brought a challenge to the decision of Harvard Pilgrim Health Care, Inc. to deny her claim for out-of-network benefits under the Harvard Pilgrim – Lahey Health Select HMO. On December 12, 2022, I: (a) remanded K.D.’s benefits claim “so that all relevant issues and provider opinions [may] be considered…

2Cases cited28 opinions

  1. Hensley v. EckerhartSupreme Court of the United States · 1983
  2. Blum v. StensonSupreme Court of the United States · 1984
  3. Hardt v. Reliance Standard Life Insurance Co.Supreme Court of the United States · 2010
  4. Gay Officers Action League v. Puerto RicoCourt of Appeals for the First Circuit · 2001
  5. Denise COUTIN, Et Al., Plaintiffs, Appellants, v. YOUNG & RUBICAM PUERTO RICO, INC., Defendant, AppelleeCourt of Appeals for the First Circuit · 1997

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