Feb 06, 2012
In response to an insurance verification inquiry from a hospital, a third party administrator for a self funded group health plan failed to disclose the limitations on coverage for a prospective patient. When the TPA denied payment, the hospital sued in state court. The TPA removed the case to federal court and argued that ERISA preempted state law claims. The federal court ruled that ERISA did not preempt the state law claims and sent the case back to state court for final resolution on the merits. You can read the decision in this website's library here.
Awarded: Suit Based on Inaccurate Insurance Verification is Not Preempted by ERISA