Smith v. Golden Rule Ins. Co.

Smith v. Golden Rule Ins. Co. (U.S. Dist. Ct. for the Southern Dist. of IN, Indianapolis Div., case no.  1:20-cv-02066-JMS-TAB, March 11, 2021).  Judge Jane Magnus-Stinson ruled that the Parity Claim could stand but the claim for prospective injunctive relief is dismissed.  Plaintiff’s son suffered from a range of MH/SUD conditions, received treatment both in wilderness and IOP programs, and died from an overdose.  The parents filed several claims due to the plan’s denial to pay for urine analysis tests and IOP, saying the test/care was not medically necessary.  In rendering her decision, the Judge completed a detailed review of many prior decisions discussing the pleading standard for a Parity Act claim. Although “there is no clear law on how to state claim for a Parity Act violation,” she sides with the Michael W v.

United Behavioral Health (D. Utah 2019) stating that any of the various pleading standards identified in this body of case law will suffice.  But she dismisses the claim for prospective injunction relief, noting that the Plaintiff (the Dad) is not “under threat of actual and imminent injury sufficient to confer standing…” likely due to his past financial injuries.