NJ wins big in insurance lawsuit

An ongoing lawsuit against Horizon Blue Cross/Blue Shield of New Jersey was settled for $1.2 million. The suit was begun by Dawn Beye after coverage for her daughter's eating disorder was denied on the grounds that an eating disorder is not a biologically based mental illness.

The family paid out of pocket for treatment, and was left tens of thousands of dollars in debt. In part to challenge the insurance company's ruling that anorexia was NOT biologically-based, and in part to get coverage for the treatment their daughter deserved, they filed suit against Horizon.

Years passed.

Today, I read a story that Horizon agreed to settle the suit (joined by other families in NJ) for $1.2 million, plus the cost of legal fees. Once the money is divided up, it might not be much, but at least the insurance company is paying.

But the real reason I'm rejoicing? This settlement means that eating disorders will be treated as biologically based mental illnesses.

From the Star-Leger article:

Under the terms of the agreement, Horizon will not admit any liability but will provide "parity treatment to eating disorder claims in the future for all current members who are fully insured," the statement added.

Previous coverage of the lawsuit (and others in NJ) can be found here:

A Whole New Battle
Insurer sued for refusing to pay the cost of anorexia
Dying to be thin: who should pay?
Families fight insurers over eating disorders
Some elite anorexia experts join Wayne mom's fight with insurer


Harriet said...

Woo-hoo! Dawn Beye, you rock!

KSabes said...

i went to treatment with her daughter! such a sweet family.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com

nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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