Introduction to the Settlement
Anthem, a multi-billion dollar insurance company, has agreed to a $12.875 million settlement in a class action lawsuit. The lawsuit alleged that Anthem denied certain claims for coverage for inpatient treatment services on the grounds that the care was not medically necessary, by using criteria that are more restrictive than generally accepted standards of care.
Eligibility for the Settlement
Members whose claims for inpatient treatment for a mental illness or substance use disorder were denied by Anthem between April 29, 2017 and April 30, 2025 may be eligible for the settlement. To be eligible, members must provide appropriate documentation. If you paid out-of-pocket for inpatient treatment services after Anthem denied your application for coverage between the dates listed above, you may apply to join the class by January 20.
Details of the Settlement
Anthem denies all claims but has entered into a settlement to "avoid the expense and uncertainty of litigation." The amount you receive from Anthem depends in part on how many group members submit claims. All class members will receive either a pro rata share of the cash recovery fund or a nominal payment of at least $100.00.
Next Steps
A fairness hearing will be held on January 26 to consider whether the settlement is “fair, reasonable and appropriate.” If you are eligible for the settlement, you can submit a claim to receive a payment. The settlement is subject to court approval, and the payment amounts will be determined after the claim submission period has ended.
