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Sibley-Schreiber v. Oxford Health Plans, Inc.

62 F.Supp.2d 979 (1999)

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Sibley-Schreiber v. Oxford Health Plans, Inc.

United States District Court for the Eastern District of New York
62 F.Supp.2d 979 (1999)

MP

Facts

A class of healthcare insureds (plaintiffs) sought judicial relief against its insurer, Oxford Health Plans, Inc., (Oxford) (defendant), when Oxford instituted a 45-day coverage freeze and six-pill-per-month limit on paying for insureds’ prescribed Viagra. The insureds alleged that Oxford’s actions constituted a wrongful denial of benefits. Oxford contended that the insureds failed to exhaust the administrative claims process under the terms of their contract and therefore they were not entitled to seek judicial relief.

Rule of Law

Issue

Holding and Reasoning (Dearie, J.)

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