Pollock Cohen and Walden Macht Launch Class Action Against Anthem Health Plans Over Coverage Issues
On July 15, 2025, Pollock Cohen LLP, collaborating with Walden Macht Haran WIlliams LLP and Izard, Kindall & Raabe LLP, announced the filing of a major class action lawsuit against Anthem Health Plans, Carelon, and their parent company, Elevance. This legal action was brought forth in a Connecticut state court, alleging deceptive and fraudulent practices concerning health insurance coverage.
The core of these allegations revolves around claims that Anthem and its associated companies systematically denied coverage for essential medical services. Furthermore, the lawsuit highlights the inaccurate provider directory that was falsely represented to patients. Many individuals have reportedly encountered significant challenges finding in-network doctors and therapists due to the misleading information provided by the defendants.
The class action potentially encompasses hundreds of thousands of residents across Connecticut as well as numerous small businesses, presenting an extensive demographic profoundly affected by these alleged misrepresentations. One of the critical elements of the lawsuit is the so-called "ghost network," which refers to the directory of supposedly available providers that do not actually exist, do not accept Anthem's insurance, or are not accepting new patients. This has compounded the difficulties faced by individuals seeking mental health care services in particular.
Plaintiffs have shared harrowing narratives detailing their exhausting attempts to locate accessible in-network clinicians. They describe the burden of financial stress incurred from using out-of-network services, highlighting the inadequacies in reimbursement practices that further add to their financial strains. The lawsuit articulates stories filled with anguish and frustration from individuals who dedicated countless hours trying to navigate the intricate and often opaque systems in place.
One particular plaintiff's story illustrates the severe implications of these alleged denials of coverage. The plaintiff, a parent of a two-year-old child diagnosed with autism, reports that despite paying over $2,000 monthly for health insurance through Anthem, no qualified in-network providers were available to provide necessary therapy. This led to additional out-of-pocket expenses ranging from $5,000 to $7,000 each month for seeking care from out-of-network providers. The family's situation became even more complicated as Anthem repeatedly failed to reimburse them adequately for the therapy sessions incurred.
Similarly, another named plaintiff, a therapist who sought her own mental health services, encountered a similar situation where none of the therapists she reached out to were actually available under her Anthem plan. After contacting many providers that Anthem claimed accepted their insurance, she ended up having to pay for out-of-network care, accumulating substantial out-of-pocket expenses.
Steve Cohen, a lead attorney representing the plaintiffs, expressed the deep-rooted issues many families face: "Inaccurate provider directories lead to delays in care. The financial burden for those who turn to out-of-network options can be overwhelming." For many, this presents a life-altering challenge, particularly for those unable to afford the high costs associated with out-of-network services, resulting in emotional and psychological distress.
The legal team, which filed the suit, argues that by providing a misleading representation of their network, Anthem and Elevance not only breached their contractual and statutory obligations but also their moral duty to individuals requiring medical assistance. Jacob Gardener, a partner at Walden Macht, reiterated the trust that patients placed in the health insurance system and how this trust has been violated.
This lawsuit marks the third action of this nature spearheaded by Pollock Cohen and Walden Macht. Earlier this year, a similar lawsuit was filed concerning Carelon Behavioral Health, which provides mental health benefits to over 1.2 million New York state and municipal employees. Additionally, the firms took legal action against Anthem Blue Cross and Blue Shield for over 150,000 federal employees in New York, further emphasizing the widespread issues prevalent in these networks associated with Elevance Health.
The implications of this lawsuit could set significant precedents for accountability in the healthcare insurance industry, especially concerning network integrity and the promise of accessible care. As the case unfolds, many will be watching closely to see how Anthem and Elevance respond to these grave allegations and what changes may be mandated in their practices moving forward.
The filing has been made in the Connecticut state court, and for those interested in accessing the official complaint, more details can be found through direct links provided by Pollock Cohen LLP.
The core of these allegations revolves around claims that Anthem and its associated companies systematically denied coverage for essential medical services. Furthermore, the lawsuit highlights the inaccurate provider directory that was falsely represented to patients. Many individuals have reportedly encountered significant challenges finding in-network doctors and therapists due to the misleading information provided by the defendants.
The class action potentially encompasses hundreds of thousands of residents across Connecticut as well as numerous small businesses, presenting an extensive demographic profoundly affected by these alleged misrepresentations. One of the critical elements of the lawsuit is the so-called "ghost network," which refers to the directory of supposedly available providers that do not actually exist, do not accept Anthem's insurance, or are not accepting new patients. This has compounded the difficulties faced by individuals seeking mental health care services in particular.
Plaintiffs have shared harrowing narratives detailing their exhausting attempts to locate accessible in-network clinicians. They describe the burden of financial stress incurred from using out-of-network services, highlighting the inadequacies in reimbursement practices that further add to their financial strains. The lawsuit articulates stories filled with anguish and frustration from individuals who dedicated countless hours trying to navigate the intricate and often opaque systems in place.
One particular plaintiff's story illustrates the severe implications of these alleged denials of coverage. The plaintiff, a parent of a two-year-old child diagnosed with autism, reports that despite paying over $2,000 monthly for health insurance through Anthem, no qualified in-network providers were available to provide necessary therapy. This led to additional out-of-pocket expenses ranging from $5,000 to $7,000 each month for seeking care from out-of-network providers. The family's situation became even more complicated as Anthem repeatedly failed to reimburse them adequately for the therapy sessions incurred.
Similarly, another named plaintiff, a therapist who sought her own mental health services, encountered a similar situation where none of the therapists she reached out to were actually available under her Anthem plan. After contacting many providers that Anthem claimed accepted their insurance, she ended up having to pay for out-of-network care, accumulating substantial out-of-pocket expenses.
Steve Cohen, a lead attorney representing the plaintiffs, expressed the deep-rooted issues many families face: "Inaccurate provider directories lead to delays in care. The financial burden for those who turn to out-of-network options can be overwhelming." For many, this presents a life-altering challenge, particularly for those unable to afford the high costs associated with out-of-network services, resulting in emotional and psychological distress.
The legal team, which filed the suit, argues that by providing a misleading representation of their network, Anthem and Elevance not only breached their contractual and statutory obligations but also their moral duty to individuals requiring medical assistance. Jacob Gardener, a partner at Walden Macht, reiterated the trust that patients placed in the health insurance system and how this trust has been violated.
This lawsuit marks the third action of this nature spearheaded by Pollock Cohen and Walden Macht. Earlier this year, a similar lawsuit was filed concerning Carelon Behavioral Health, which provides mental health benefits to over 1.2 million New York state and municipal employees. Additionally, the firms took legal action against Anthem Blue Cross and Blue Shield for over 150,000 federal employees in New York, further emphasizing the widespread issues prevalent in these networks associated with Elevance Health.
The implications of this lawsuit could set significant precedents for accountability in the healthcare insurance industry, especially concerning network integrity and the promise of accessible care. As the case unfolds, many will be watching closely to see how Anthem and Elevance respond to these grave allegations and what changes may be mandated in their practices moving forward.
The filing has been made in the Connecticut state court, and for those interested in accessing the official complaint, more details can be found through direct links provided by Pollock Cohen LLP.
Topics Health）
【About Using Articles】
You can freely use the title and article content by linking to the page where the article is posted.
※ Images cannot be used.
【About Links】
Links are free to use.