Wit vs UBH

[Mic Drop]

I expect most people here don't know, but back in March, the 9th circuit reversed Wit v UBH for, basically, no reason. All the law blogs were croggled: the decision of the court was both very short and just made no sense.

What's Wit vs UBH? A really important decision about a law suit against a health insurance company under a federal law called ERISA. ERISA is a consumer protection law that says if a company takes your money to provide you a financial service, they can't take advantage of the fact they have your money hostage to fleece you. It asserts the company has what's called a "fiduciary duty" – they have to behave in a trustworthy manner and do what they said they were going to do when you contract with them for a service. The Wit vs UBH suit argued that they had caught UBH, a health insurance company, making up standards of medical necessity for when they should have to pay for medical care that were in violation of widely agreed upon standards of care in medicine, and in some cases were hard or impossible for any patient to meet. All to get out of having to pay for health care services their members needed, leading to a bunch of people dying – it was a class action suit and some of the members of it were surviving family of the patients. The Wit case was particularly egregious because they found smoking-gun internal emails of doctors in the insurance company, UBH, saying to management, this is against medical standards, and we could probably be sued into oblivion if caught. There was no question what the plaintiffs alleged was actually going on, and everyone doing it knew it was criminal.

The ninth circuit ruled, nah, it's cool. Insurance companies don't need to actually, you know, pay for the healthcare they charged you premiums to cover, if they can invent an excuse. Any excuse really.

As a consequence, they just basically invalidated the whole of ERISA. Which doesn't just cover insurance – it covers all banking and investment companies too. Or did.

And by extension, they may have just knocked over consumer protection laws as a class.

Because what is anyone going to do about it? Appeal to the Supreme Court? The Supreme Court we have would love to destroy the principle of consumer protection laws.