What legal precedents govern a health insurance claim denied appeal involving experimental cancer therapies under self-funded employer health plans?
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The searches the AI actually ran for this prompt.
SEED QUERY
What legal precedents govern a health insurance claim denied appeal involving experimental cancer therapies under self-funded employer health plans?
4 real searches · 1 real-search pass
ERISA experimental investigational cancer treatment denial cases appellate court health plan coverage precedentGoogle ↗
OBSERVED
ERISA self funded health plan experimental treatment exclusion cancer therapy medical necessity court cases de novo arbitrary capriciousGoogle ↗
OBSERVED
29 CFR 2560.503-1 health benefit claims appeals full and fair review external review experimental treatmentGoogle ↗
OBSERVED
ERISA Supreme Court Firestone Glenn denial benefits standard of review conflict of interestGoogle ↗
OBSERVED
Badge and edge weight = share of passes that produced the query. Hover a query for its intent and routing format.
Query classes
Google's semantic query class for every sub-query: what kind of answer each search is after, simulated vs real.
Classifying 4 queries…
Searches and sources
ChatGPT4 real searches · gpt-6
ERISA experimental investigational cancer treatment denial cases appellate court health plan coverage precedent Google ↗
ERISA self funded health plan experimental treatment exclusion cancer therapy medical necessity court cases de novo arbitrary capricious Google ↗
29 CFR 2560.503-1 health benefit claims appeals full and fair review external review experimental treatment Google ↗
ERISA Supreme Court Firestone Glenn denial benefits standard of review conflict of interest Google ↗
- Nickolas Zervos, Plaintiff-appellant-cross-appellee v. Verizon New York, Inc., F/k/a Verizon Communications Inc., F/k/a Nynex Corporation, F/k/a New York Telephone Company, and Empire Healthchoice, Inc., F/k/a Empire Blue Cross Blue Shield, Defendants-appellees-cross-appellants,united Healthcare Co., Inc., A/k/a United Healthcare, Defendant, 277 F.3d 635 (2d Cir. 2002) :: Justia · law.justia.com
- ZERVOS v. United Healthcare Co., Inc., a/k/a United Healthcare, Defendant. (2002) · caselaw.findlaw.com
- FIRESTONE TIRE AND RUBBER COMPANY, et al., Petitioners v. Richard BRUCH, etc., et al. | Supreme Court | US Law · law.cornell.edu
- Firestone Tire & Rubber Co. v. Bruch | 489 U.S. 101 (1989) · supreme.justia.com
- Metropolitan Life Ins. Co. v. Glenn | 554 U.S. 105 (2008) · supreme.justia.com
- FMC CORPORATION, Petitioner, v. Cynthia Ann HOLLIDAY. | Supreme Court | US Law · law.cornell.edu
- FMC Corp. v. Holliday | 498 U.S. 52 (1990) · supreme.justia.com
- 29 CFR § 2560.503-1 - Claims procedure. | Electronic Code of Federal Regulations (e-CFR) | US Law · law.cornell.edu
- Compliance Assistance - Group Health and Disability Plans Benefit Claims Procedure Regulation (29 CFR 2560.503-1) · dol.gov
- Understanding Your Fiduciary Responsibilities Under A Group Health Plan · dol.gov
- 45 CFR § 147.136 - Internal claims and appeals and external review processes. | Electronic Code of Federal Regulations (e-CFR) | US Law · law.cornell.edu
- HHS-Administered Federal External Review Process for Health Insurance Coverage · cms.gov
Queries
4 queries · click a column to sort
| Query / type | Search | Intent | Query class | Routing format | Cluster | Freq ↓ | Weight |
|---|---|---|---|---|---|---|---|
ERISA experimental investigational cancer treatment denial cases appellate court health plan coverage precedent OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 | |
ERISA self funded health plan experimental treatment exclusion cancer therapy medical necessity court cases de novo arbitrary capricious OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 | |
29 CFR 2560.503-1 health benefit claims appeals full and fair review external review experimental treatment OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 | |
ERISA Supreme Court Firestone Glenn denial benefits standard of review conflict of interest OBSERVED | Google ↗ AI Mode ↗ | — | — | — | — | 1x of 1 |