Judge Approves Class-Action Lawsuit Against Montana’s Largest Insurer
A federal judge has given the green light to a class-action lawsuit against Blue Cross Blue Shield of Montana, operated by Health Care Service Corporation (HCSC). The case could impact thousands of Montanans whose high-dollar insurance claims were denied.
What’s the Lawsuit About?
The suit, led by Helena couple Johnny and Mary Rutherford, accuses BCBS of systematically denying expensive claims (over $50K) without proper review. The court found evidence that:
Claims were often denied using quick checklists with no specialist input.
Medical records weren’t fully reviewed, and doctors weren’t contacted.
The process may have violated Montana laws requiring reasonable investigation.
The Numbers
15,127 claims were denied as "not medically necessary" in 5 years.
Only 25% were appealed, and just 30% of those appeals were successful.
Former employees say the system was designed so most people would just pay out of pocket.
Why It Matters
This ruling means thousands of affected Montanans can now join the lawsuit. If successful, it could force BCBS to:
Reform how claims are handled
Pay out wrongly denied claims
Face further legal and financial consequences
What You Can Do
If you had a high-dollar claim denied by BCBS in recent years, you may be eligible to join the class. Please let us know if believe your claim was wrongly denied.
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Bottom line: This is a big step toward holding insurers accountable in Montana.