The United States private health insurance industry covers roughly 60.7% of the total U.S. population, or 203 million individuals. In 2022, it raked in $18 billion in revenue. Unsurprisingly, the industry has not been free from controversy, both in the court of public opinion and in the federal and state courtrooms of the nation. Since 2019, the top health insurance companies have been involved in 9,271 cases. This analysis examines the parties involved, the law firms representing them, and the nature of the suits.
Elevance Health, formerly Anthem, is the largest for-profit company in the Blue Cross Blue Shield network. In Docket Alarm’s database, they faced more lawsuits than any other private insurer, over 2,700 cases. The plurality of these cases were heard in small claims court, presumably over payments to providers. Next were suits under the Employee Retirement Income Security Act of 1974 (ERISA). These suits tend to involve patients suing to force Elevance to cover some care that their plan allegedly covers.
Most often, Elevance worked with Pepper Hamilton, who primarily handled ERISA cases. They also sent ERISA work to Reed Smith and Seyfarth Shaw, though the latter also handled labor litigation. Morgan, Lewis & Bockius handled Elevance’s trademark litigation.
The second-most targeted health insurance company in the last four and a half years was Kaiser Permanente. Unlike the others, the majority of their legal involvement dealt with the National Labor Relations Board. This is unsurprising considering the labor fights their workers have waged over better working conditions in recent years. According to Forbes, a nationwide strike of Kaiser workers might be imminent.
Kaiser Permanente, along with UnitedHealth Group, has been caught up in the giant multidistrict litigation in the Northern District of Ohio over the opioid epidemic.
Kaiser generally used in-house counsel in recent years.
UnitedHealth is the largest company represented in health insurance litigation, though they sit at third in case load for this analysis. The bulk of this litigation has fallen under various tort liability Nature of Suit codes, most of which fall within the aforementioned multidistrict litigation. UnitedHealth, specifically, has been targeted for their subsidiary OptumRx, a pharmacy benefit manager. OptumRx allegedly played a role in distributing opioids to the masses.
For their tort litigation, UnitedHealth has worked with Williams Mullen and Alston & Bird. For their patent and trademark filings, they worked with Seyfarth Shaw.
The plurality of Humana’s legal action has been trademark applications and oppositions, for which they use in-house counsel. They have also dealt with some of the usual ERISA and insurance litigation, for which they primarily work with Squire Patton Boggs.
Unique among the largest health insurers, Humana has filed some private antitrust lawsuits. For these, they tend to work with Crowell & Moring. Also of note, they have dealt with some civil rights jobs cases, in which they have been represented by Ogletree, Deakins, Nash, Smoak & Stewart.
Rounding out the list of most litigious private health insurers is Centene. The plurality of their cases have been trademark applications, for which they have used in-house counsel. Second, they have faced various forms of labor litigation in which they usually work with Littler Mendelson. At a distant third, they’ve worked with Crowell & Moring on a mélange of antitrust, racketeering, and insurance litigation.