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B.H. v. State of Ohio Department of Administrative Services

Court of Appeals of Ohio, Tenth District

December 14, 2017

B.H. et al., Plaintiffs-Appellants,
v.
State of Ohio Department of Administrative Services et al., Defendants-Appellees.

         APPEAL from the Franklin County Court of Common Pleas (C.P.C. No. 15CV-5837)

         On brief:

          Michael H. Gertner; Law Offices of Karl W. Schedler, and Karl W. Schedler, for appellants.

         Argued:

          Karl W. Schedler.

         On brief:

          Grant A. Wolfe, and J. Robert Rishel, Special Counsel for appellees State of Ohio Department of Administrative Services, and Robert Blair, Director of the Department of Administrative Services.

         Argued:

          Grant A. Wolfe.

         On brief:

          Kegler, Brown, Hill & Ritter, L.P.A., and Ralph E. Breitfeller, for appellees United Health Group Incorporated, United HealthCare Services, Inc., and United HealthCare Insurance Company of Ohio.

         On brief:

          Fraser Trebilcock, and Thaddeus E. Morgan, pro hac vice for appellees United Health Group Incorporated, United HealthCare Services, Inc., and United HealthCare Insurance Company of Ohio.

          DECISION

          DORRIAN, J.

         {¶ 1} Plaintiffs-appellants, B.H. and R.H. (collectively, "appellants"), appeal from a judgment of the Franklin County Court of Common Pleas granting motions for judgment on the pleadings filed by defendants-appellees, the Ohio Department of Administrative Services and Robert Blair, in his official capacity as director of the Department of Administrative Services (collectively, "DAS"), and UnitedHealth Group, Incorporated, United HealthCare Services, Inc., and United HealthCare Insurance Company of Ohio (collectively, "United"). Because we conclude the portion of the judgment granting United's motion for judgment on the pleadings is not a final, appealable order, we dismiss the appeal to the extent it challenges that portion of the judgment. Further, because we conclude the trial court did not err by granting judgment on the pleadings in favor of DAS, we affirm that portion of the judgment.

         I. Facts and Procedural History

         {¶ 2} B.H. is an employee of the state of Ohio and receives health insurance coverage through his employer. R.H. is B.H.'s son and is also covered as a dependent through B.H.'s state employee health insurance plan. From July 11, 2012 until July 10, 2013, R.H. received mental health treatment at a residential treatment facility in Virginia. B.H. asserts that United denied insurance coverage for R.H.'s treatment at the residential facility in two letters issued on July 12 and August 8, 2012. B.H. claims that he and his wife paid the full cost of R.H.'s treatment, a total of $134, 600, as a result of the denials of coverage.

         {¶ 3} Appellants filed a complaint in the Franklin County Court of Common Pleas on July 9, 2015, asserting they were entitled to a declaratory judgment because United and DAS had wrongfully denied insurance coverage for R.H.'s treatment. Appellants sought judgment against United and DAS for the amount that would have been paid under the insurance plan, which they asserted to be 60 percent of the total cost. Appellants asserted United and DAS breached their fiduciary duties by failing to provide a full and fair review of appellants' insurance claims. Appellants further ...


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