Caldwell

INTRODUCTION

19 Affiliated plan administrators move for summary judgment on all claims brought by a 20 class of medical insurance plan beneficiaries seeking coverage for liposuction to treat 21 lipedema.

STATEMENT

23 Class representative Mary Caldwell received medical insurance through her husband’s 24 employer, Oracle (Def. Exh 108 at UHC_CALD_0000651; Def. Exh. 28 at 25 UHC_CALD_0001082). Oracle funded the insurance but delegated plan administration to 26 UnitedHealthCare Insurance Company (“United”) (Def. Exh. at UHC_CALD_0001082). 27 Caldwell sought treatment of her lipolymphedema, the late-stage form of lipedema, a chronic progressive condition causing the abnormal accumulation of fat deposits in the trunk and appendages that can possibly become painful, immobilizing, and lead to other health consequences. Since 2017, Caldwell has sought to treat her lipolymphedema with liposuction, a surgical procedure which uses suction to remove fatty tissue from the body. Caldwell requested that United approve coverage for liposuction and was twice denied on the basis that her request fell under United’s “unproven” exclusion. Caldwell…