AGG Healthcare Litigation attorneys Rich Collins and Landen Benson represent two of the three named plaintiffs in an ERISA class action against UnitedHealthcare (“United”), involving the insurer’s denial of access to proton beam radiation therapy (“PBRT”) to treat cancer. The lawsuit — Weissman v. UnitedHealth Insurance Co., et al., Case No. 1:19-cv-10580 (D. Mass.) — was originally filed in 2019 by United insured and AGG client, Kate Weissman, who was denied access to PBRT to treat her cervical/gynecological cancer. After her claim was denied by United, she paid out of pocket for her lifesaving PBRT. Weissman subsequently filed a lawsuit to enjoin United from using its internal PBRT medical policy to deny PBRT treatment for similarly situated United members, and to recover reimbursement for her out-of-pocket expenses. The case was later consolidated in the United States District Court for the District of Massachusetts with two subsequently filed lawsuits challenging United’s denial of PBRT for individuals diagnosed with central nervous system cancer and prostate cancer.
On May 13, 2025, U.S. District Court Judge Allison D. Burroughs granted preliminary approval of a proposed $9.25 million class action settlement that revises United’s PBRT medical policy to expand access to PBRT. The settlement also provides up to $75,000 to each United member who, during the relevant time period, was denied PBRT treatment for cervical/gynecological, prostate, or primary central nervous system cancer and had to pay out of pocket for their treatment. This result could not have been achieved without the resilient efforts of all three named plaintiffs.
The proposed changes to United’s PBRT medical policy include removal of a list of 13 different cancer sites for which United deemed PBRT “unproven and not medically necessary due to insufficient evidence of efficacy for treating all other indications.” If the proposed settlement is approved, individuals may access coverage for PBRT for these cancer sites if there is (1) documentation supporting that surrounding tissue cannot be spared with standard radiation; and (2) an evaluation and comparison of treatment plans for PBRT, intensity-modulated radiation therapy (“IMRT”), and stereotactic body radiation therapy (“SBRT”) for the specific member. The revisions to the policy reflect developments and studies supporting the use of PBRT, including the American Society of Radiation Oncology’s Model PBRT Policy.
Individuals may qualify for up to $75,000 in payment if they:
If the settlement fund is exhausted, class members who submitted claims will share in the recovery on a pro rata basis.
On June 12, 2025, notices were mailed to prospective class members. The deadline to submit claims is August 21, 2025. The deadline to opt out of the class or object to the settlement is July 28, 2025. If a class member fails to submit a claim and fails to opt out of the class, they will receive no compensation and be bound by the terms of the settlement agreement once approved. Please visit the United PBT Settlement website, call 1-888-562-4024, or email info@UnitedPBTSettlement.com for more information about the claim submissions process. Even if you did not receive a notice in the mail, you may still qualify as a class member.
For more information about the lawsuit and proposed settlement, to determine if you qualify as a class member, or if you are an individual or healthcare provider who has been denied PBRT coverage by an insurer, please contact AGG Healthcare Litigation attorneys Rich Collins or Landen Benson.
Authors:
Richard Collins, Partner
Email: rich.collins@agg.com
Landen Benson, Associate
Email: landen.benson@agg.com