UnitedHealthcare $6.75 Million Proton Therapy Denial Settlement

Consumers who were members, participants, or beneficiaries of a UnitedHealthcare Insurance Co. or UnitedHealthcare Services LLC employee welfare benefit plan, and who received a denial of coverage for proton beam radiation therapy (PBRT) between March 26, 2016, and August 28, 2023, may be eligible to receive up to $75,000 from a $6.75 million class action settlement.

UnitedHealthcare Insurance Co. and UnitedHealthcare Services LLC agreed to pay $6.75 million to resolve allegations that they wrongfully denied coverage for PBRT to treat prostate, primary central nervous system, cervical, and gynecological cancers.

Who Is Eligible

Class members must meet all of the following criteria:

  • Were members, participants, or beneficiaries of an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA) that was administered or insured by UnitedHealthcare Insurance Co. and/or UnitedHealthcare Services LLC.
  • Between March 26, 2016, and August 28, 2023, they or a covered beneficiary:
    • Were diagnosed with one of the following cancers: prostate cancer, primary central nervous system cancer, cervical cancer, or another gynecological cancer.
    • Received a denial of a precertification request or post-service benefit claim for PBRT for clinical reasons.
    • Paid out-of-pocket for PBRT treatment following the denial.
    • Did not receive reimbursement for PBRT from another commercial, self-funded, or government health benefits provider.

Individuals who received a notice from the settlement administrator indicating their eligibility are likely class members according to UnitedHealthcare’s records.

Potential Settlement Payments

Eligible class members may receive reimbursement of up to $75,000 for out-of-pocket PBRT treatment costs paid or still owed for covered cancers.

If the total amount of valid claims exceeds the $6.75 million fund, payments will be reduced on a pro rata basis.

How to Submit a Claim

Class members must submit a claim form and supporting documentation by October 29, 2025. Claims can be submitted in any of the following ways:

  • Complete the online claim form.
  • Download, print, fill out, and mail the claim form.
  • Email the completed form and documentation to the settlement administrator.
  • Mail the completed claim form and documentation to:

United PBT Settlement Administrator
c/o Rust Consulting Inc.
8966 P.O. Box 2599
Faribault, MN 55021-9599
Email: info@UnitedPBTSettlement.com

Class members filing online must include the claimant ID number found on their settlement notice.

Required Documentation

Claimants must provide documentation supporting the amount claimed. Acceptable proof includes:

  • Receipts or invoices for PBRT treatment from a hospital, treatment center, or physician.
  • Cancelled checks or credit card statements.
  • Documentation from UnitedHealthcare Insurance Co.
  • Loan or collection records related to unpaid PBRT bills.
  • Self-pay agreements or current outstanding invoices from providers.

Payment Method

The settlement administrator will mail checks directly to the address provided by each eligible claimant on their claim form.

Settlement Fund Details

The settlement includes:

  • Up to $2,500,000 for settlement administration costs, attorneys’ fees and expenses, and service awards to class representatives (paid separately).
  • Up to $6.75 million in payments to eligible class members.

Important Dates

  • Deadline to opt out: July 28, 2025
  • Claim submission deadline: October 29, 2025
  • Final approval hearing: December 12, 2025

Payment Timeline

Payments will be issued after the court grants final approval of the settlement and any appeals have been resolved.

Case Background

The lawsuit alleged that UnitedHealthcare wrongfully denied precertification requests and post-service benefit claims for proton beam radiation therapy under ERISA-governed plans. Plaintiffs claimed the denials were improper and violated federal benefit laws.

UnitedHealthcare denied wrongdoing but agreed to the settlement to avoid the cost and uncertainty of continued litigation. As part of the agreement, the company also agreed to revise its PBRT coverage policy.

Summary

  • Settlement amount: $6,750,000
  • Maximum payment: Up to $75,000 per eligible claimant
  • Claim deadline: October 29, 2025

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