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Fraud and deception alleged in class action lawsuit against Teachers Health Trust

Teachers paid for healthcare they didn't receive
Posted at 5:45 PM, Dec 11, 2017
and last updated 2018-11-21 16:56:36-05

We count on them to teach and care for our children every day.  

But in many cases, they cannot care for themselves.  

"Medication is not affordable and access to care is not available," Clark County School District teacher Sheri DeBartolo told Darcy Spears in May.

DeBartolo has since left CCSD in order to get more reliable health insurance.

"And it's very difficult and it's very frustrating," said former CCSD school psychologist Diana Goodsell, who also quit CCSD over inadequate healthcare.

Goodsell, DeBartolo and CCSD Special Education Facilitator Paul Feaker are spearheading the lawsuit against Teachers Health Trust, its administrator, WellHealth, and its board of directors for negligence, fraud and deception.

"When you purchase a product, especially a health insurance product, you expect to have your medical claims paid," said Attorney Matthew Callister, whose firm is representing the plaintiffs.

According to the lawsuit, Teachers Health Trust routinely denies valid medical claims and charges sky high co-pays.  

CCSD educators often have to choose between paying out of pocket or not getting care.  

After Diana Goodsell was side-swiped in a car accident, she was forced to delay a needed cervical spinal fusion surgery when her entire year's out-of-pocket expense was demanded up front.

"It was $6,800 in one lump sum."

She says she didn't find that out until the morning of the surgery when she was being admitted.

"It was shocking to me that there would be any kind of average family that worked for the school district--or even the average family in this valley--that could afford to pay that much to have a needed surgery."

The lawsuit also says teachers are being turned away by doctors, even "sued by providers WellHealth refused to pay."

"I can't fathom the fact that we can treat people so poorly who do so much for the kids in this community, and do so little to make sure that they're taken care of, and really to the point of putting people and families on the brink of medical bankruptcy."

The school district says it provided a $9 million-dollar bailout to the Teachers Health Trust in 2016, but the trust paid 100,000 fewer claims last year than the year before.  

The class action could cover an estimated 30,000 people.

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