C.J., and F.R. v. United Healthcare Insurance Company, United Behavioral Health, Cigna Health and Life Insurance Company, Cigna Behavioral Health, and the Pittsburgh Foundation Benefits Plan

CourtDistrict Court, D. Utah
DecidedJune 10, 2026
Docket2:22-cv-00092
StatusUnknown

This text of C.J., and F.R. v. United Healthcare Insurance Company, United Behavioral Health, Cigna Health and Life Insurance Company, Cigna Behavioral Health, and the Pittsburgh Foundation Benefits Plan (C.J., and F.R. v. United Healthcare Insurance Company, United Behavioral Health, Cigna Health and Life Insurance Company, Cigna Behavioral Health, and the Pittsburgh Foundation Benefits Plan) is published on Counsel Stack Legal Research, covering District Court, D. Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
C.J., and F.R. v. United Healthcare Insurance Company, United Behavioral Health, Cigna Health and Life Insurance Company, Cigna Behavioral Health, and the Pittsburgh Foundation Benefits Plan, (D. Utah 2026).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF UTAH

C.J., and F.R., MEMORANDUM DECISION AND ORDER GRANTING IN PART [109] Plaintiffs, PLAINTIFFS’ MOTION FOR ATTORNEY’S FEES v. Case No. 2:22-cv-00092-DBB-CMR UNITED HEALTHCARE INSURANCE COMPANY, UNITED BEHAVIORAL District Judge David Barlow HEALTH, CIGNA HEALTH and LIFE INSURANCE COMPANY, CIGNA BEHAVIORAL HEALTH, and the PITTSBURGH FOUNDATION BENEFITS PLAN,

Defendants.

Before the Court is Plaintiffs’ Motion for Attorney’s Fees.1 BACKGROUND This case involves an insurance coverage dispute arising under the Employee Retirement Income Security Act of 1974. In February 2022, Plaintiffs filed a complaint alleging in part that Defendants violated ERISA by denying coverage for Plaintiff F.R.’s medically necessary mental health treatment and by failing to provide sufficient justification in support of that denial.2 On December 12, 2023, Plaintiffs voluntarily stipulated to dismiss Defendants United Healthcare Insurance Company and United Behavioral Health with prejudice.3

1 Motion for Attorney’s Fees, ECF No. 109, filed Jan. 9, 2026. 2 Compl. ¶¶ 59–65, ECF No. 2, filed Feb. 14, 2022. 3 Notice of Voluntary Dismissal, ECF No. 57, filed Dec. 12, 2023. The parties filed cross motions for summary judgment in February 2024. In their motion, Plaintiffs argued that the coverage denial was arbitrary and capricious and that Defendants’ actions violated the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”).4 Plaintiffs asked the court to find that the denial of benefits was arbitrary and capricious and to order Defendants to pay the benefits.5 Defendants argued the opposite in their motion, contending that the benefits denial was reasonable and based on substantial evidence and asking the court to uphold the benefits determination.6 Defendants further argued that, in the event the court found abuse of discretion, the case should be remanded for additional review.7 On September 24, 2024, the court granted in part Plaintiffs’ motion and denied Defendants’ motions.8 In its order, the court found that Defendants’ denial letters did not meet

ERISA’s minimum standards because they were conclusory, failed to state what clinical information was used to make the denial decision, did not cite to medical records, and failed to grapple with facts that could have justified awarding benefits.9 The court further found that Defendants did not consider relevant medical necessity opinion letters and failed to engage in a meaningful dialogue with Plaintiffs.10 Based on these findings, the court held that Defendants’ denial of coverage was arbitrary and capricious.11 However, the court was unable to determine from the record whether coverage was warranted, so the matter was remanded for further

4 Plaintiffs’ Motion for Summary Judgment (“Pls.’ MSJ”), ECF No. 67, filed Feb. 5, 2024. 5 Id. at 21, 22. 6 Cigna Motion for Summary Judgment (“Cigna MSJ”) 23, ECF No. 65, filed Feb. 5, 2024. 7 Id. at 37. 8 C.J. v. United Healthcare Ins. Co., No. 2:22-CV-00092, 2024 WL 4279007, at *1 (D. Utah Sept. 24, 2024). 9 Id. at *11–12. 10 Id. at 14. 11 Id. consideration.12 Following the remand, Defendants again denied coverage,13 and Plaintiffs chose

not to pursue further review.14 Plaintiffs now seek attorney’s fees.15 STANDARD In an ERISA action, “the court in its discretion may allow a reasonable attorney’s fee and costs of action to either party.”16 “A fee claimant need not be a prevailing party to be eligible for an award of attorney’s fees and costs under ERISA.”17 Instead, a court may award fees and costs under § 1132(g)(1), “as long as the fee claimant has achieved ‘some degree of success on the merits.’”18 The Tenth Circuit Court of Appeals has established five factors a court may consider in deciding whether to exercise its discretion to award attorney’s fees and costs under ERISA: (1) the degree of the opposing party’s culpability or bad faith; (2) the opposing party’s ability to satisfy an award of fees; (3) whether an award of fees would deter others from acting under similar circumstances; (4) whether the party requesting fees sought to benefit all participants and beneficiaries of an ERISA plan or to resolve a significant legal question regarding ERISA; and (5) the relative merits of the parties’ positions.19

“No single factor is dispositive and a court need not consider every factor in every case.”20

12 Id. at *14–15. The court also declined to reach Plaintiffs’ MHPAEA claim in light of the remand. Id. at *16. 13 See Post Remand Denial Letter, ECF No. 113-2, filed Mar. 2, 2026. 14 Motion for Attorney’s Fees 4; Cigna Opposition to Motion for Attorney’s Fees (“Cigna Opp’n”) 4, filed Mar. 2, 2026. 15 Defendant Pittsburgh Foundation Benefits Plan filed an opposition that incorporated the entirety of Defendant CIGNA’s opposition. See Pittsburgh Foundation Benefits Plan Opposition (“Plan Opp’n”), ECF No. 115, filed Mar. 9, 2026. Accordingly, the court will consider the CIGNA Opp’n as applying to all Defendants. 16 29 U.S.C.A. § 1132(g)(1). 17 Cardoza v. United of Omaha Life Ins. Co., 708 F.3d 1196, 1207 (10th Cir. 2013). 18 Hardt v. Reliance Standard Life Ins. Co., 560 U.S. 242, 245 (2010) (quoting Ruckelshaus v. Sierra Club, 463 U.S. 680, 694 (1983)). 19 Cardoza, 708 F.3d 1196 at 1207. 20 Id. DISCUSSION I. Some Degree of Success Plaintiffs first argue that they achieved “some degree of success on the merits” because they secured remand for further consideration.21 Defendants respond that Plaintiffs did not achieve any degree of success on the merits because the court denied Plaintiffs’ request for benefits and because Defendants, not Plaintiffs, requested remand in the event of a determination that the denial was arbitrary and capricious.22 Defendants further characterize the remand as a “procedural victory” that does not provide a basis for ERISA attorney’s fees.23 A remand order by itself may not always constitute some success on the merits.24 However, “[d]istrict courts routinely hold that a determination that an insurer has arbitrarily and

capriciously rejected a claim, paired with a remand, is enough to warrant an award of attorney’s fees.”25 In this case, the court agreed with Plaintiffs that Defendants’ denial of coverage was arbitrary and capricious.26 Thus, remand was not merely a procedural victory for Plaintiffs; it was based on a finding that Defendants failed provide a full and fair review as required by ERISA. Even though the court did not award benefits or resolve Plaintiffs’ MHPAEA claim,

21 Motion for Attorney’s Fees 3. 22 Cigna Opp’n 3–4. 23 Id. at 2. 24 See Manna v. Phillips 66 Co., 820 F. App’x 695, 703 (10th Cir. 2020) (unpublished) (“Accordingly, on these facts we cannot say that a remand order alone constitutes some success on the merits.”); see also L.E. v. Deseret Mut. Benefit Adm’rs, No. 2:20-CV-00707-RJS-DBP, 2023 WL 4083381, at *13 (D. Utah June 20, 2023) (finding that a plaintiff “ha[d] not achieved much success on the merits” and was not owed attorney’s fees when the matter was remanded solely because the plaintiff had failed to exhaust her administrative remedies under the plan but that failure was excused under the circumstances). 25 Theo M. v. Beacon Health Options, Inc., No. 2:19-CV-00364-JNP-DBP, 2023 WL 4826771, at *3 (D. Utah July 27, 2023). 26 C.J. v. United Healthcare Ins. Co., No. 2:22-CV-00092, 2024 WL 4279007, at *14 (D. Utah Sept. 24, 2024). remand based on a finding that Defendants’ actions were arbitrary and capricious represents some success on the merits.27 II.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Hensley v. Eckerhart
461 U.S. 424 (Supreme Court, 1983)
Ruckelshaus v. Sierra Club
463 U.S. 680 (Supreme Court, 1983)
Blum v. Stenson
465 U.S. 886 (Supreme Court, 1984)
Cardoza v. United of Omaha Life Insurance
708 F.3d 1196 (Tenth Circuit, 2013)
Hardt v. Reliance Standard Life Insurance Co.
176 L. Ed. 2d 998 (Supreme Court, 2010)
Stoedter v. Gates
320 F. Supp. 3d 1265 (D. Utah, 2018)

Cite This Page — Counsel Stack

Bluebook (online)
C.J., and F.R. v. United Healthcare Insurance Company, United Behavioral Health, Cigna Health and Life Insurance Company, Cigna Behavioral Health, and the Pittsburgh Foundation Benefits Plan, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cj-and-fr-v-united-healthcare-insurance-company-united-behavioral-utd-2026.