An insurance carrier cannot use a general exclusion barring coverage for in-school treatment

“Ultimately, we simply do not believe that the legislature intended to permit insurers to exclude coverage in the sensory-laden educational environment where children spend large portions of their days, or to require families to litigate the issue of medical necessity discretely in individual cases to secure such location-specific coverage for the treatment,” Pennsylvania Supreme Court Chief Justice Thomas Saylor, who wrote the 22-page majority opinion, said. See full article

Article Author, Max Mitchell from, Justices Nix Exclusion Barring In-School Coverage for Autism Treatment, October 10, 2017.