Patient lawsuit alleges Delta Dental misrepresents out-of-network coverage

Defendants scheduled to respond to complaint by April 7

A class-action lawsuit filed by patients insured by Delta Dental alleges the insurer misrepresents its out-of-network coverage.

The lawsuit, which was filed Dec. 31, 2025, in the U.S. District Court for the Southern District of New York, claims Delta Dental covers less than its stated percentage for out-of-network treatment. It alleges Delta Dental tells policyholders it will cover 50%-100% of the cost of out-of-network dental services, but that reimbursement is based on an internal price set by the insurer rather than the fee charged by the provider.

The plaintiffs further allege Delta Dental will not disclose its internal price to customers even if they ask for it, making it difficult for them to determine what they will ultimately need to pay for out-of-network treatment.

The lawsuit names Delta Dental Plans Association and its affiliates as defendants. The defendants who have been served to date are scheduled to respond to the complaint by April 7.