Guarantee Trust Life Insurance Company v. Edward M. Gavin, D.C., D/B/A Gavin Chiropractic Clinic

GEE, Circuit Judge:

Facts

In 1984 and 1985, Dr. Gavin, a chiropractor, provided care to various Louisiana State University students who assigned to him their benefits under an insurance policy issued to them by Guarantee Trust through the University. In processing the claims, Guarantee Trust limited payment to Dr. Gavin pursuant to a policy provision restricting reimbursement for the kind of treatment he provided to eighty percent of the claim, up to $100 per month, with an annual limit of $1,000. Thereafter, Dr. Gavin attempted to recover the fees denied him, arguing that the policy provision…