Wota v. Blue Cross and Blue Shield

We granted certiorari to determine whether the court of appeals erred in affirming the summary judgment entered by the district court for Blue Cross and Blue Shield of Colorado (Blue Cross) and the dismissal of Michael Joseph Wota’s claim, under a group health plan, for medical expense benefits related to heart transplant surgery. Wota v. Blue Cross & Blue Shield, 820 P.2d 1137 (Colo.App.1991). We affirm.

At the time in controversy Wota was insured under a “Custom Plus” group health plan issued by Blue Cross. Under the plan, Wota received major medical-surgical and hospital benefits coverage…