Raymond v. Halifax Hospital Medical Center

COWART, Judge.

This case involves the question of whether an insured has a cause of action against an insurer because the insurer mistakenly paid a third party (a hospital) and the third party voluntarily refunded to the insurer; the hospital bill being admittedly not covered by the insurance policy.

An insured, now deceased, had a medical insurance policy with appellee Blue Cross providing medical coverage to the insured. The policy excluded preexisting conditions. The insured received hospital services relating to a condition preexisting the insurance policy, the hospital sent a bill to Blue…