Squillace v. Wyoming State Employees' & Officials' Group Insurance Board of Administration

I respectfully dissent. There is little question that an insurer is not required to pay for medical treatment simply because a treating physician has recommended the treatment. It is equally certain, however, that an insurer does not have sole discretion to decide that medical treatment obtained upon advice of a physician is not medically necessary. Upon the request of either the insurer or the insured, courts may review insurance payment decisions and the assessment procedures utilized by the insurers in making its decision. In conducting that review, courts must not add terms to a contract…