Legal Opinion
LifeCare Management Services LLC v. Insurance Management Administrators Inc.
Court of Appeals for the Fifth Circuit
Decided January 4, 2013No. 11-10733PublishedCited by 70 opinions
1Opinion of the Court
HIGGINSON, Circuit Judge:
A third-party administrator of medical benefits plans denied claims made on behalf of two patients who received treatment from the same medical provider. The district court found that (1) the plan administrator incorrectly interpreted the plans to deny the claims in a way that abused its discretion and (2) the administrator may be held liable for its wrongful denial. The district court also awarded attorneys’ fees to the medical provider. We AFFIRM.
1. Facts and Proceedings
Christopher Evans suffered a cervical spine fracture that resulted in quadriplegia. Evans…
2Cases cited33 opinions
- Metropolitan Life Insurance v. GlennSupreme Court of the United States · 2008
- Pegram v. HerdrichSupreme Court of the United States · 2000
- Hardt v. Reliance Standard Life Insurance Co.Supreme Court of the United States · 2010
- Harris Trust & Savings Bank v. Salomon Smith Barney Inc.Supreme Court of the United States · 2000
- Vilma Lissette Vega Jose Vega v. National Life Insurance Services, Inc., Pan-American Life Insurance CompanyCourt of Appeals for the Fifth Circuit · 1999
28 more not listed; retrieve them via the Exa API.
3Cited by70 opinions
- Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc.Court of Appeals for the Ninth Circuit · 2014
- Cynthia Larson v. United Healthcare Insurance CoCourt of Appeals for the Seventh Circuit · 2013
- New York State Psychiatric Ass'n v. UnitedHealth GroupCourt of Appeals for the Second Circuit · 2015
- Wendy Davis v. Rick PerryCourt of Appeals for the Fifth Circuit · 2015
- Terri Truitt v. Unum Life Ins Co. of AmericaCourt of Appeals for the Fifth Circuit · 2013
65 more not listed; retrieve them via the Exa API.