Wimer v. Pennsylvania Employees Benefit Trust Fund

OPINION

Justice BAER.

We granted review in this healthcare subrogation case to address the following issues. First, whether a recipient of healthcare benefits paid by the Pennsylvania Employees Benefit Trust Fund (hereinafter “PEBTF” or “Appellant”) is contractually obligated, when challenging a subrogation claim and a termination of healthcare benefits, to exhaust internal appeals to PEBTF’s Board of Trustees prior to seeking recourse through filing an action for declaratory judgment with a court. Second, whether PEBTF’s right to subrogation against a healthcare recipient’s recovery from a…