Schroeder Ex Rel. Swanson v. Blue Cross & Blue Shield United of Wisconsin

In this insurance case, the trial court granted summary judgment to Blue Cross & Blue Shield (Blue Cross), holding that the Schroeders' expenses for home care treatment were not covered by their Medex-Plus Medicare supplement policies. We reverse, holding that the trial court improperly found that Blue Cross had reserved the right independently to determine the appropriateness of doctor-certified treatment.

Michael and Helen Schroeder were an elderly husband and wife, 1 each covered by the federal Medicare program and by a Blue Cross insurance policy supplementing Medicare coverage,…