Legal Opinion
Pacificare Inc., Dba Pacificare of California v. Vernon D. Martin Sherrie Sue Martin, and Scott Douglas Martin, a Minor
Court of Appeals for the Ninth Circuit
Decided September 1, 1994No. 92-55476PublishedCited by 43 opinions
1Opinion of the Court
Opinion by Judge O’Scannlain; Dissent by Judge Norris.
O’SCANNLAIN, Circuit Judge:
We must decide whether an ERISA plan health insurer has a cause of action against its insured for reimbursement of medical expenses advanced under the policy when the insured recovers a full award against a third party.
I
Scott Martin was insured under a pre-paid health plan pursuant to a group subscriber agreement between Pacificare, a federally-qualified health maintenance organization, and his father’s employer, Thums Long Beach Company (“Thums”). The agreement included a provision requiring the insured to…
2Cases cited8 opinions
- Pilot Life Insurance v. DedeauxSupreme Court of the United States · 1987
- Provident Life & Accident Insurance Company v. Mary J. Waller, Provident Life & Accident Insurance Company v. Mary J. WallerCourt of Appeals for the Fourth Circuit · 1990
- Theodore Kanne and Beatriz Kanne v. Connecticut General Life Insurance Company, Lincoln National Life Insurance Company and Harlow Carpets, Inc., Theodore Kanne and Beatriz Kanne v. Connecticut General Life Insurance CompanyCourt of Appeals for the Ninth Circuit · 1989
- Pm Group Life Insurance Co. v. Western Growers Assurance Trust, Loma Linda University Medical CenterCourt of Appeals for the Ninth Circuit · 1992
- Credit Managers Ass'n v. Kennesaw Life & Accident InsuranceCourt of Appeals for the Ninth Circuit · 1987
3 more not listed; retrieve them via the Exa API.
3Cited by43 opinions
- Reich v. LancasterCourt of Appeals for the Fifth Circuit · 1995
- Aetna Life Insurance Company v. Rey L. BayonaCourt of Appeals for the Ninth Circuit · 2000
- Alan Stuart G. Raleigh Hanbury v. Unum Life Insurance Company of America, and Desert HospitalCourt of Appeals for the Ninth Circuit · 2000
- Cement Masons Health And Welfare Trust Fund For Northern California v. Raymond StoneCourt of Appeals for the Ninth Circuit · 1999
- JOHN MCKEEHAN, — v. CIGNA LIFE INSURANCE COMPANY LIFE INSURANCE COMPANY OF NORTH AMERICA, —Court of Appeals for the Eighth Circuit · 2003
38 more not listed; retrieve them via the Exa API.