Blue Cross Blue Shield of Texas v. Duenez

Xavier Duenez was a state employee who was insured — through the Employee Retirement System of Texas (ERS) — by Blue Cross Blue Shield of Texas. 1 When his daughter was seriously injured in an automobile accident, Duenez sought benefits from BCBS. Initially, BCBS certified that his daughter’s private nursing care was covered, but later informed him that it planned to discontinue the coverage. In response, Xavier and Irene Duenez, individually and as next friends of their daughter, brought suit in district court, seeking a declaratory judgment that the care was covered, and injunctions…