Beverly v. Grand Strand Regional Medical Center, LLC
Beverly v. Grand Strand Regional Medical Center, LLC (South Carolina Court of Appeals, Jan. 15, 2020): A state appellate court held that a plaintiff insured through Blue Cross Blue Shield (BCBS) was a third party beneficiary to a contract between BCBS and Grand Strand Regional Medical Center through which the Center agreed to provide care to BCBS insureds at established rates. As a result, the plaintiff may proceed on her claim that the Center was not allowed to bill her directly for services or to bill her at rates higher than those established in the contract between BCBS and the Center. The court found that despite explicit contractual language that there are no intended third party beneficiaries, the contract as a whole established that the fundamental purpose of the contract was to allow BCBS insureds to receive care from the Center at established rates. The court therefore found that insureds were indeed third party contract beneficiaries. The plaintiff’s breach of contract claim alleging that the Center must only bill BCBS at the contractually agreed rates will proceed to trial. Read the decision here.
View all cases in the Judicial Trends in Public Health – February 18, 2020.