Rizzi

Rizzi v. Blue Cross of Southern California

Good Law
1988 Cal. App. LEXIS 1129·206 Cal. App. 3d 380·253 Cal. Rptr. 541
Court of Appeal of CaliforniaDecember 2, 1988D006848California6,842 words

Opinion

Opinion

Work, J.

Anthony Rizzi appeals a summary judgment for Blue Cross of Southern California (Blue Cross) after the trial court concluded Rizzi’s complaint—alleging, inter alia, violations of California Insurance Code section 790.03 in the denial of his claim for medical benefits under his employer’s group insurance policy—was preempted by the Employee Retirement Income Security Act (ERISA; see 29 U.S.C. § 1001 et seq.). We affirm the judgment because we conclude substantial evidence supports the trial court’s finding the group insurance program was an employee welfare benefit plan established by Rizzi’s employer under ERISA and the cause of action based on California Insurance Code section 790.03 is preempted by ERISA (§ 1144).

I

Rizzi’s complaint alleges that in January 1975, Blue Cross issued an employees group health insurance policy to his employer, New Way Enterprises. After being notified by Blue Cross that he was insured, he incurred medical expenses, for which he filed a claim. However, Blue Cross allegedly failed and delayed to make medical benefit payments knowing he was entitled to them and with insufficient information to justify their action, misrepresented policy…

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