Parnell
Parnell v. Adventist Health System/West
Opinion
Opinion
VARTABEDIAN, Acting P.J.
This is an appeal from a judgment on the pleadings entered against plaintiff on his Unfair Practices Act complaint. We reverse the judgment and remand the case for further proceedings.
Appellant Joel K. Parnell had medical insurance through the Wholesale Beer Distributor Industry Trust Health Plan (the Plan). The Plan had entered into a contract with Community Care Network (CCN), a "preferred provider" network, which in turn had contracts for medical services with numerous hospitals and doctors. One such hospital with which CCN had a services contract was respondent San Joaquin Community Hospital, owned and operated by respondent Adventist Health System/West. Both entities are California nonprofit corporations; we will refer to them collectively as respondent.
In 1997, appellant was injured in an automobile accident while he was a passenger in a taxicab. Appellant received hospital care from respondent as a preferred provider under the Plan. Respondent presented a claim for payment to the Plan and received payment in full (from the Plan and from appellant's copayment) at the rates specified in the various provider contracts.