Williams v. California Physicians' Service

Plaintiffs Kent and Marjorie Williams appeal from summary judgment in favor of defendant California Physicians’ Service, doing business as Blue Shield of California (hereafter Blue Shield), in plaintiffs’ action alleging breach of contract and breach of the duty of good faith and fair dealing based on defendant’s refusal to pay for physical therapy for plaintiff Marjorie Williams under defendant’s health care service plan (the Plan). Plaintiffs contend the right to therapy “vested” on the date of injury and cannot be restricted by subsequent amendment of the contract upon its renewal. We shall affirm the judgment.

Factual and Procedural Background

On July 18, 1991, plaintiff Marjorie Williams was injured in an aircraft accident, assertedly rendering her an “incomplete quadriplegic.” At the time of the accident, plaintiffs were individual subscribers in the Plan with Blue Shield providing a maximum aggregate coverage of $2 million. (Plaintiffs assert on appeal that the Plan became effective May 8, 1991, but they cite no supporting evidence, and the complaint alleged the Plan was issued on or before March 1, 1991.) At the time of the accident, the Plan had no specific…