Clinton H. Mitchell and Agnes W. Mitchell v. Occidental Insurance, Medicare

Clinton and Agnes Mitchell (Appellants) seek to review benefits paid under Supplemental Medical Insurance Benefits for the Aged Program (Supplemental Benefits). 42 U.S.C. §§ 1395 et seq. The district court dismissed their action for lack of subject matter jurisdiction. They appeal. We affirm.

The Mitchells filed this action in Small Claims Court, Mt. San Jacinto Judicial District, County of Riverside, California, to recover $40.00, the amount disallowed by Occidental Life Insurance Company (Occidental) acting in its capacity as a carrier for the Medicare Program. Occidental contracted with the Government to administer benefits and claims for Supplemental Benefits under the Medicare Program. Occidental determined that of $240.75 in claims submitted by the appellants only $188.75 was reasonable and allowable. The program reimburses 80 per cent of reasonable charges; the $40.00 in issue is the difference between the claims submitted and the amounts allowed.

In Kuenstler v. Occidental Life Insurance Company, 292 F.Supp. 532 (C.D.Cal.1968), a case involving the same issues, the district court in a well considered opinion held that the action was properly removed from the small claims…