Alvin Jones, Dolores Jones, James (Haim) Bicher, James (Haim) Bicher M.D., Inc. v. Laborers Health & Welfare Trust Fund

Plaintiffs appeal the district court’s grant of summary judgment against their claim that the Laborers Health & Welfare Trust Fund improperly denied them benefits. We affirm.

BACKGROUND

Alvin Jones is a participant in an insurance plan that defendant Trust Fund provides. This dispute arose when the Trust Fund refused to pay for certain treatments for Jones’s wife, who was suffering from breast cancer. The Trust Fund denied payment for these treatments — a regimen of hyperthermia — because they were “not medically necessary.” The Trust Fund relied on the opinion of its medical consultant, Dr. White, who stated that hyperther-mia was “experimental” and “not therapeutically effective.” Jones presented the testimony of Dr. Bicher, the physician who prescribed the hyperthermia treatment. Bicher stated that the treatment was effective and that other insurance carriers pay for it. Jones appealed the Trust Fund’s denial of benefits to the district court, which upheld the Trust Fund’s decision. Jones now appeals the district court’s decision.

DISCUSSION

A. Standard of Review

Plaintiffs argue that the district court relied on an improper standard of review in granting summary judgment.…