Deno Price v. Provident Life and Accident, Insurance Company, Aka, the Provident the Florsheim Shoe Company, AKA the Florsheim Shoe Company-South

Deno Price filed suit to recover damages against Provident Life and Accident Insurance Company for its failure to pay medical expenses incurred by his decedent son under an insurance contract issued through his employer. The district court granted summary judgment in favor of Provident, holding that the statute of limitations had run on Price’s claim.

We reverse.

Deno Price was provided medical benefits by Provident through his employer, Florsheim Shoes, from April 26, 1982 through May 18, 1984. The policy provided coverage to Price’s offspring from birth. Price’s son, Andre, was born September 9, 1982. Andre was born with biliary atresia, a serious medical condition, for which he received extensive treatment between January 1983 and his death on April 20, 1984. The hospital submitted his bills directly to Provident. Price filed a claim with Medi-Cal, the state of California’s version of Medicaid, to cover any costs that exceeded Provident’s policy limit of $100,000.

Provident sent Price thirty-three notices, thirty of which indicated payment of various medical bills and three of which indicated nonpayment of bills due to a “preexisting condition”. In January and March 1983,…