Cooper
Cooper v. Premera Blue Cross
Opinion
Lead Opinion
MEMORANDUM *
Joseph Cooper filed a claim under the Employee Retirement Income Security Act (“ERISA”) against his medical insurance provider, Premera Blue Cross (“Premera”), after its affiliate Calypso Healthcare Solutions (“Calypso”), sought and received reimbursement of benefits paid to Cooper. Premera claims it was entitled to the reimbursement under the group health insurance plan (the “Plan”) that governed Premera’s liability to Cooper.
The district court granted Premera’s motion for summary judgment, holding that Premera was entitled to recover PIP benefits paid to Cooper. We review that decision de novo, see Qwest Comm’ns, Inc. v. Berkeley, 433 F.3d 1253 , 1256 (9th Cir.2006), and affirm the district court.
At the time he was injured, Cooper had PIP and UM coverage through his liability insurance carrier, Allied Insurance Company (“Allied”). He therefore sought payments from Allied under the PIP and UM policies. Allied initially denied Cooper’s PIP claim in July 2004, because the PIP policy did not cover injuries caused by ATVs.
Cooper later resubmitted his PIP claim to Allied, and in May 2005 Allied reversed its denial. As a result, Cooper received $10,000 (the PIP…