Pearson

Pearson v. Prudential Health Care Plan of California, Inc.

Good Law
942 F. Supp. 1284·1996 WL 603786·1996 U.S. Dist. LEXIS 19448
United States District Court, Eastern District of CaliforniaApril 10, 1996No. CIV-S-94-1255 DFL PANCalifornia3,496 words

Opinion

lead Opinion

Levi, J.

AMENDED MEMORANDUM OF OPINION AND ORDER

Plaintiffs Gary and Cynthia Pearson (“the Pearsons”) brought suit to recover benefits under health insurance and health maintenance plans provided by defendants Prudential Health Care Plan of California, Inc. (‘Trucare”) and Omni Healthcare, Inc. (“Omni”). The parties have made cross-motions for summary judgment. 1

*1286 I. Factual Background

Beginning in December, 1992 the Pearsons were covered under a group health plan issued by Prucare to Gary Pearson’s employer, Mepco Label Systems (“Mepco”). On March 26, 1993 Mepco canceled its policy with Pru-care effective March 31, 1993. Mepco then entered into a contract with Omni, under which the Pearsons were covered effective April 1, 1993.

Cynthia Pearson visited the emergency room at Dameron Hospital in Stockton, California for labor pains on March 31, 1993. She was sent home that same evening. On the following day, she returned to Dameron, was admitted, and delivered her baby, Christopher Pearson. Due to complications in the delivery, she remained in Dameron for four days, and Christopher remained in Damer-on’s neonatal unit until April 30, 1993. The bill for Cynthia and Christopher’s stay…

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