Blue Cross and Blue Shield of Kansas, Inc. v. Riverside Hospital

237 Kan. 829, 703 P.2d 1384 (1985)

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Blue Cross and Blue Shield of Kansas, Inc. v. Riverside Hospital

Kansas Supreme Court
237 Kan. 829, 703 P.2d 1384 (1985)

  • Written by Sheryl McGrath, JD

Facts

Leslie Stadalman (Leslie) had group health- insurance coverage through her employer, Riverside Hospital (Riverside) (defendant). Stadalman’s spouse had group health-insurance coverage through his employer, the City of Wichita, and the coverage was provided by Blue Cross and Blue Shield of Kansas, Inc. (BCBS) (plaintiff). The BCBS insurance contract covered the employees’ dependents. In 1982, Leslie incurred medical expenses. Both Riverside and BCBS initially declined to cover the expenses. Riverside and BCBS each said that the other company must pay Leslie’s claim. Riverside and BCBS based their denials on their respective insurance contracts’ provisions regarding duplication of benefits and coordination of benefits. Both companies’ insurance contracts contained provisions stating that the contracts were secondary to any other coverage. BCBS eventually paid Leslie’s claim, and then BCBS sued Riverside in district court for reimbursement. The district court ruled that the coordination-of-benefits clauses in the two insurance contracts conflicted, and that as a result each insurance company must pay one-half of Leslie’s claim. Both insurance companies appealed.

Rule of Law

Issue

Holding and Reasoning (McFarland, J.)

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