Fuja v. Benefit Trust Life Insurance Company
United States Court of Appeals for the Seventh Circuit
18 F.3d 1405 (1994)
In August 1989, Grace Fuja (plaintiff) was diagnosed with breast cancer. Fuja underwent a lumpectomy, a modified radical mastectomy, and then six months of chemotherapy treatment. Although Fuja’s breast cancer went into remission, in February 1992, her oncologist discovered that the cancer had spread to both of her lungs. Fuja received standard chemotherapy from February until December 1992. Fuja’s doctor then determined that chemotherapy would not increase her chance of survival. As a result, Fuja’s doctor prescribed a regimen of HDC/ABMT, which was a treatment that involved removing and freezing a patient’s bone marrow, subjecting the patient to high-dose chemotherapy, and then reinfusing the patient’s bone marrow. HDC/ABMT had been proven effective in treating certain types of cancers, but it was not universally accepted. Benefit Trust Life Insurance Company (Benefit Trust) (defendant) refused to cover HDC/ABMT, because Benefit Trust claimed, HDC/ABMT was not medically necessary under the insurance contract. Benefit Trust claimed that this was, in part, because HDC/ABMT was “furnished in connection with medical or other research.” Fuja sued Benefit Trust to enjoin Benefit Trust from denying coverage. After a hearing, the court ordered Benefit Trust to pay for Fuja’s HDC/ABMT treatment. Fuja underwent the treatment, but the treatment was unsuccessful, and Fuja died in April 1993. Benefit Trust appealed.
Rule of Law
Holding and Reasoning (Coffey, J.)
What to do next…
Unlock this case brief with a free (no-commitment) trial membership of Quimbee.
You’ll be in good company: Quimbee is one of the most widely used and trusted sites for law students, serving more than 97,000 law students since 2011. Some law schools—such as Yale, Vanderbilt, Berkeley, and the University of Illinois—even subscribe directly to Quimbee for all their law students. Read our student testimonials.
Learn more about Quimbee’s unique (and proven) approach to achieving great grades at law school.
Quimbee is a company hell-bent on one thing: helping you get an “A” in every course you take in law school, so you can graduate at the top of your class and get a high-paying law job. We’re not just a study aid for law students; we’re the study aid for law students. Read more about Quimbee.
Here's why 175,000 law students have relied on our case briefs:
- Written by law professors and practitioners, not other law students. 14,000 briefs, keyed to 188 casebooks. Top-notch customer support.
- The right amount of information, includes the facts, issues, rule of law, holding and reasoning, and any concurrences and dissents.
- Access in your classes, works on your mobile and tablet. Massive library of related video lessons and high quality multiple-choice questions.
- Easy to use, uniform format for every case brief. Written in plain English, not in legalese. Our briefs summarize and simplify; they don’t just repeat the court’s language.