Torts

I am currently employed at Blue Cross Blue Shield and there are many torts of liablity issues that arise. There was an incident that happen which led to negligence and intetional torts. Ther was a plantiff and his daughter seeking to recover medical expenses incurred by his daughter for inpatient medical care received by her while she was a college student. HealthNow issued a group health insurance policy insuring the partners and employees of the law firm of which he is a partner, and his daughter was also covered by that policy. HMO-CNY is a managed care subsidiary of Blue Cross & Blue Shield of Central New York, which serves the territory where his daughter went to college. By contract issued directly to him, HMO-CNY furnished coverage for her as a "guest member" while she resided outside the service area of HealthNow. His daughters primary health care providers requested authorization from HMO-CNY for inpatient care for an eating disorder. Those requests were denied on the grounds that the services provided were "not the most appropriate course of treatment" and that the facility was a nonparticipating provider. Jane Doe nevertheless sought and received inpatient treatment at two out-of-state long-term care facilities from March 5, 1998 through June 4, 1998.

There was action against HMO-CNY on July 14, 1999, seeking to recover the expenses incurred in those facilities. They sought leave to serve a supplemental summons and amended complaint adding HealthNow as a defendant in February 2001, and leave was granted by the court upon stipulation of the parties. The amended complaint asserts in allegations directed at both defendants, causes of action for breach of contract, negligence, and "intentional tort." The action was commenced against HealthNow by filing the supplemental summons and amended complaint on March 12, 2001.