Cargill, Blue Cross Win ERISA Benefit Denial Case

A participant in Cargill Inc.'s medical plan can’t continue with his ERISA claim that the plan and its claims administrator were unreasonable in denying coverage for spinal fusion surgery, the U.S. District Court for the Southern District of Illinois ruled (Kaemmerer v. Cargill Inc., 2016 BL 12138, S.D. Ill., 15-CV-856-SMY-DGW, 1/15/16).

In her Jan. 15 opinion, Judge Staci M. Yandle granted summary judgment to the plan and the claims administrator, holding that they acted reasonably in denying benefits to a participant who failed to timely provide “straightforward documentation” required by the plan to cover spinal surgery.

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