SPADAFORE v. BLUE SHIELD

No. 84AP-232.

21 Ohio App. 3d 201 (1985)

SPADAFORE, APPELLANT; WEISENSTEIN, APPELLEE, v. BLUE SHIELD, OHIO MEDICAL INDEMNITY CORPORATION, APPELLEE.

Court of Appeals of Ohio, Franklin County.

Decided January 15, 1985.


Attorney(s) appearing for the Case

Terry D. Van Horn, for appellant.

Vorys, Sater, Seymour & Pease and Jonathon M. Norman, for appellee.


VICTOR, J.

James Spadafore, plaintiff-appellant, after consultation with his family dentist, Dr. Paul R. Weisenstein, submitted a claim in August 1981 for predetermination of benefits to Ohio Medical Indemnity Mutual Corporation (hereinafter "Blue Shield"). A predetermination was required by the contract because the proposed dental work would exceed $100 and, in fact, would cost $2,400. Dr. Weisenstein prepared the claim form and X-rays and sent these to the insurance...

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