PACIFICARE INC. v. MARTIN

No. 92-55476.

34 F.3d 834 (1994)

PACIFICARE INC., dba Pacificare of California, Plaintiff-Appellee, v. Vernon D. MARTIN; Sherrie Sue Martin, Defendants, and Scott Douglas Martin, a minor, Defendant-Appellant.

United States Court of Appeals, Ninth Circuit.

Submission Deferred August 20, 1993.

Submitted December 2, 1993.

Decided September 1, 1994.


Attorney(s) appearing for the Case

Ernest J. Franceschi, Jr., Los Angeles, CA and William E. Cavanaugh, Costa Mesa, CA, for defendant-appellant.

Jon N. Manzanares, Konowiecki & Rank, Los Angeles, CA, for plaintiff-appellee.

Before: NORRIS, WIGGINS, and O'SCANNLAIN, Circuit Judges.


Opinion by Judge O'Scannlain; Dissent by Judge Norris.

O'SCANNLAIN, Circuit Judge:

We must decide whether an ERISA plan health insurer has a cause of action against its insured for reimbursement of medical expenses advanced under the policy when the insured recovers a full award against a third party.

I

Scott Martin was insured under a pre-paid health plan pursuant to a group subscriber agreement between Pacificare, a federally-qualified...

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