Bixler V. Lucinda Bixler Case

Improved Essays
This case was brought by Mrs. Lucinda Bixler after the death of her husband, Vaughn. Mr. Bixler was employed by a company called Drivers who supplied truck drivers to local firms and was also a member of Teamsters Local 776. This union established a fund to supply members with medical, disability, and life insurance which the Bixlers were paying into and receiving benefits from. This fund is designed to accept contributions from the members of the union in line with collective bargaining agreements establishing a number of different levels of coverage.
Mr. Bixler just happened to become ill during a time when the bargaining was at a stalemate and coverage was in jeopardy of being cut to the members of the union fund. The managers of the fund intended to raise the dues required for coverage from $165 to $277 per month and Drivers wouldn’t agree to the new rate. After an attempt to negotiate an agreement it was determined that the Fund’s coverage of
…show more content…
Bixler stated she received the notice for coverage but it was after her husband was already in the hospital for the mortal heart condition. The notices had a 60 day opt-in period during which Mr. Bixler passed away. Both the fund and Drivers state they are not responsible for the medical bills incurred by Mr. Bixler, but it’s those medical costs Mrs. Bixler was trying to recoup. The court found the Fund was not liable since Mrs. Bixler was aware of the COBRA notice and had not elected coverage. The court did not rule on whether Drivers was liable for the medical costs as they did not determine if the employer was acting as a fiduciary in advising Mrs. Bixler. They could not determine if the employer knew about all the circumstances surrounding Mr. Bixler’s death and advising Mrs. Bixler to return the COBRA notice to elect coverage would allow payment of medical bills. The definition of whether the employer was acting as the Bixler’s fiduciary in this case was left to the lower court to

Related Documents

  • Improved Essays

    Ronald Vaden V

    • 904 Words
    • 4 Pages

    The court referred to previous cases and one in particular, Tonkovic vs. State Farm Mutual. The insured again had requested a disability policy that would pay home mortgage if he became disabled. The insurance agent who was aware of what was being requested, did not make an attempt to inform Tonkovic that this policy would not coincide with the coverage that was being…

    • 904 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Dr. Halle planned for Mr. Barnes to see a neurologist on January 31, and have a MRI and Echocardiogram within one week. But when Mrs. Barnes arrived from work she found Mr. Barnes sitting in a recliner and when she looked at him she noticed something was wrong. Mr. Barnes did not look okay, his mouth was crooked, at that point Mrs. Barnes’ cousin drove the Barneses to GBMC. Mr. Barnes had suffered a stroke. Statement of Issues Breached the Standard of Care in not admitting Mr. Barnes on January 26.…

    • 913 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    During this investigation, the Alive and Weill Check with Ms. Emma Hernandez took place during an announced visit with her at the La Posada retirement community center at 501 S. La Posada Circle, Green Valley, AZ 85614. The retirement community center is a private well-guarded facility with roaming Security Guards throughout the center which prohibits photos to be taken within the facility, as all visits must be through contacting the front lobby office and checking in before any contact is to be made with any of the tenants. Ms. Hernandez’s meeting was held in her apartment # 123, which was found to be a one bedroom apartment which had a small front living room and a small kitchen with a refrigerator and stove. The interior of the home seemed to be cluttered with various pictures and mementos. However, the apartment was clean and smelled fresh without no present of pet odors.…

    • 526 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    The highlighted language is a broad and material exception to the operation of Section 2.6. SelectCare is prohibited from denying a medically necessary claim under circumstances where good cause existed for the lack of prior authorization. This exception prevents SelectCare from unreasonably shifting the costs of its member’s medically necessary services to the Hospitals when the Hospital is not at fault. As discussed more fully below, good cause existed for the lack of authorization on each of the claims at issue. Accordingly, SelectCare’s denial of these medically necessary claims was unreasonable and payment should be made to the Hospitals.…

    • 441 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Abner was injured at the Community Center's pool after jumping off the diving board, and attempted to hold the Community Center liable claiming that he had been charged a fee, so the immunity under KRS 411.190 did not apply. Id. at 349. However, it was…

    • 945 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Remicade Case Studies

    • 899 Words
    • 4 Pages

    There is a letter from the carrier to the member dated 02/01/2016, which states in part: “I must regretfully inform you that after giving careful consideration to all of this information, the trustees have determined that they must deny your appeal. Their decision was based upon the fact that they are required by federal law to administer the plan…

    • 899 Words
    • 4 Pages
    Improved Essays
  • Decent Essays

    In the Baze v. Rees case, two inmates named Ralph Baze and Thomas Bowling were convicted for murder and sentenced with the death penalty. In 1992, Ralph Baze killed a Kentucky County Sheriff with three shots fired in his back, and also killed a deputy sheriff with two shots in the back and one in the back of his head (Rushford). The other inmate, Thomas Bowling rammed into a car in the dry cleaning parking lot; he got out of the car and shot the couple and the two-year-old child in the car and drove away in 1990 (Rushford). Baze and Bowling had claimed that Kentucky’s lethal injections is cruel and unusual punishment which is a violation of his Eighth Amendment rights. The lethal injections is a process that includes a dose of Diazepam which…

    • 190 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Identification: Legal Services Corporation v. Velazquez 531 U.S. 533 (2001) Facts: Carmen Velazquez, a 56-year-old grandmother, claimed her public assistance benefits were wrongfully terminated. Her benefits were terminated for failure to participate in a job search program without a pre-termination hearing. Without the pre-termination hearing, she was not allowed to present her physical impairment as cause for her inability to work.…

    • 636 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Harco Case Study

    • 664 Words
    • 3 Pages

    First, the court has ruled in favor of the plaintiff with respect to the alter ego argument; that the four entities Starline USA, Starline of Hollywood, Screamline and Movieland Charter are alter egos of one another and qualify as a named insured under Harco’s Commercial Auto policy. Furthermore, California Insurance Code states, an occurrence involving a motor vehicle, where multiple policies are available, the motor vehicle’s auto policy is primary and all other liability policies shall be excess. Harco’s defense counsel estimates there is $12,000,000 in excess coverage over Harco’s $5,000,000 policy limit. However, this is…

    • 664 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    In the Morgan V Virginia case Irene Morgan, a negro woman got aboard led a motor common carrier from Gloucester County in the state of Virginia headed for Baltimore, Maryland. When she was asked to give up her seat to a white person and move to the back of the bus and a law in Virginia ordered. However, she refused to give away her seat stating that the bus she boarded was an interstate bus and that the Virginia law that demanded she give up her seat did not apply here. Upon refusal to give up her seat, Irene Morgan was arrested and charged, under a state law that imposed the segregation of passengers in public facilities and public transportations based on their race. In 1946, Irene was tried and convicted of being in violation of a Virginia segregation law on interstate buses and, was also fined $10.…

    • 576 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Tinker vs. Des Moines This court case took place in the December of 1965, in Des Moines, Iowa. A group of students at a local high school decided that to protest the Vietnam war, they would wear black armbands from December 16 until New Year’s at school. The principals at the high school learned of the protest, and established a new rule on December 14th.…

    • 667 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Garrett Vs Fisher

    • 1297 Words
    • 6 Pages

    I represent the Respondent, and request of the court to affirm the decision of the United States Court of Appeals for the Second Circuit. The legal standard is intermediate scrutiny. In order to disprove negligence, the challenged classification must serve an important state interest and is at least substantially related to serving that interest.…

    • 1297 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    A 1. In this paper I will be comparing the overall healthcare systems between the United States and that of Great Britain. A 2. In the United States we have private healthcare which each individual person has to pay for, one way or another. There are some government programs such as Medicare, Medicaid, Veterans health administration and Children's Health Insurance Program that help supplement healthcare but there are strict qualifications that must be met and not everyone may qualify for it.…

    • 688 Words
    • 3 Pages
    Improved Essays
  • Decent Essays

    Case Study: UPS V. US

    • 123 Words
    • 1 Pages

    Peggy Young, the plaintiff, worked for the UPS as a pickup and delivery driver. While working for UPS, the requirements was for drivers to be able to “lift, lower, push, pull, leverage and manipulate…packages weighing up to 70 pounds” and to “assist in moving packages weighing up to 150 pounds.” (Find Law, 2017) After becoming pregnant in 2006, Young’s doctor advise her not to lift more than 20 pounds during the first 20 weeks of her pregnancy or more than 10 pounds thereafter. Failing to comply UPS’s lifting requirements, Young was placed on leave and eventually lost her employee medical coverage. Young then filed suit in the district court, claiming that UPS had acted unlawfully in refusing to accommodate her pregnancy-related lifting restriction.…

    • 123 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Manuel Huanosto, Jr. Drop Box Assignment – Week 7 1. pg 433, 20.1 Workers' Comp Medrano is employed as a journeyman electrician in Missouri electrical contracting (MEC). He had taken up instructive cost for the association's work around night time and the instructive cost and the book fees were paid by MEC. It takes 70 miles to accomplish his house from the class.…

    • 1082 Words
    • 5 Pages
    Improved Essays