skip to Main Content

Hunter v. Baylor Health Care System

Court: ND Tx  08/14/2019  District Court Finds that a Hospital was not an "Insurer" for Purposes of Determining whether a Discretionary Clause in an Occupational Injury Benefit Plan was Banned

A Court of the Northern District of Texas granted a hospital's motion for summary judgment that it, as an administrator of a ERISA plan, did not qualify as an insurer under Texas Insurance Code Sec. 1701.062 (banning discretionary clauses in certain insurance policies), where the claimant failed to meet her burden to show the hospital qualified as insurer; thus, an abuse of discretion standard apllied to review of the hospital's claim denial rather than statutory de novo review.

occupational injury benefit plan, ERISA plan, denial of claim, preexisting condition, Texas Insurance Code Section 1701.062, discretionary clause, abuse of discretion, de novo review, substantial evidence

Reviewing the Case Document is for members only. Please login




ILS Login

Forgot Password?

Join Us

Password Reset
Please enter your e-mail address. You will receive a new password via e-mail.

Back To Top