DISCLAIMER: Any unofficial case summaries below are prepared by the clerk's office
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161557P.pdf 05/04/2017 Raleigh Spizman v. BCBSM, Inc.
U.S. Court of Appeals Case No: 16-1557
U.S. District Court for the District of Minnesota - Minneapolis
[PUBLISHED] [Loken, Author, with Murphy and Kelly, Circuit Judges]
Civil case - ERISA. Plaintiffs' claim for round-the-clock in-home nursing
care fell within the plain meaning and common understanding of the
"private-duty nursing" exclusion in the plaintiffs' 2012 policy; the Plan
Administrator's decision that round-the-clock nursing was excluded from
the 2013 policy was not an unreasonable interpretation of the plan; with
respect to plaintiffs' claim that defendant's agents' representations
regarding coverage estopped defendant from denying the claim, plaintiffs
cannot use an estoppel theory to enlarge their benefits under a written
plan.