United States First Circuit

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Stephanie C. v. Blue Cross Blue Shield of Mass, 16-1997

In an action brought pursuant to the Employee Retirement Income Security Act (ERISA), 29 U.S.C. section 1132(a)(1)(B), seeking reimbursement for certain expenses connected with the treatment of plaintiff's teenage son, the district court's judgment affirming the denial of her claim is affirmed where: 1) because an ERISA plan is a form of contract, and contract-law principles inform the construction of an ERISA plan, the plain language of the plan provisions should normally be given effect; and 2) applying the plain language of the plan, the clear weight of the evidence dictates a finding that the disputed charges were not medically necessary and, thus, were not covered.

Appellate Information

  • Argued
  • Submitted
  • Decided
  • Published 2017/03/27




  • United States First Circuit


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