The state high court ruled that the birth parents’
plan was no longer obligated to pay the baby’s medical
bills after the birth parents were legally relieved of
responsibility for the child when their parental rights
ended. That’s when responsibility passed to a plan
covering the adoptive father, justices ruled.
Also, the adoptive father’s plan’s coordination of benefits provision did not mean the plan could refuse coverage, the court decided.
The case involves Robert and Sue Quaid and the adopted child Skylar, who the court said was born in New York on June 24, 1999 with severe birth defects, including congenital heart disease, that rendered him totally disabled.
The baby received inpatient treatment at Schneider Children’s Hospital in New York. The Quads initiated adoption proceedings in the Fall of 1999 and the adoption of Skylar was finalized on November 14, 1999, the court said.
According to the ruling, the adoptive father’s policy refused to guarantee the child’s coverage until it could determine how benefits under the plan should be coordinated with the birth parents’ policy.
The adoptive father’s plan administrator later
denied coverage for certain medical expenses incurred after
the child’s enrollment on the basis that the birth
parents’ insurer was liable as the child’s primary
insurance provider. The birth parents’ plan also denied
those claims and the adoptive parents sued the adoptive
father’s plan and the birth parents’ insurer.
The trial court ruled for the adoptive father’s plan and the parents appealed.
The Utah Supreme Court ruling in Quaid v. U.S. Healthcare, Inc., 2007 UT 27 (Utah 2007) is here .