Reinsurer Not Obligated to Pay Claim for Transplant Patient’s Care, Texas Judge Opines

GALVESTON, Texas — A Texas federal magistrate judge has recommended awarding a reinsurer summary judgment in a lawsuit accusing it of wrongfully denying a health insurer’s claim for costs arising from a heart transplant patient’s hospital care, ruling that the expenses incurred before the reinsurance agreement’s term.

In a Nov. 8 report and recommendation, Magistrate Judge Andrew M. Edison of the U.S. District Court for the Southern District of Texas agreed with American National Insurance Co. (ANIC) that the underlying care charges incurred on the date of the patient’s admission to the hospital, which was before the reinsurance agreement’s term.