In Peter N. Anderson v. WEA Trust (2017AP2386), the Court of Appeals District IV held that health insurance company WEA Trust did not breach its implied contractual duty of good faith when it denied primary coverage of medical expenses because its denial was unambiguously stated on the plaintiff’s monthly statements.

Under Peter Anderson and his wife’s retiree insurance plan, WEA provided secondary insurance for expenses above and beyond Medicare Part B. For the first few months of the plan, Anderson had not yet enrolled in Medicare Part B and incurred approximately $3,000 in medical expenses. WEA denied Anderson’s claims for those expenses that should have been covered under Medicare Part B. Anderson claimed that WEA breached its implied contractual duty of good faith because it failed to inform him that it had denied coverage.

The court of appeals upheld the ruling that Anderson’s monthly statements from WEA clearly stated that WEA denied his claims. The court declined to address Anderson’s other appellate arguments that WEA failed to state clearly in the contract that it was only offering secondary insurance and that WEA failed to inform him he was not enrolled in Medicare Part B.