Wellpoint Claims Not Covered Under Reinsurance Certificates, Ind. Appeals Court Affirms

INDIANAPOLIS — A health benefits company is not entitled to reinsurance coverage for claims that it improperly denied reimbursement to doctors, an Indiana appeals court affirmed, finding the alleged wrongful acts did not arise “solely in the rendering of or failure to render professional services," as required by the reinsurance certificates.

The Indiana Court of Appeals found the allegations against Wellpoint Inc. (NYSE: WLP) did not involve "mistakes inherent in the practice of that particular profession or business," therefore they were not "professional services" covered by the certificates.

Wellpoint’s predecessor, Anthem Inc., set up a complex and multi-tiered arrangement to …