Health Benefits Company Entitled to Reinsurance Coverage for Alleged Wrongful Acts, Ind. High Court Rules

INDIANAPOLIS — A health benefits company is entitled to reinsurance coverage for claims accusing it of improperly denying reimbursement to doctors, the Indiana Supreme Court has ruled, finding the alleged wrongful acts fall within the certificates’ coverage for liability stemming from “the rendering of or failure to render professional services.”

On April 22, the high court found that to qualify for coverage, Anthem's entire liability need not arise solely out of its claims handling activities; rather, the policy extends coverage to “any claim or claims” resulting from “any wrongful act” by Anthem that occurred “solely in the rendering of or …