Tim Weaver and Allison Weaver, Appellants (plaintiffs) v. Blue Cross-Blue Shield of Wyoming, Appellee (defendant)

Summary

The Wyoming Supreme Court reversed a summary judgment for Blue Cross-Blue Shield in an insured's action to recover maternity benefits after her employer's group policy was canceled while she was pregnant. The court rejected the insured's theory that her maternity benefits vested when she became pregnant under the still-effective group policy, but held that genuine issues of material fact precluded summary judgment: the record lacked the replacement group contract and the 'Group Conversion' regulations, the contract's grace-period provisions did not clearly cover her circumstances, and whether the insurer's agents' assurances should estop it from denying continuous coverage was a question for the fact finder. The case was remanded for further proceedings.