Burt v. Blue Shield of Southwest Ohio

591 F. Supp. 755, 1984 U.S. Dist. LEXIS 20056
CourtDistrict Court, S.D. Ohio
DecidedJanuary 27, 1984
DocketC-3-83-55
StatusPublished
Cited by6 cases

This text of 591 F. Supp. 755 (Burt v. Blue Shield of Southwest Ohio) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Burt v. Blue Shield of Southwest Ohio, 591 F. Supp. 755, 1984 U.S. Dist. LEXIS 20056 (S.D. Ohio 1984).

Opinion

DECISION AND ENTRY; DEFENDANT OHIO MEDICAL’S MOTIONS FOR SUMMARY JUDGMENT AND TO DISMISS SUSTAINED; DEFENDANT METROPOLITAN’S MOTION FOR SUMMARY JUDGMENT AND TO DISMISS SUSTAINED; PLAINTIFF’S MOTION TO FILE AN AMENDED COMPLAINT OVERRULED; CLERK TO ENTER JUDGMENT FOR DEFENDANTS AND AGAINST PLAINTIFF; TERMINATION ENTRY

RICE, District Judge.

Plaintiff James C. Burt, M.D., is a physician licensed to practice medicine in Ohio. He is a specialist in the field of gynecology and obstetrics. In the practice of his specialty, Plaintiff has developed a surgical procedure for the reconstruction of women’s vaginas. The Defendants, Ohio Medical Indemnity Mutual Corporation (“Ohio Medical”) 1 and Metropolitan Life Insurance Company (“Metropolitan”) provide medical insurance policies to individuals and groups. Some of Plaintiff’s patients are insured by one or the other of the Defendants.

In January, 1978, Defendant Ohio Medical ceased paying Plaintiff’s fee for vaginal reconstructive surgery. A few months later, Defendant Metropolitan also ceased paying Plaintiff for this procedure.

As a result of the Defendants’ decisions, Plaintiff initiated this action. In his complaint (Doc. # 1), Plaintiff alleges that after Ohio Medical stopped paying his fees, Metropolitan took the same action “pursuant to an agreement with [Ohio Medical] that neither Defendant would cover Plaintiff’s vaginal reconstructive procedures.” Complaint, ¶ 8. Since this agreement was entered into, neither Defendant has covered Plaintiff’s fee for the procedure. Id. Plaintiff alleges that the agreement is an illegal restraint of trade in violation of § 1 of the Sherman Act, 15 U.S.C. § 1. Complaint, ¶ 9.

Plaintiff asserts five additional claims against the Defendants, individually. 2 Each of these claims is for breach of insurance contract resulting from one of the Defendants refusing to pay Plaintiff’s fee for performing vaginal reconstructive surgery. In each instance, a patient of Plaintiff, who is also insured by a Defendant, has assigned her claim to Plaintiff. The Plaintiff seeks to have the Court exercise pendent jurisdiction over these claims.

This cause is now before the Court on the Defendants’ motions for summary judgment and to dismiss. First, the Court will address Ohio Medical’s motions. Then, the Court will turn to those of Metropolitan.

1. Motions of Ohio Medical Blue Shield of Southwest Ohio

Ohio Medical has filed a motion for summary judgment on Plaintiff’s antitrust claim and a motion to dismiss the breach of insurance contract claims for lack of subject matter jurisdiction. (Doc. # 19).

A. Ohio Medical’s Motion for Summary Judgment

Ohio Medical seeks summary judgment on Plaintiff’s antitrust claims. In the recent case of Bouldis v. U.S. Suzuki Motor Corp., 711 F.2d 1319 (6th Cir.1983); the court discussed the use of summary judgment in antitrust litigation.

It is a well established rule that motions for summary judgment are disfavored in antitrust litigation and that the standard *758 for granting summary judgment is strict. See, First National Bank of Arizona v. Cities Service Co., 391 U.S. 253, 284-90, 88 S.Ct. 1575, 1590-93, 20 L.Ed.2d 569, reh’g denied, 393 U.S. 901, 89 S.Ct. 63, 21 L.Ed.2d 188 (1968); Poller v. Columbia Broadcasting System, Inc., 368 U.S. 464, 473, 82 S.Ct. 486, 491, 7 L.Ed.2d 458 (1962); Smith v. Northern Michigan Hospitals, Inc., 703 F.2d 942, 947 (6th Cir.1983); Davis-Watkins Co. v. Service Merchandise, 686 F.2d 1190, 1197 (6th Cir.1982); Taylor Drug Stores, Inc. v. Associated Dry Goods Corp., 560 F.2d 211, 213 (6th Cir.1977). However, this general rule does not preclude the use of summary judgment in appropriate antitrust litigation. See, First National Bank of Arizona, supra, 391 U.S. at 288-90, 88 S.Ct. at 1592-93; Smith, supra, 703 F.2d at 947-48; Davis-Watkins Co., supra, 686 F.2d at 1197; Lupia v. Stella D’Oro Biscuit Co., Inc., 586 F.2d 1163, 1166-67 (7th Cir.1978), cert. denied, 440 U.S. 982, 99 S.Ct. 1791, 60 L.Ed.2d 242 (1979). See also, Fed.R.Civ.P. 56 advisory committee note (1982) (Summary judgment is “inapplicable to all actions”). Indeed, the very purpose of a motion for summary judgment, to eliminate a trial where it would be unnecessary and merely result in delay and expense, warrants summary disposition of cases when appropriate.

Id. at 1324.

In antitrust litigation, as in all litigation, summary judgment is proper only when there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Fed. R.Civ.P. 56(c). In re Atlas Concrete Pipe, Inc., 668 F.2d 905, 908 (6th Cir.1982). In ruling on a motion for summary judgment, the court must construe the evidence in the light most favorable to the opposing party. Willetts v. Ford Motor Co., 583 F.2d 852, 855 (6th Cir.1978); Weaver v. Shopsmith, Inc., 556 F.Supp. 348, 351 (S.D.Ohio 1982). However, if such a motion is made and properly supported, the opposing party may not rest on its pleadings, but must present affidavits or other evidence, setting forth specific facts to demonstrate a genuine issue of a material fact. Gillmore v. Procter & Gamble Company, 417 F.2d 615 (6th Cir.1969); Fed.R.Civ.P. 56(e).

With these standards in mind, the Court turns to the arguments that Ohio Medical makes to support its motion for summary judgment. Ohio Medical points out that the essence of Plaintiffs antitrust claim is an alleged agreement between it and Metropolitan to cease paying for Plaintiffs procedure. Ohio Medical argues that the existence of such an agreement is not a genuine issue of fact.

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Bluebook (online)
591 F. Supp. 755, 1984 U.S. Dist. LEXIS 20056, Counsel Stack Legal Research, https://law.counselstack.com/opinion/burt-v-blue-shield-of-southwest-ohio-ohsd-1984.