Hasty v. Central States, Southeast & Southwest Areas Health & Welfare Fund

859 F. Supp. 339, 1994 U.S. Dist. LEXIS 10924, 1994 WL 409573
Procedural entryThis page is a short order in Hasty v. Central States, Southeast & Southwest Areas Health & Welfare Fund. Read the opinion of the Court — 851 F. Supp. 1250
District Court, N.D. Indiana·Decided August 4, 1994·No. No. 1:94-CV-96·Published

Opinion

ORDER

WILLIAM C. LEE, District Judge.

This matter is before the court on plaintiffs Motion for Amendment, Alteration and/or a New Trial. For the following reasons, plaintiffs Motion is denied.

BACKGROUND

The facts surrounding this litigation are adequately addressed in this court’s Order denying plaintiffs Motion for Summary Judgment and granting defendant’s Motion for Summary Judgment. See, Hasty v. Central States, Southeast and Southwest Areas Health and Welfare Fund, 851 F.Supp. 1250 (N.D.Ind.1994). Accordingly, the court shall not address the facts again.

DISCUSSION

Plaintiff asks this court to reconsider its opinion in whole and hold that the proposed treatment for plaintiffs cancer is covered by the C-6 Health Benefit Plan. However, plaintiff directs all of her argument in her Memorandum in Support of Motion for Amendment, Alteration and/or New Trial towards only one portion of the court’s Order denying plaintiffs Motion for Summary Judgment. Specifically, plaintiff takes exception to this court’s analysis regarding the appropriateness of dissecting the proposed treatment into its five (5) separate and distinct stages and requiring defendant to pay for some stages of the treatment, while possibly finding that other stages are not reimbursable under the C-6 Health Benefits Plan. Id. at 1259. If this court is not willing to order coverage for plaintiffs proposed treatment, plaintiff asks this court to at least reissue its Order in a form that removes any statements that may provide an inference that plaintiffs attorneys may have acted in an improper or unethical manner.

Although plaintiff does not explicitly state under which Federal Rule of Civil Procedure she is proceeding, the court interprets the Motion to fall under either Fed.R.Civ.P. 59(e) or 60(b). Under Fed.R.Civ.P. 59(e), “[m]o-tions for a new trial or to alter or amend a judgment must clearly establish either a manifest error of law or fact or must present newly discovered evidence.” Federal Deposit Ins. Corp. v. Meyer, 781 F.2d 1260, 1268 (7th Cir.1986). Motions under Rule 59(e) cannot be utilized to raise arguments that could have been raised before the judgment issued. Id.

In addition, the Seventh Circuit Court of Appeals has established a high standard for prevailing on a motion brought under Fed. R.Civ.P. 60(b): “Rule 60(b) provides for extraordinary relief and may be invoked only upon a showing of exceptional circumstances.” DiVito v. Fidelity and Deposit Co. of Maryland, 361 F.2d 936, 938 (7th Cir.1966).

Based upon plaintiffs arguments in her Motion and the applicable standards under Rule 59(e) and Rule 60(b), plaintiffs Motion [341]*341must fail. Plaintiff does not establish a manifest error of law or fact, does not present new evidence on the merits, nor does the Motion allege any exceptional circumstances. Plaintiff basically advances two (2) arguments as to why this court should amend or alter its prior Order denying plaintiffs Motion for Summary Judgment.

First, plaintiff asserts that she did not raise the issue of separating the proposed treatment into its subparts and analyzing whether each subpart is covered under the Health Benefits Plan at “the stroke of the last bell.” Hasty, 851 F.Supp. at 1259. Plaintiff states that she maintained such a theory throughout this litigation arguing that the case at bar is analogous to Doe v. Group Hospitalization Services, 3 F.3d 80 (4th Cir.1993).

Second, and intricately tied to the first argument in plaintiff’s Motion now before the court, plaintiff asserts that her counsel did not advance inconsistent arguments before this court and before the United States District Court for the Eastern District of Virginia in Wheeler v. Dynamic Engineering, Inc., 850 F.Supp. 459 (E.D.Va.1994), in regards to whether the proposed treatment should be viewed as a single procedure or as five (5) separate and distinct procedures.

Raised at the Last Bell?

Plaintiff asserts that the following passage from this court’s Order denying plaintiff’s Motion for Summary Judgment is not an accurate portrayal of how and when plaintiff raised the possibility that the proposed treatment could be separated into its subparts and a determination made as to whether any subpart is covered under the C-6 Health Benefits Plan.

Finally, in her Reply Memorandum, plaintiff suggests that the HDC/PSCR treatment can be separated into subparts and the question of coverage considered separately for each subpart. However, plaintiff requested the Board of Trustees to certify that the entire procedure would be covered under the C-6 Health Benefits Plan, not whether the treatment could be parcelled into subparts where some sub-parts would be covered and others possibly not. The Trustees considered the entire treatment as a whole and determined that the treatment as a whole is not covered under the terms of the Plan.
The court is of the opinion that the treatment should be considered as a whole as there would be no need for the induction, mobilization, leukapheresis or hospitalization stages if it was not for the HDC aspect of the treatment. Indeed, in previous litigation and in the instant case Plaintiffs attorney has made representations that the treatment is to be considered only as a whole and not separated into sub-parts. See, Wheeler v. Dynamic Engineering, Inc., 850 F.Supp. 459 (E.D.Va.1994) (Court found that HDC/PSCR began with the initial induction phase of treatment, and therefore, insurer could not amend plan after treatment had begun to avoid paying for the treatment).
The court questions whether R.T. Inc., its physicians, plaintiff and plaintiffs attorney belief that HDC/PSCR is an integrated or disjointed procedure depends on medical fact or how best to obtain payment? To adopt different litigation strategies under similar circumstances in different cases on this particular point does not lend credibility to plaintiffs argument in the instant case. The court will not begin its own partitioning of the Plan and the proposed treatment at the stroke of the last bell. The court’s limited roll in the instant case is to determine whether the Board of Trustees acted arbitrarily or capriciously when it decided that the entire proposed treatment was not covered by the C-6 Health Benefits Plan.

Hasty, 851 F.Supp. at 1259.

Plaintiff asserts that she addressed the issue of separating the subparts of the proposed treatment before and during the litigation of this matter. She argues that she did not first advance the argument in her Reply Memorandum.

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Hasty v. Central States, Southeast & Southwest Areas Health & Welfare Fund, 859 F. Supp. 339, 1994 U.S. Dist. LEXIS 10924, 1994 WL 409573 (N.D. Ind. 1994).

859 F. Supp. 339 (Hasty v. Central States, Southeast & Southwest Areas Health & Welfare Fund) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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