The Court of Appeal of California upheld a trial court’s decision to sustain Blue Shield’s demurrer without leave to amend and dismiss the action.
Plaintiff Van Slyke filed a lawsuit on behalf of himself and all others similarly situated against California Physicians’ Services d/b/a Blue Shield of California (Blue Shield). The class action complaint alleged that because members of the putative class indicated on their application that they were single adult males, Blue Shield owed a duty to inform them that the policy included maternity coverage, and that other policies without maternity coverage were available. The complaint alleged that Blue Shield was negligent and also violated California’s unfair competition law by engaging in unlawful, unfair or fraudulent conduct.
The appeals court found that Van Slyke could have rejected the coverage offered to him in favor of a plan from another provider and that Blue Shield had no special duty to Van Slyke. The court also found that Blue Shield’s agent did not misrepresent the scope of the coverage in assuring Van Slyke it provided protection for a single adult male. The court stated that Van Slyke was responsible for reading the provisions of his agreement with Blue Shield. The court also found that Blue Shield did not have a statutory duty to Van Slyke nor was there a basis for a claim that Blue Shield acted in bad faith.