Judge: Gregory Keosian, Case: 20STCV27757, Date: 2022-10-24 Tentative Ruling
Case Number: 20STCV27757 Hearing Date: October 24, 2022 Dept: 61
Defendant Aetna Life Insurance Co.’s Motion for Summary
Judgment or Adjudication is GRANTED as to the fifth cause of action for breach
of written contract and all claims related to the treatment of patient C.G. The
motion is DENIED as to all other causes of action.
I.
OBJECTIONS
Plaintiff Healthcare
Ally Management of California, LLC (Plaintiff) objects to various factual
propositions put forth in Defendant Aetna Life Insurance Co.’s (Defendant’s)
separate statement in support of its motion for summary judgment. Most of these
objections are fairly read as targeting the testimony of Renae Hansen, an
executive director of Defendant’s Provider Contact Centers, who testifies
concerning the training, qualifications, and customary practices of the
customer service representatives employed by Defendant to answer questions by
providers concerning coverage and payment. These objections are OVERRULED, as
Hansen provides sufficient foundation for her testimony concerning these
practices.
A.
SUMMARY JUDGMENT
A party may move for summary judgment “if it
is contended that the action has no merit or that there is no defense to the
action or proceeding.” (Code Civ. Proc.
§ 437c, subd. (a).) “[I]f all the evidence submitted, and all inferences
reasonably deducible from the evidence and uncontradicted by other inferences
or evidence, show that there is no triable issue as to any material fact and
that the moving party is entitled to judgment as a matter of law,” the moving
party will be entitled to summary judgment.
(Adler v. Manor Healthcare Corp.
(1992) 7 Cal.App.4th 1110, 1119.) A motion for summary adjudication may be made
by itself or as an alternative to a motion for summary judgment and shall
proceed in all procedural respects as a motion for summary judgment. (Code Civ. Proc. § 437c, subd. (f)(2).)
The moving party bears an initial burden of
production to make a prima facie showing of the nonexistence of any triable
issue of material fact, and if he does so, the burden shifts to the opposing
party to make a prima facie showing of the existence of a triable issue of
material fact. (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 850;
accord Code Civ. Proc. § 437c, subd. (p)(2).)
Once the defendant has met that burden, the burden shifts to the plaintiff
to show that a triable issue of one or more material facts exists as to that
cause of action or a defense thereto. (Aguilar, supra, 25 Cal.4th at 850.) The plaintiff may not rely upon the mere
allegations or denials of its pleadings to show that a triable issue of
material fact exists but, instead, shall set forth the specific facts showing
that a triable issue of material fact exists as to that cause of action or a
defense thereto. (Ibid.) To establish a triable issue of material
fact, the party opposing the motion must produce substantial responsive
evidence. (Sangster v. Paetkau (1998) 68 Cal.App.4th 151, 166.)
Defendant Aetna Life Insurance Co. (Defendant) moves for summary judgment
as to all causes of action alleged in the Third Amended Complaint (TAC).
Defendant argues that Plaintiff Healthcare ally Management of California, LLC’s
(Plaintiff’s) claims are dependent upon the terms of various self-insurance
plans that are covered by the federal Employment Retirement Income Security Act
(ERISA) and therefore preempted by the same Act. (Motion at pp. 10–11.)
Defendant further argues that communications with its customer service
representatives concerning coverage are not promises that form the foundation
for an oral contract between itself and a medical provider, and that the
provider in this case — Keith Feder, M.D. (Feder) — could not reasonably rely
on such assurances for the purposes of establishing a promissory estoppel or
negligent misrepresentation claim. (Motion at pp. 12–15, 18–19.) Defendant
further argues that its purported violations of the Knox-Keene Act cannot
provide the foundation for a claim under California’s Unfair Competition Law
(UCL), because the Act did not regulate the plans in question, and because the
alleged violations are too vague to be actionable. (Motion at pp. 15–17.) As to
Plaintiff’s claim for breach of written contract, Defendant argues that neither
Plaintiff nor Feder had any written contract with Defendant, and that any
contract claims between the individual patients treated by Feder and Defendant
are preempted by ERISA. (Motion at pp. 19–20.) Finally, Defendant argues that
the claims related to one particular patient, C.G., fail because Defendant did
not administer his plan. (Motion at p. 20.)
B. ERISA PREEMPTION
ERISA is a
“comprehensive regulation of employee welfare and pension benefit plans.” (New
York State Conference of Blue Cross & Blue Shield Plans v. Travelers Ins.
Co. (1995) 514 U.S. 645, 650.) The Act contains a preemption provision,
stating that it supersedes “any and all State laws insofar as they may now or
hereafter relate to any employee benefit plan.” (29 U.S.C. § 1144, subd. (a).)
This preemption
does not apply to “any law of any State which regulates insurance, banking, or
securities.” (29 U.S.C. § 1144, subd. (b)(2)(A).) But Defendant argues that the
plans at issue here were self-funded plans not included within this provision.
(Motion at pp. 10–11, citing Rush Prudential HMO, Inc. v. Moran (2002)
536 U.S. 355, 371 fn. 6; see 29 U.S.C. § 1144, subd. (b)(2)(B).)
Defendant argues that because Plaintiff’s suit is an attempt to recover amounts
owed under Plaintiffs’ self-funded employee benefit plans, the claims are
therefore preempted. (Motion at p. 11.)
Plaintiff in
opposition presents an instructive case: Morris B. Silver M.D., Inc. v. International Longshore & Warehouse
etc. (2016) 2 Cal.App.5th
793, 801. That case, like the present case, involved an out-of-network medical
provider suing a health plan for failing to pay for care provided to patients
according to earlier representations made to the provider by the plan. (Morris
B. Silver M.D., Inc., supra, 2 Cal.App.5th at p.
796–797.) When the defendant plan argued that the claims were barred by ERISA,
the court noted that state law causes of action “based on alleged improper
processing of a claim for benefits under an employee benefit plan, undoubtedly
meet the criteria for pre-emption under § 514(a).” (Id. at p. 801.) However,
the court distinguished “between claims by a plan participant for additional
benefits and claims by third-party medical providers,” whose claims are subject
to a two-factor test to determine whether they are preempted: “(1) the state
law claims address areas of exclusive federal concern, such as the right to
receive benefits under the terms of an ERISA plan; and (2) the claims directly
affect the relationship among the traditional ERISA entities—the employer, the
plan and its fiduciaries, and the participants and beneficiaries.” (Id.
at pp. 803–804.) The court embraced the reasoning of prior federal cases, which
held: that disallowing claims by third-party providers would frustrate the
purposes of ERISA by deterring them from offering care to covered employees;
that such claims in any event did not expand the rights of any patient in
relation to their plan; and finally that the relationship between a third-party
provider and a plan was not among the core relationships that ERISA sought to
regulate. (Id. at pp. 804–805.)
Similar logic
applies here. Plaintiff’s claims arise from representations made by Defendant
to a medical provider prior to the provision of care to Defendant’s plan
members. The relationship between provider and plan, and the representations
made in the course of that relationship, do not implicate the core purposes or
protections of ERISA, which primarily concern the relationship among “the
employer, the plan, the plan fiduciaries, and the beneficiaries.” (Id.
at p. 805.) Precluding providers from relying on plan statements given prior to
medical treatment would, as noted in Morris B. Silver, M.D., Inc. and
its cited authority, harm the policies that ERISA seeks to promote, by placing
obstacles between plan beneficiaries and care. (Id. at p. 805.) The
claims raised here do not address the right of beneficiaries to receive ERISA
benefits, and do not directly affect the relationship among traditional ERISA
entities.
C. ORAL
CONTRACTS
“[T]he elements of
a cause of action for breach of contract are (1) the existence of the contract,
(2) plaintiff's performance or excuse for nonperformance, (3) defendant's
breach, and (4) the resulting damages to the plaintiff.” (Oasis West Realty,
LLC v. Goldman (2011) 51 Cal.4th 811, 821.) “[T]he vital elements of a
cause of action based on contract are mutual assent (usually accomplished
through the medium of an offer and acceptance) and consideration.” (Pacific
Bay Recovery, Inc. v. California Physicians' Services, Inc. (2017) 12
Cal.App.5th 200, 215.)
Defendant argues
that no oral contracts were formulated in this case between itself or the
medical provider at issue because of the limited authority and training given
to its customer service representatives (CSRs), which permits them merely to
verify a patient’s insurance information, not to opine upon how payment for
that service will ultimately be calculated. (Motion at pp. 12–13; Hansen Decl.
¶¶ 5–20.) Defendant further argues that even if its CSRs were authorized
to make binding promises concerning payment, there was in the present case a
lack of mutual assent to what was understood by the term “usual, customary, and
reasonable” (UCR) rates, which could implicate a number of different methods of
calculation. (Motion at p. 14.)
Defendant cites various federal cases that have embraced
similar arguments. There is Community Hospital of the Monterey Peninsula v.
Aetna Life Insurance Company (N.D. Cal. 2015) 119 F.Supp.3d 1042, 1049), in
which the court held that no agreement was formed between a medical provider
and Aetna for “100 percent payment of billed charges” based on prior
authorization calls, when all parties understood the patient to be
out-of-network, and therefore to be reimbursed at a discounted level. (Id.
at p. 1049.) There is Vencor Hospitals v. Blue Cross Blue Shield of Rhode
Island (11th Cir. 2002) 284 F.3d 1174, in which the court held that the
insurer’s representations concerning whether a particular treatment was covered
were distinct from “statements regarding the costs of such treatment,” and as
such could not support a promissory estoppel claim based on costs. (Id.
at p. 1185.) There is Cedars Sinai Medical Center v. Mid-West Nat. Life Ins.
Co. (C.D. Cal. 2000) 118 F.Supp.2d 1002, 1008, in which the court held that
a verification of insurance did not constitute a promise to pay, as the medical
provider’s own expert witness had testified that verifications could not be interpreted
in that fashion. And there is DePaul Hosp. v. Mutual Life Ins. Co. of New
York (La. Ct. App. 1986) 487 So.2d 143, 146, in which the court held that
no contract was formed between a hospital and an insurance company when the
company sent a form to the hospital and patient merely verify the existence of
benefits.
Plaintiff in opposition presents different evidence and
authority. IT submits the declaration of the medical provider, Keith Feder, who
states that it is the regular practice of his office to confirm payment from a
patient’s insurer before providing treatment. (Feder Decl. ¶ 4.) Feder’s staff
documents after each call whether payment is to be made according to UCR rates
or Medicare rates. (Feder Decl. Exhs. A, C.) Feder states that UCR rates are
customarily derived from a public Fair Health resource, and payments based on
Medicare derived from the Medicare Fee Schedule. (Feder Decl. ¶ 17.) For the
patients at issue, here, Feder maintains that Defendant’s representatives
promised that the payment would be UCR, and was never told that the payment
would be based on Medicare. (Feder Decl. ¶¶ 14–16.)
There is also the case of Bristol SL Holdings, Inc. v.
Cigna Health and Life Insurance Company (9th Cir., Jan. 14, 2022, No. 20-56122)
2022 WL 137547, at *1, in which the court upheld a breach of oral contract
claim founded upon similar facts:
We first
conclude that the district court erred in granting Cigna's motion for summary
judgment on the breach of contract and promissory estoppel claims. Grants of
summary judgment are reviewed de novo, with all facts and inferences drawn in
favor of the non-moving party. [Citation.] Here, we conclude that Bristol
introduced sufficient evidence to create a genuine dispute of material fact
regarding the potential formation of an enforceable contract. In addition to
the hundreds of verification and authorization calls, Bristol introduced
evidence of a prior course of dealing with Cigna, specific and individualized
treatment plans, as well as agreements over specific percentages of UCR rates
for the services rendered. These actions are sufficient for a reasonable
factfinder to conclude that an enforceable contract had been formed under
governing California law. [Citation.]
In reaching
the opposite conclusion, the district court relied primarily on two arguments:
(1) a lack of discussion between the two parties over the “usual, customary,
and reasonable rate” (UCR), meaning the percentage of costs that Cigna would
reimburse for Sure Haven's services, and (2) the automatic disclaimers Cigna
says were played before all or most verification and authorization calls with
Sure Haven. Neither argument justifies the district court's summary judgment
ruling. First, Bristol did introduce evidence of discussions over UCR, which
the district court improperly ignored. Cigna disputes whether the evidence
Bristol introduced actually relates to UCR, but this factual dispute proves
summary judgment was inappropriate. Second, the district court improperly
concluded that the disclaimers Cigna played before most verification or
authorization calls stating that the information provided “does not guarantee
coverage or payment” established an intent not to form a contract. However,
Cigna's disclaimer could be reasonably interpreted as informing providers like
Sure Haven that it must fulfill the required terms of the deal (such as
properly providing the healthcare services) before it could be guaranteed
payment. The parties may have formed a contract, but payment was not yet
“guaranteed” and still contingent on satisfactory performance of the terms of
the contract. [Citation.]. This is sufficient to hold that summary judgment
against Bristol on these claims was improper, and therefore we reverse. Since both
parties linked the promissory estoppel claim with the implied and oral contract
claims, we reverse the dismissal of the promissory estoppel claim as well.
There is also Enloe
Medical Center v. Principal Life Ins. Co. (E.D. Cal., Dec. 20, 2011, No.
CIV S-10-2227 KJM) 2011 WL 6396517, at *7, in which the court held that whether
an insurer’s authorization of treatment constituted an offer to contract
depended on “the totality of circumstances” based on facts in the record. The
court went on to conclude that it could not rule in the insurer’s favor merely
by reference to a disclaimer that was purportedly played during the call. (Id.
at p. 7.)
Here, there are
triable issues of fact as to whether the calls at issue here constituted
contracts or promises to pay. First, it is important to note that the existence
of mutual assent to contract “is determined under an objective standard applied
to the outward manifestations or expressions of the parties, i.e., the
reasonable meaning of their words and acts, and not their unexpressed
intentions or understandings.” (Long v. Provide Commerce, Inc. (2016)
245 Cal.App.4th 855, 862.) Second, we
must note the precise promise that formed the basis for the oral contract claim
here — specifically, the promise that Defendant would pay Feder at the UCR
rate. (TAC ¶ 285.) Plaintiff does not allege that a promise of coverage
entitled Feder to 100% payment on all charges billed, or that verification of
insurance entitled him to reimbursement at a rate beyond that normal for
out-of-network providers.
Defendant’s
evidence does not foreclose the existence of triable issues of fact concerning
contract formation. Renae Hansen testifies concerning the training given to
CSRs and their ordinary duties, noting that their primary purpose with regard
to outside providers is “to inform the provider on the benefits available to
the member based on the provider’s non-participating status,” and to determine
“what type of reimbursement schedule would apply,” based on the member’s plan
documents. (Hansen Decl. ¶¶ 5–6.) Hansen testifies that CSRs cannot guarantee
how a claim is going to be paid, offer a quote as to the amount to be paid for
a given treatment, calculate UCR rates for any services, or provide opinions as
to whether or not a given procedure is medically necessary. (Hansen Decl. ¶¶
10–18.) This testimony, however, says little about CSR’s ability to state
whether payment for a given treatment will be made according to UCR rates or
Medicare rates. It also relies on evidence of CSR training and instruction
internal to Aetna, rather than objective indications, apparent to Feder or
other medical providers, that representations concerning UCR rates were not
promises to pay. This is unlike Cedars Sinai Medical Center, in which
the provider’s own expert testified that the verifications did not constitute
promises to pay. (Cedars Sinai Medical Center, supra, 118
F.Supp.2d at p. 1008.) And even
if this evidence constituted objective indicia of a non-promissory intent,
Plaintiff has presented evidence to place this evidence in dispute — namely the
critical reliance that Feder and his staff place upon Defendant’s
representations before determining whether to provide treatment to a patient.
(Feder Decl. ¶¶ 7, 10–12.) Triable issues of fact thus remain as to the
parties’ mutual assent to contract.
Defendant argues
that even if mutual assent existed for a contract, there could be no agreement
concerning the meaning of UCR. (Motion at p. 14.) But this argument is
unsupported. It relies on no evidence, and only cites a case standing for the
proposition that the reasonable value of a vendor’s services can be determined
by “a wide variety of evidence.” (Children's Hospital Central California v.
Blue Cross of California (2014) 226 Cal.App.4th 1260, 1274.) It does not
stand for the proposition that parties cannot contract to pay the usual and
customary rate.
Accordingly, the
motion is DENIED as to the first cause of action.
D.
PROMISSORY
ESTOPPEL
“The elements of a
promissory estoppel claim are ‘(1) a promise clear and unambiguous in its
terms; (2) reliance by the party to whom the promise is made; (3) [the]
reliance must be both reasonable and foreseeable; and (4) the party asserting
the estoppel must be injured by his reliance.” (Jones v. Wachovia Bank
(2014) 230 Cal.App.4th 935, 945.)
Here, Defendant
contends that Plaintiff cannot show an unambiguous promise to pay at the UCR
rate, or that there was reasonable reliance upon such a promise. (Motion at pp.
14–15.)
These arguments
are unpersuasive. First, as explained in relation to Defendant’s arguments on
the oral contract claim, triable issues of fact remain as to whether
Defendant’s representations concerning the applicability of UCR rates
constituted promises to pay. Such issues are equally applicable to the
promissory estoppel claim.
Second, Plaintiff
presents evidence, based on Feder’s testimony and the patient intake documents
that he authenticates, that Defendant’s representatives told him that the
payment rate for the procedures at issue would eb “usual and customary or UCR.”
(Feder Decl. ¶ 14.) He further testifies that he relied upon these
representations. (Feder Decl. ¶ 7.) Although Defendant cites the case Tenet
Healthsystem Desert, Inc. v. Fortis Ins. Co., Inc. (C.D. Cal. 2007) 520
F.Supp.2d 1184, 1196, for the proposition that insurer or plan quotes
concerning coverage and reimbursement cannot be reasonably relied upon, the
plaintiff in that case admitted that no reasonable reliance took place, because
“it would have treated [the patient] regardless of whether Defendant authorized
treatment.” (Id. at p. 1196.) Here, Feder testifies that he will “refuse
to provide services or make other arrangements with the patient if an insurer
will not agree to pay for the procedure.” (Feder Decl. ¶ 4.)
The motion is DENIED as to the promissory estoppel claim.
E. NEGLIGENT
MISREPRESENTATION
“The elements of
negligent misrepresentation are “(1) the misrepresentation of a past or
existing material fact, (2) without reasonable ground for believing it to be
true, (3) with intent to induce another's reliance on the fact misrepresented,
(4) justifiable reliance on the misrepresentation, and (5) resulting damage.” (National
Union Fire Ins. Co. of Pittsburgh, PA v. Cambridge Integrated Services Group,
Inc. (2009) 171 Cal.App.4th 35, 50.)
Here, Defendant
argues that no claim for negligent misrepresentation exists because insurance
verification calls are not tantamount to promises to pay, and are therefore not
representations upon which a medical provider is entitled to rely. (Motion at
pp. 18–19.) However, this argument rests on essentially the same premises as
those advanced against the promissory estoppel and contract claims, and fails
for the same reason: triable issues of fact exist as to whether Defendant’s
representations concerning the applicability of UCR rates constituted promises
upon which Feder could rely.
The motion is
therefore DENIED as to the negligent misrepresentation claim.
F.
UNFAIR
COMPETITION LAW (UCL)
California’s Unfair Competition Law (UCL) proscribes “any
unlawful, unfair or fraudulent business act or practice.” (Bus. & Prof.
Code § 17200.) “By proscribing ‘any unlawful’ business practice, section
17200 borrows' violations of other laws and treats them as unlawful
practices that the unfair competition law makes independently actionable.”
(Cel-Tech Communications, Inc. v. Los Angeles Cellular Telephone Co. (1999)
20 Cal.4th 163, 180, internal quotation marks omitted.)
Defendant argues
that Plaintiff cannot prevail on its UCL claim under the “unlawful” prong
because the provisions of the Knox Keene Act adopted to advance the claim
confer only regulatory authority to enforce nonspecific standards, and do not
outline a particular violation susceptible to private enforcement. (Motion at
pp. 16–18.) Defendant also argues that the Knox Keene provisions do not apply
to it, as it is not a “health care service plan” licensed by the Department of
Managed Health Care, which are the entities that Knox Keene regulates. (Motion
at p. 16.)
Defendant’s motion
does not support this latter argument. The Knox Keene Act indeed applies to “health
care service plans and specialized health care service plan contracts.” (Health
& Saf. Code, § 1343, subd. (a).) The term “health care service plan” means
either:
(1) Any person who undertakes to arrange for
the provision of health care services to subscribers or enrollees, or to pay
for or to reimburse any part of the cost for those services, in return for a
prepaid or periodic charge paid by or on behalf of the subscribers or
enrollees.
(2) Any person, whether located within or
outside of this state, who solicits or contracts with a subscriber or enrollee
in this state to pay for or reimburse any part of the cost of, or who
undertakes to arrange or arranges for, the provision of health care services
that are to be provided wholly or in part in a foreign country in return for a
prepaid or periodic charge paid by or on behalf of the subscriber or enrollee.
(Health &
Safety Code § 1345, subd. (f)(1), (2).) Defendant does not elaborate on how it
does not fall into one or the other of these definitions.
Defendant argues
that another Knox Keene provision exempts it from coverage; namely an exception
stating that the Act does not apply to “A person organized and operating
pursuant to a certificate issued by the Insurance Commissioner unless the
entity is directly providing the health care service through those entity-owned
or contracting health facilities and providers, in which case this chapter
shall apply to the insurer's plan and to the insurer.” (Health & Saf. Code,
§ 1343, subd. (e)(1).) But although Defendant claims that it is an insurance
provider registered with the California Department of Insurance, it cites no
evidence in support of this fact. (Motion at p. 16, fn. 10.)
Defendant further
argues that the laws that furnish the basis for Plaintiff’s UCL claim does not
target sufficiently specific conduct. Defendant relies on the case Samura
v. Kaiser Foundation Health Plan, Inc. (1993) 17 Cal.App.4th
1284, which discussed the authority of private parties to sue under certain
provisions of the Knox Act’s implementing regulations. The court noted that
authority to enforce the law “has been entrusted exclusively to the Department
of Corporations, preempting even the common law powers of the Attorney General.”
(Id. at p. 1299.) At the same time, the court noted that private parties
could still use Business & Professions Code § 17200 “to enjoin acts which are declared to be
unlawful under a statutory enforcement scheme.” (Id. at p. 1299.) Under
this authority, a private party may sue upon a law that “defines an unlawful
act that may be enjoined as unfair competition under the Business and
Professions Code,” but not statutes that “pertain to the exercise of the
Department of Corporation's regulatory power.” (Id. at p. 1300.)
Here, this argument is unpersuasive, as the laws that
support Plaintiff’s UCL claim proscribe specific conduct, and do not merely
confer broad regulatory authority. Specifically, Plaintiff’s claims are
supported by Health & Safety Code § 1371.31, subd. (b), which states that
out-of-network providers providing certain services to covered individuals
shall be reimbursed “the amount set forth in the enrollee's evidence of
coverage.” (Health & Saf. Code, § 1371.31, subd. (b).) The claim thus
relies on provision of law that proscribes or mandates certain conduct.
The motion is therefore DENIED as to the third cause of
action under the UCL.
G. BREACH
OF WRITTEN CONTRACT
Defendant argues that Plaintiff’s claim for breach of
written contract fails, as there were no written contracts between Defendant
and Feder. (Motion at pp. 19-20.) Plaintiff in opposition contends that it is
entitled to payment under the patients’ plans, pursuant to the provisions of
the Knox Keene Act discussed above. (Opposition at pp. 19–20.)
Defendant’s argument is the more persuasive. There exists no
written contract between Plaintiff or Feder and Defendant, save for the alleged
oral contracts formed by Defendant’s representatives. Although Plaintiff argues
that it may assert the medical provider’s right to payment under Knox Keene,
the authority cited suggests the opposite: that the Knox Keene Act may entitle
“an out-of-network, nonemergency service provider” to reimbursement on
specified terms, and that claims based upon this statutory guarantee are not
founded in a common law breach of contract claim. (Pacific Bay Recovery,
Inc. v. California Physicians' Services, Inc. (2017) 12 Cal.App.5th 200,
216 [affirming demurrer against implied-in-fact contract claim asserted
alongside Knox Keene claim].)
Plaintiff further argues that it has been assigned the
claims of the patients in this case, and may pursue breach of contract claims
on their behalf. (Opposition at pp. 19–20.) But Plaintiff specifically
disclaims that it is bringing any breach of contract claims assigned to it by
the individual patients. (Opposition at p. 1, fn. 1.)
The motion is therefore GRANTED as to the fifth cause of
action for breach of contract.
H. C.G.’S
COVERAGE
Defendant argues
that it cannot be held liable for non-payment of charges incurred for patient
C.G., because C.G.’s health benefits plan was administered by Meritain Health,
Inc., a separate entity from Defendant Aetna. (Motion at p. 20; Losel Decl. ¶
5, Exh. 10.)
This argument is
persuasive. Separate corporations are presumed to have separate existences. (Mid-Century
Ins. Co. v. Gardner (1992) 9 Cal.App.4th 1205, 1212.) Plaintiff in
opposition presents no evidence or argument to contravene Meritain’s presumed
separateness.
The motion is
therefore GRANTED as to the claims based on C.G.’s treatment.