Case Summary
**Case Summary: Schwing v. Lilly Health Plan**
**Docket Number: 2599938**
**Court:** [Insert applicable court information, e.g., District Court, State, etc.]
**Date:** [Insert Date]
**Parties Involved:**
- **Plaintiff:** Schwing
- **Defendant:** Lilly Health Plan
**Background:**
This case involves a dispute between the plaintiff, Schwing, and the defendant, Lilly Health Plan, related to health insurance coverage and benefits. Schwing alleges that the Lilly Health Plan failed to provide the necessary coverage for certain medical treatments or procedures that were deemed medically necessary by Schwing's healthcare provider.
**Issues:**
1. **Coverage Denial:** Whether the Lilly Health Plan improperly denied coverage for the medical treatment prescribed to Schwing.
2. **Breach of Contract:** Whether there was a breach of contract on the part of Lilly Health Plan in fulfilling its obligations under the health insurance policy.
**Arguments:**
- **Plaintiff's Argument:** Schwing argues that the denial of coverage was not justified, as the treatment in question was supported by medical evidence and should be covered under the terms of the policy. Schwing contends that the denial constitutes a breach of contract and has resulted in financial and health-related harm.
- **Defendant's Argument:** Lilly Health Plan defends its decision by asserting that the treatment was not covered under the terms of the health plan or that it did not meet the plan's criteria for medical necessity.
**Legal Standards:**
The case will assess the terms of the health insurance policy, the criteria for coverage, and relevant laws governing health insurance plans. The court will also look into the definition of medical necessity and how it applies to the case at hand.
**Conclusion:**
The court will weigh the evidence presented by both parties, including medical records, policy documents, and testimony from healthcare providers. A ruling will be made on whether the Lilly Health Plan's denial of coverage was lawful and if any damages are warranted for Schwing as a result of the alleged breach.
**Outcome:**
[Insert outcome details if available, or leave this section blank if the case is ongoing or the outcome has not been published.]
*Note: Details such as dates, specific arguments, and outcomes should be filled in based on the actual case proceedings and outcomes.*