Legal Case Summary

W.A. Griffin v. Aetna Health Inc.


Date Argued: Wed Aug 15 2018
Case Number: 17-13113
Docket Number: 7807016
Judges:Not available
Duration: 61 minutes
Court Name: Court of Appeals for the Eleventh Circuit

Case Summary

**Case Summary: W.A. Griffin v. Aetna Health Inc.** **Docket Number:** 7807016 **Court:** [Specify Court Name] **Date:** [Specify Date of Decision] **Background:** W.A. Griffin filed a lawsuit against Aetna Health Inc. concerning issues primarily related to health insurance coverage. The case revolves around allegations of improper denial of claims or failure to provide coverage as outlined in Griffin's insurance policy with Aetna. **Facts:** - The plaintiff, W.A. Griffin, was covered under a health insurance policy issued by Aetna Health Inc. - Griffin filed several claims for medical services received, which he believed were covered under his policy. - Aetna Health Inc. denied the claims, citing various reasons that included lack of medical necessity, policy exclusions, or failure to follow pre-authorization procedures. - Griffin contended that these denials were unjust and inconsistent with the terms of his insurance policy, which he asserted provided for the coverage of the necessary medical treatments. **Issues:** 1. Did Aetna Health Inc. improperly deny Griffin's claims for medical services? 2. Was Aetna's reasoning for denying the claims consistent with the terms of the insurance policy? 3. What damages, if any, is Griffin entitled to as a result of the alleged improper denial of claims? **Ruling:** [Provide the court's ruling, whether the claims were upheld, dismissed, or settled.] **Legal Principles:** The court examined the contractual obligations of Aetna Health Inc. under the insurance policy, relevant health insurance regulations, and precedents regarding good faith and fair dealing in insurance claims handling. The court also assessed the evidence presented to determine if Aetna's denial of the claims was justified based on the policy’s terms. **Conclusion:** The case highlighted important issues related to health insurance claim practices and the obligations insurers have towards their policyholders. The outcome of W.A. Griffin v. Aetna Health Inc. serves as a reference point for similar disputes regarding health insurance coverage and claims denials. **Note:** For specific details regarding the ruling and any applicable statutes or legal precedents, further research may be required based on the documented decision from the court. --- Please replace placeholders such as "Specify Court Name" and "Specify Date of Decision" with the relevant information for a complete case summary.

W.A. Griffin v. Aetna Health Inc.


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