Opinion ID: 1755276
Heading Depth: 1
Heading Rank: 7

Heading: date on which limitations period began to run

Text: Having determined that the 3-year contractual limitation was enforceable, we turn to the question of when the 3-year limitations period commenced. Brodine argues that the period would commence on January 2, 2001, or 18 months from July 2, 1999, the date on which her claims were processed and denied by Blue Cross. However, the contractual provisions of the policy do not support Brodine's argument that July 2, 1999, was significant for determining when the 3-year period commenced. The Master Group Contract provided that an insured could not start a legal action after three years from the date written proof of loss is required. (Emphasis supplied.) Thus, we must determine when Brodine was required to provide written proof of loss under the policy. To receive benefits under the policy, an insured who received medical treatment was required to file with Blue Cross a claim containing written proof of the Services provided. A claim could be filed by the insured or directly by the health care provider, as occurred in Brodine's situation. We conclude that the date on which written proof of loss is required, as set forth in the limitations provision of the Master Group Contract, refers to the same date on which an insured was required to file with Blue Cross his or her claim. The notion that claim is synonymous with written proof of loss is supported by the heading to the policy provision requiring insureds (or their service providers) to file claims with Blue Cross. That heading states: NOTICE OF CLAIM/PROOF OF LOSS. This reading of the policy is consistent with the certificate of coverage given to Brodine. It stated that the insured could not file a lawsuit more than three years from the time the claim is required to be filed. (Emphasis supplied.) The contract provided two alternative deadlines for filing a claim for services with Blue Cross. The claim was to be filed within 90 days of the time medical services had been provided, and if the claim was not filed within 18 months, benefits would not be paid. The last date on which Brodine received medical treatment was May 7, 1999. Accordingly, at the earliest, she was required to file a claim with Blue Cross within 90 days of May 7, and at the latest, within 18 months of May 7. For purposes of our summary judgment analysis, we give Brodine the benefit of all reasonable inferences deducible from the evidence and assume that the 3-year limitations period started to run 18 months from May 7, 1999. As the district court concluded, 3 years plus 18 months from the last date of service required Brodine to file her action against Blue Cross no later than November 7, 2003. Thus, the time for filing this action had come and gone by the time Brodine filed on December 22. We conclude the district court correctly determined that Brodine's action was untimely filed. Brodine's argument is without merit.