Opinion ID: 2337711
Heading Depth: 1
Heading Rank: 2

Heading: the case against farm bureau.

Text: LDC filed the second of the two cases at issue against Kentucky Farm Bureau Mutual Insurance Company. Farm Bureau had issued an automobile insurance policy to Blanch Merryman. The policy contained, in part, mandatory no-fault coverage of $10,000 in basic reparation benefits. Merryman's granddaughter, Jennifer Lee McCord, claimed that she was injured in an automobile accident and asserted a claim to recover no-fault benefits under Merryman's policy. At the time of the accident, McCord was living with Merryman. Fifteen months after the accident, McCord sought treatment with a chiropractor for injuries that she alleged stemmed from the automobile accident. The chiropractor ordered magnetic resonance imaging (MRI) of both McCord's lumbar and cervical spines, which LDC performed. Similar to Hughes's case, at the time McCord had the MRIs, LDC required her to complete the form entitled, Agreement to Pay and Assignment of Benefits. The form contained the exact same language as the one that Hughes signed. McCord completed the form and provided that her reparation obligor was Farm Bureau. LDC submitted its bills for the two procedures, also totaling $2,394, to Farm Bureau for payment from McCord's no-fault benefits. In McCord's case, however, Farm Bureau sent the bills to an outside company for peer review. A reviewing physician advised Farm Bureau that it should not allow payment because (1) McCord did not initiate the treatment until fifteen months after the motor vehicle accident; and (2) no medical history existed to indicate that the treatment was accident-related. The reviewing physician recommended that payment for the billed MRIs should be submitted to McCord's health insurance provider. Farm Bureau notified LDC that it would not pay for the MRIs and advised LDC of the recommendation to submit its bills to the health insurance provider. Choosing to rely instead on the assignment provisions of the form that McCord completed when she had the two MRIs, LDC filed suit against Farm Bureau. Farm Bureau filed a motion to dismiss the case in which it argued that LDC's cause of action should be dismissed because (1) Kentucky law does not provide LDC with a direct cause of action against Farm Bureau; and (2) the peer review, conducted under Kentucky law, found LDC's charges and services neither reasonable nor medically necessary. In an opinion and order, the district court granted Farm Bureau's motion to dismiss LDC's action, with prejudice. LDC appealed, and the circuit court affirmed the district court's order of dismissal. The Court of Appeals granted discretionary review and heldconsistent with the companion State Farm casethat LDC simply lacked standing to assert a claim by attempted assignment against State Farm.