Barbara Schermer v. BCBSM, Inc., etc.

U.S. Court of Appeals for the Eighth Circuit
Barbara Schermer v. BCBSM, Inc., etc., 356 F. App'x 916 (8th Cir. 2009)

Barbara Schermer v. BCBSM, Inc., etc.

Opinion

PER CURIAM.

Barbara and Irvin Schermer challenge the district court’s 1 dismissal of their amended complaint. These appeals arise out of a denial of a claim for home health care benefits for Barbara Schermer. Barbara Schermer and her husband, the primary insured on the group health insurance policy issued by BCBSM, sought reimbursement from BCBSM for the expense of having a person come to their home to assist Barbara in tasks such as “walking, bathing, getting around, getting into bed, [and] getting dressed.” As the district court pointed out, and as is apparent in the complaint, it is clear that medical reports recommend such care for Barbara, and that such care was likely needed. Yet, the issue is whether the relevant BCBSM policy covers the expenses associated with the receipt of these services. In a thorough and detailed analysis, the magistrate judge 2 concluded that the requested custodial care was not covered. The district court, in response to objections to the Report and Recommendation, agreed, as set out in the court’s similarly detailed analysis. The Schermers appeal, raising various legal theories and statutory claims challenging BCBSM’s claims procedure and ultimate denial of benefits as well as challenging particular plan language.

Having reviewed the complaint and those portions of the plan that the pleadings necessarily embrace, see Mattes v. ABC Plastics, Inc., 328 F.3d 695, 697-98 n. 4 (8th Cir. 2003), as well as the Schermers’ arguments on appeal, we conclude that dismissal was proper for the very reasons stated in the district court’s opinion, which expressly adopts the report and recommendation of the magistrate judge. Friends of Lake View Sch. Dist. Inc. No. 25 v. Beebe, 578 F.3d 753, 757-58 (8th Cir. 2009) (“We review de novo a district court’s decision to grant a motion to dismiss.”); Hillstrom v. Kenefick, 484 F.3d 519, 524 (8th Cir. 2007) (discussing judicial review of a decision to deny benefits under *917 an ERISA plan — -whether for abuse of discretion or plenary).

Accordingly, we affirm. See 8th Cir. R. 47B.

1

. The Honorable John R. Tunheim, United Stales District Judge for the District of Minnesota.

2

. The Honorable Franklin L. Noel, United States Magistrate Judge for the District of Minnesota.

Reference

Full Case Name
Barbara A. SCHERMER, Appellant, v. BCBSM, INC., Doing Business as Blue Cross Blue Shield of Minnesota, Appellee; Irvin E. Schermer, Appellant, v. BCBSM, Inc., Doing Business as Blue Cross Blue Shield of Minnesota, Appellee
Status
Unpublished