Kelly Health Care v. The Prudential Insurance Co. of America
Supreme Court of Virginia
309 S.E.2d 305 (1983)
Kelly Health Care (plaintiff) provided services to Green, who was insured by Prudential (defendant); Green signed two documents allowing Prudential to pay insurance proceeds directly to Kelly, though Prudential never received the first and received the second only months after Kelly began treating Green. When Kelly billed Prudential directly and was refused payment, Kelly sued both Green (who defaulted) and Prudential, arguing the documents made Kelly Green's assignee. The trial court found the documents were merely an authorization rather than an assignment and granted Prudential summary judgment; Kelly appealed.
Whether documents in which an insured authorizes an insurance carrier to pay health care benefits directly to a provider can constitute an assignment enforceable by the provider.