Professional Service Exclusion Did Not Bar Coverage For Settlement Where Provision Of Credentialed Physicians Was Not Principal Service Provided By Blue Cross

Blue Cross of Idaho Health Serv., Inc. v. Atlantic Mut. Ins. Co., No. 1:09-CV-246-CWD, 2011 WL 162283, at *18-19 (D. Idaho Jan. 19, 2011)

 

Professional Service Exclusion Did Not Bar Coverage For Settlement Where Provision Of Credentialed Physicians Was Not Principal Service Provided By Blue Cross

 

The court found the “professional service” exclusion ambiguous as applied to the services Blue Cross provided.  Health care providers participated in Blue Cross’s provider network via “provider agreements” which required physicians to be credentialed but did not make this credentialing activity Blue Cross’ main service to render its business, a “professional service” within the meaning of the policy’s exclusion on “professional services.”

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