Health care providers, such as hospitals and physicians, often rely on assignments of benefits from their patients in order to receive payment directly under the health insurance policies or other health benefit plans covering the patients. Employer-provided health benefit plans are subject to the Employee Retirement Income Security Act of 1974 (ERISA), which empowers certain classes of people to bring civil actions to recover benefits due under such plans. Because health care providers are not named as one of the classes, the question arises as to whether a heath care provider may bring an action against a health benefit plan payor to recover the benefits payable under the plan for the services rendered by the provider to the participants in or beneficiaries of the plan. For example, in Kennedy v Connecticut Gen. Life Ins. Co. (1991, CA7 Ill) 924 F2d 698, 13 EBC 1572, 133 ALR Fed 591, the court held that a health care provider with an assignment of benefits from his patient could bring such an action against the health insurer in that case. This annotation collects and analyzes those reported federal and state cases in which the courts determined or recognized whether a health care provider, as assignee, may bring an action under ERISA against the person—usually a health insurance company—obligated to make payment under the ERISA-governed health benefit plan in which the provider's patient is a participant or beneficiary.
