What Do You Mean It's Not Covered: "Experimental or Investigative"

Arguing that it had a legitimate reason for concluding in 1986 that MRIs of the prostate were experimental or investigative and, thus, that it had a reasonable basis upon which to deny coverage, Blue Cross argued that the trial court properly directed a verdict in its favor on Griffis' bad faith claim. However, Griffis contended, and the Court of Civil Appeals agreed, that this case did not fall within the category of an "ordinary" bad faith case and should not have been applied by the trial court. The Court of Civil Appeals ruled that the trial court had properly submitted the contract claim to the jury, but, characterizing this as an "extraordinary" bad faith case, ruled that the trial court had erred in directing a verdict for Blue Cross on the bad faith claim. But it cited no cases in support of its holding that this was an "extraordinary" bad faith case and therefore not subject to the "directed verdict on the contract claim standard." Both Griffis and Blue Cross pressed the case up to the state supreme court. After reviewing the record, the supreme court concluded that this was not an "extraordinary" bad faith case. The Alabama court held that it would have frustrated the purpose of the bad faith action and allowed Blue Cross to avoid bad faith liability. "In the present cases, we have what then Justice Jones characterized... as `the more normal situation in which the factual dispute centers around the reasonable, but conflicting, inferences that may be drawn from' objective information."