Blue Cross & Blue Shield of Georgia, Inc. v. Kell, 227 Ga. App. 266

Summary

The Georgia Court of Appeals affirmed summary judgment for Dr. Kell on Blue Cross's counterclaims for fraud and violations of the Georgia Fair Business Practices Act. The court held that Blue Cross failed to present admissible evidence creating a factual issue regarding fraudulent intent and failed to show justifiable reliance on any alleged misrepresentations. The court also held that Blue Cross was not a statutory consumer under the 1996 amendment defining consumer as a natural person.

Holdings

1. Blue Cross failed to present admissible evidence creating a genuine issue of material fact regarding Dr. Kell's intent to defraud, and summary judgment on the fraud counterclaim was proper.
2. Blue Cross failed to establish a genuine issue on essential elements of its fraud claim, including justifiable reliance.
3. Blue Cross was not a consumer entitled to protection under the Georgia Fair Business Practices Act because the 1996 statutory amendment defined consumer as a natural person.
4. The court could not consider Blue Cross's reliance on a federal court order because the copy in the record was not certified as required to prove the asserted defense.

Questions Presented

1. Whether Blue Cross presented admissible evidence creating a genuine issue of material fact regarding Dr. Kell's intent to defraud.
2. Whether Blue Cross presented evidence of justifiable reliance on any alleged misrepresentations.
3. Whether Blue Cross could establish a fraud counterclaim based primarily on hearsay evidence from an unidentified employee.
4. Whether Blue Cross was a consumer entitled to protection under the Georgia Fair Business Practices Act.
5. Whether an uncertified federal court order could control the issues in the case.

Disposition

affirmed