McCoy v. Blue Cross and Blue Shield of Utah

Summary

The Utah Supreme Court affirmed the denial of Blue Cross and Blue Shield of Utah's motion to compel arbitration. The court held that Blue Cross failed to provide direct and specific evidence that McCoy received the policy amendment adding a mandatory arbitration provision. The court also held that McCoy did not waive his right to contest arbitration because a later letter mentioning a right to seek arbitration did not establish that arbitration was mandatory.

Holdings

1. A party seeking to compel arbitration must provide direct and specific evidence of an agreement to arbitrate between the particular parties. Evidence showing only that an insurer generally mailed an arbitration amendment to a large group of policyholders, without identifying the individual policyholder in the recorded evidence or establishing an actual mailing directed to that person, is insufficient.
2. A policyholder does not waive the right to contest a mandatory arbitration provision merely by failing to act after receiving a letter advising him that he had a right to seek arbitration, where the letter did not provide the amendment's text or notify him that arbitration was mandatory or exclusive.

Questions Presented

1. Whether Blue Cross presented sufficient direct and specific evidence to establish that McCoy agreed to the mandatory arbitration amendment.
2. Whether McCoy waived his right to contest the arbitration provision by failing to invoke arbitration after receiving a benefits-denial letter that mentioned a right to seek arbitration.

Disposition

affirmed