1.0 DESCRIPTION
Court-ordered care is medical
service, including inpatient admissions, that a court of law orders or
directs a party in a legal proceeding to obtain.
2.0 POLICY
The fact that medical services
are ordered by a court does not determine the coverage of those medical
services. Benefits will be paid only if the service is to diagnose
or treat a covered condition, if the service is at the appropriate
level of care to treat the condition, and if the beneficiary (or
the beneficiary’s family) has a legal obligation to pay for the
service.