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Marques v. Harvard Pilgrim Healthcare of New England9/1/2005
Thomas P. Seymour, appearing pro se, appeals from the denial of his motion for summary judgment and from the grant of summary judgment in favor of the appellee, Harvard Pilgrim Healthcare of New England, Inc. (HPHC-NE). Relying upon Title III of the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. ยง 12101 et seq., Mr. Seymour contends that he was discriminated against on the basis of his disabilities when he was denied health insurance from HPHC-NE.
Facts and Travel
On August 16, 1995, Mr. Seymour requested that HPHC-NE send him an application form for health-care coverage, and HPHC-NE duly mailed an application form to him.
On August 21, 1995, HPHC-NE received an application from Mr. Seymour, but its underwriting department determined that the application was incomplete because of the applicant's failure to provide certain information which it considered necessary. HPHC-NE returned the partially completed application to Mr. Seymour on the following day. In an accompanying letter, HPHC-NE explained its reasons for returning the application and informed Mr. Seymour that he was required to provide the additional information before it could consider his application for health-care coverage.
Over a month later, on September 30, 1995, HPHC-NE notified Mr. Seymour in writing that it had not yet received the previously requested obligatory information; and it informed him that, unless it received a completed application within two weeks, his partially-completed application would be voided and he would have to reapply for coverage. Mr. Seymour failed to respond within the specified two-week period. Accordingly, on October 15, 1995, HPHC-NE voided Mr. Seymour's partially-completed application.
In early December 1995, Mr. Seymour received a document entitled "Ten-Day Notice" from the Rhode Island Department of Human Services (DHS). The text of that notice informed Mr. Seymour that, after December 26, 1995, he would no longer be eligible to receive Medical Assistance (Medicaid) benefits due to his " ailure to cooperate." The notice specified that Mr. Seymour had failed to provide the agency with documentation about a change in his financial situation. The notice from DHS also informed Mr. Seymour that he had the right to request and receive a hearing. The ten-day notice document further informed him that, should he request a hearing within ten days, his Medicaid benefits would continue uninterrupted pending the outcome of the hearing. Mr. Seymour did not request a hearing. Accordingly, his Medicaid benefits were terminated on December 26, 1995.
Several weeks later, on February 12, 1996, Mr. Seymour contacted HPHC-NE to inquire about the status of his August 21, 1995 application for health-care coverage. HPHC-NE advised him that his application had been voided because he had failed to provide in a timely manner the additional information that was necessary for the application to be complete. It further advised Mr. Seymour that, should he still be interested in obtaining heath-care coverage from HPHC-NE, he would have to recommence the process by submitting a completed application.
On February 20, 1996, Mr. Seymour submitted a completed application to HPHC-NE. After reviewing the submitted materials, the underwriters at HPHC-NE concluded that Mr. Seymour presented an unacceptably high risk of loss due to the fact that he suffers from Arthrogryposis and Crohn's Disease. As a result, on February 27, 1996, HPHC-NE denied Mr. Seymour's application for health-care coverage because it had concluded that he did not meet its eligibility guidelines.
Mr. Seymour then filed a complaint with the Department of Business
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