William Bohannon filed an action seeking a determination that his health benefits plan provided coverage for a stem cell transplant as treatment for his kidney cancer. Bohannon requested a permanent injunction ordering the defendants1 to immediately approve and authorize the treatment. After an expedited hearing, the trial court ruled in Bohannon’s favor, compelling HHC to cover the treatment. HHC appeals, contending the trial court erred in ruling that HHC was estopped from denying coverage for Bohannon’s treatment. “Under OCGA § 9-11-52 a, a trial court’s findings in non-jury trials shall not be set aside unless clearly erroneous, and due regard shall be given to the opportunity of the trial court to judge the credibility of the witnesses.” Citation and punctuation omitted. Insurance Industry Consultants, Inc. v. Essex Inv., Inc. , 249 Ga. App. 837, 839 1 549 SE2d 788 2001. In reviewing the decision in a non-jury trial, the appellate court construes the evidence in favor of the judgment and will not disturb the trial court’s factual findings if there is any evidence to sustain them. Enviro Pro, Inc. v. Emanuel County , 265 Ga. App. 309, 311 593 SE2d 673 2004; Insurance Industry Consultants, Inc. v. Essex Inv., Inc. , 249 Ga. App. at 839-840 1. The trial court’s interpretation and application of the law to those findings, however, are subject to de novo review. Insurance Industry Consultants, Inc. v. Essex Inv., Inc. , 249 Ga. App. at 839-840 1.
Construed in favor of the trial court’s ruling, the record shows the following facts. HHC, a hospital authority created by law,2 operates several healthcare facilities and has hundreds of employees. It provides its employees a health benefits plan which is self-funded for the first $100,000 of each claim. HHC contracts with a third-party administrator “TPA” to select a network of “preferred providers” and to evaluate and process claims. HHC’s TPA also drafts the health benefits plan document, a booklet listing covered services, exclusions, and other material terms, and prints booklets for distribution to plan enrollees. For the relevant calendar year, 2003, Blue Cross served as the plan’s TPA.3
