IOWA CITY, Iowa (AP) – An appeals court says Iowa’s largest health insurer improperly refused to pay claims for expensive life-saving drugs for patients with a rare blood disease. The court ruled Tuesday that Wellmark Blue Cross and Blue Shield searched for reasons to deny millions of dollars in claims for drugs used to treat hemophilia, an inherited condition in which patients suffer excessive bleeding.

The medicine at issue, so-called factor drugs, is injected by patients at home so they don’t bleed to death. The ruling means a judge will calculate how much Wellmark owes Iowa City pharmacist Michael Stein. Wellmark is pledging an appeal.

Stein, a provider in Wellmark’s network, dispensed the drugs to 24 patients around the country. He sued Wellmark after the company refused to reimburse him for $7 million in claims.