Maddox tosses class action on last day in office

Steve Gonzalez Dec. 12, 2006, 9:30am

On her last day on the job, Madison County Circuit Judge Lola Maddox dismissed a class action suit that alleged Pekin Insurance Co. improperly reduced payments for treatment of patients who suffered injuries in accidents.

Maddox, who retired Nov. 30, ruled the plaintiffs suffered no out of pocket losses as required by Price v. Phillip Morris and Avery v. State Farm.

Frank Bemis, Dale Fischer and Thomas Kaltenbronn brought the four-count suit against Pekin alleging its "acts and omissions" constituted fraud, civil conspiracy, unjust enrichment, and were in violation of the Illinois Consumer Fraud Act.

Madison County chiropractors have filed more than 40 class action lawsuits since 2003, nearly all of them handled by The Lakin Law Firm in Wood River.

"Plaintiffs' failed expectations of receiving 100 percent of what they billed (or payment of their billing at usual and customary rates) does not constitute actual damages," Maddox wrote in dismissing Count I of the suit for failure to state a cause of action.

On Count II, the unjust enrichment allegation, Maddox ruled that the only benefit Pekin received was the insurance premiums paid for by the insureds.

"Plaintiffs presents no case authority that the reductions from their charges to the PPO schedule rates constitute a benefit to Defendant for which suit can be brought for unjust enrichment," Maddox wrote in dismissing the claim.

Maddox also ruled that the plaintiffs did not have a contract with Pekin therefore no breach could exist.

The plaintiffs claimed Pekin did not provide steerage or referrals to them in exchange for the reduced payouts.

Maddox ruled any agreement could only be enforced by the PPO administrator and Pekin, not the plaintiffs. Therefore the plaintiffs lacked standing to sue Pekin based on the terms of any payor agreement because they were not parties.

"Plaintiffs have failed to establish any duty or responsibility on the Defendant for providing plaintiffs steerage under Illinois law," Maddox wrote. "Because there was no breach of any contract, there can be no damages."

Maddox also ruled there was no civil conspiracy because there was no contract between the plaintiffs and Pekin, dismissing the fourth and final count of the complaint.

"Given that this court has concluded that all counts of plaintiffs' complaint against Pekin should be dismissed without leave to amend, the plaintiffs have no viable personal causes of action," Maddox wrote.

"Plaintiffs thus cannot act as class representatives and no class can be certified by the court."

Maddox ordered the clerk to close the file.

David Osborne of Chicago represented Pekin.

In July, Don Weber denied Auto Owners Casualty and Surety Company's motion to dismiss a class action case filed by Bemis.

Citing the case Zinser v. State Farm, which allows doctors or medical organizations to sue whenever consumer protections are implicated, Weber ruled Bemis does have standing to bring suit.

"This court notes that many doctors have left, and continue to leave Madison County because of medical malpractice insurance rates. The delivery of quality healthcare at affordable costs is implicated in this lawsuit," Weber wrote. "Consumers of healthcare in general have a legitimate interest in the allegations and defenses of this action."

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