MOUNT VERNON – Fifth District appellate justices will review former Madison County Circuit Judge Daniel Stack's certification of a class action against Met Life.
On Jan. 28, the Fifth District granted leave for Met Life to appeal an order Stack signed in his final week on the job last November.
Stack appointed chiropractor Lawrence Shipley to represent a class alleging breach of contract on hundreds of thousands of insurance claims in 15 states dating back to 1993.
In December, Met Life petitioned the Fifth District for review.
Troy Bozarth of Edwardsville wrote that Shipley didn't prove injury or standing.
Bozarth wrote that a conflict of interest existed between Shipley and those he treated.
He wrote that laws of the 15 states varied and conflicted. And, he wrote that at least six other potential class actions over medical payments were pending and four class certifications orders were before the Fifth District.
Andrew Kuhlmann, of LakinChapman in Wood River, answered that Met Life agreed to pay reasonable amounts.
He wrote that the question of what reasonable means is common to the class.
He wrote that state laws were materially the same.
Shipley sued in 2003, claiming insurers must pay the provider's bill in the absence of evidence of fraud or bad faith.
Stack agreed, finding Shipley's construction of the contract would establish a right of recovery for the class.
He wrote that he would not prejudge the merits at the class certification stage.
"Ultimately, plaintiffs proffer that the issue of damages should be susceptible to a formulaic resolution based on actual billed charges, or to expert damage calculation based on a statistical analysis," Stack wrote.
"In the unlikely event that these solutions prove unmanageable, the court would also have the power to resolve the liability issues and consider a claims process, or even decertification of the class to permit class members to pursue their individual damage claims in small claims court."
The class includes insured persons and providers in Alabama, Arizona, California, Colorado, Connecticut, Georgia, Illinois, Indiana, Louisiana, Missouri, North Carolina, Ohio, South Carolina, Tennessee and Wisconsin.
Stack excluded from the class persons who settled claims through similar litigation in King County, Wash.