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MADISON - ST. CLAIR RECORD

Friday, March 29, 2024

Liberty Mutual asks for summary judgment in certified class action

Crowder

Class action chiropractors claim Liberty Mutual Insurance should have steered workers compensation patients to them, but according to the insurer that kind of steering would have broken the law.

"Illinois is an employee choice state for workers compensation and it is illegal for an employer or insurer to interfere in any way with an employee's right to choose his or her medical provider," Tom Keefe of Belleville wrote on Jan. 29.

Keefe asked Madison County Circuit Judge Barbara Crowder to grant summary judgment in a case she certified as a class action in 2008.

Chiropractors Thomas Kaltenbronn, Richard Coy and Dale Fischer claim they joined a preferred provider organization, First Health, expecting an increase in referrals.

They allege that they did not receive full benefits due to Liberty Mutual's actions.

The Lakin Law Firm filed suit for them in 2004.

According to Keefe, the chiropractors received benefits in the form of directory listings, prompt payments, and reductions in deductibles and co-payments.

These benefits kept Kaltenbronn in First Health for 11 years, Fischer for 10, and Coy for six, Keefe wrote.

Kaltenbronn and Coy didn't terminate their memberships until after they sued, he wrote, and Fischer hadn't terminated his when Liberty Mutual deposed him.

Keefe wrote that Liberty Mutual calculated and billed premiums based on actual costs.

"Such determinations and payments cannot be undone," he wrote.

The chiropractors can't seek restitution, he wrote, because they did not disaffirm or void their contracts.

"Plaintiffs cannot disgorge the benefits they received by remaining in the network for an extended period," he wrote.

"The performance of the parties pursuant to their contracts cannot be undone going back for more than a decade in time," he wrote.

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