Hylla
LakinChapman lawyers settled a potential class action over claims that One Beacon Insurance improperly discounted medical bills before paying them.
Madison County Circuit Judge David Hylla announced an agreement on Sept. 29, asking for appropriate papers before Nov. 17.
He set the stage in August by denying summary judgment to the insurer.
The former Lakin law firm sued One Beacon in 2005, ahead of the effective date of the Class Action Fairness Act that steered most new class actions to federal courts.
As the deadline approached, the Lakins sued every insurer they could.
For class representatives they offered a network of local chiropractors and their clinics, alone or in combinations, with identities and roles that would shift from year to year.
Hylla's August order identified Lebanon Chiropractic Clinic as lead plaintiff.
His September order, in his own hand, identified Metro East as lead plaintiff.
All the complaints focus on contractors the chiropractors didn't sue.
Hylla's August order declared, "Genuine issues of material fact still exist as to whether Intracorp had a contract with CCN during the 1997 and 2000 time frames."
"In addition, the court finds that Intracorp was not a 'payor' as defined and required by the provider agreements," Hylla wrote.
"Also, nothing in the provider agreements authorizes a payor to pass along PPO discounts to a non-payor such as defendant, One Beacon.
"Whether Defendants had a contract with or were in privity with a party that had a contract with plaintiffs for PPO discounts remains a question of material fact."
Hylla found further issues of fact on consumer fraud and unjust enrichment, "including whether contractual privity existed that entitled defendant to take PPO discounts."
"If no such contractual privity existed, defendants' representations that it was taking discounts pursuant to such privity may be found to be fraudulent," Hylla wrote.
He held that workers' compensation law didn't apply because the alleged damages didn't result from a patient's injury.