A Madison County judge is set to hear a series of summary judgment motions in a 2004 class action over allegedly improper Preferred Provider Organization (PPO) discounts filed against Liberty Mutual Insurance company and Liberty Mutual Fire Insurance Company.

Lead plaintiff Thomas Kaltenbronn D.C. claims he and other health care providers were shorted on claims they filed with Liberty through a "silent PPO."

Madison County Circuit Judge Dennis Ruth was set to hear the motions at 9 a.m. Friday.

Madison County Circuit Judge Barbara Crowder formerly had the case.
Crowder certified the Illinois class in 2008.

That class consists of all healthcare providers in the state that had claims reduced by Liberty from Jan. 1, 1997 to June 30, 2008.

The suit is one of a number of PPO class actions brought in Madison County in the early part of the last decade by attorneys from the Lakin Law Firm – now LakinChapman LLC of Wood River – and Freed & Weiss of Chicago.

That partnership fell apart in 2007.

Lead plaintiff Kaltenbronn is joined as class representative by chiropractor Richard Coy and Dale Fisher.

Coy has led other PPO class actions including one against First Health that resulted in a still-disputed settlement.

The third amended complaint in the Kaltenbronn suit contends that he, his co-lead plaintiffs and other health care providers lost out on money from workers compensation claims they treated when Liberty Mutual took improper PPO discounts.

The plaintiffs claim that Liberty did not steer claims to the providers who were members of the PPO.

Liberty Mutual moved for summary judgment in March 2010.

In that motion, Liberty Mutual claims that the plaintiffs did benefit from the PPO in the form of directory listings, prompt payments, and other incentives.

The insurers also allege that three lead plaintiffs stayed with the PPO because of those incentives.

The plaintiffs filed a cross-motion for partial summary judgment in the suit June 25, 2010.

In that motion, Kaltenbronn, Coy and Fisher claim that Liberty Mutual did nothing to steer workers compensation claims to them.

The failure to do so, according to the plaintiffs' motion, included not giving claimants incentives to use the providers in the PPO and not establishing the PPO they were members of as a panel under Illinois workers compensation law.

They claim there is no dispute that Liberty Mutual was obligated to steer clients to them and therefore they are entitled to partial summary judgment.

Motions to quash a defense subpoena to non-party First Health and a plaintiffs' motion for sanctions against Liberty Mutual for allegedly "inappropriate gamesmanship" during discovery were also filed last year.

Robert Schmieder II is class counsel.

Thomas Keefe Jr. and others represents Liberty Mutual.

The case is Madison case number 04-L-1416.

More News