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MADISON - ST. CLAIR RECORD

Saturday, April 20, 2024

IBJI withdraws $500K settlement claim in Cincinnati PPO class action; case closed

Schmieder II

Odland

A class member that had asked for payment on a settlement claim worth more than $500,000 in a Preferred Provider Organization (PPO) class action brought against Cincinnati Insurance Company and Cincinnati Casualty Company has dropped its request.

Madison County Circuit Judge William Mudge approved the withdrawal of the claim that had been pursued by the Illinois Bone and Joint Institute (IBJI) May 6 and closed the 2005 case.

The claimant's reason for dropping the matter is not given in its withdrawal request.

The IBJI was one of a class of Illinois healthcare providers led by chiropractor Frank Bemis.

Bemis and the class claimed in their suit that Cincinnati took PPO discounts it wasn't entitled to from workers' compensation treatment claims.

The suit is one of a number of PPO class actions filed in the early part of the last decade in both Madison and St. Clair Counties.

The class consisted of 32,000 members.

The suits were filed by the then-legal partnership of the Lakin Law Firm of Wood River and the Chicago firm of Freed & Weiss.

That partnership broke up in 2007.

The Lakin firm's successor, LakinChapman LLC of Wood River remained as class counsel on the Cincinnati suit.

The parties settled for $3.5 million in 2009.

Bemis took home $5,000 while the class counsel from LakinChapman got $700,000 in fees.

The IBJI's initial claim was partially paid.

Cincinnati paid the institute $52,000 of a $485,000 claim.

The defendants rejected the bulk of the claim on the grounds that the class member failed to submit the right documentation of the alleged wrongful deductions.

The IBJI then went on to find what it claimed were further wrongful claims deductions which brought its total settlement claim to more than $500,000.

Cincinnati rejected that claim last year.

The IBJI then moved for a court resolution of the dispute.

Mudge heard arguments in December 2010 and March of this year on the matter and reviewed the documentation that the IBJI argued would support its claims.

Cincinnati took issue with the form of the documentation and the math included in spreadsheets the IBJI submitted to Mudge for review.

Cincinnati attorney Omar Odland noted March 24 in a hearing on the matter before Mudge that one patient who appeared over 50 times in the records had claims that weren't related to workers' compensation injuries.

Class counsel Robert Schmieder II countered at the same hearing that the IBJI had supported its claims with hard numbers.

"It may be cumbersome and they may not like it but they have the data," Schmieder II said at the March 24 hearing.

Mudge gave the parties an additional 60 days following the March hearing to conduct any needed discovery on the issue.

The IBJI withdrew its claim May 6, the same day that Mudge approved the withdrawal and closed the case.

The suit had previously been assigned to Madison County Circuit Judge Barbara Crowder.

The case is Madison case number 05-L-178.

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