Court Finds No Standing In Unpaid Medical Bill Suit

July 22, 2003 (PLANSPONSOR.com) - Never being billed, combined with no indication that a participant would ever be billed, leads to a participant's lawsuit for unpaid medical bills having no standing.

>US District Judge Barbara Crabb of the US District Court for the Western District of Wisconsin determined the participant’s lawsuit had no standing under Article III of the US Constitution and thus granted summary judgment for the defendant in Bollig v. Christian Community Homes and Services Inc.   Crabb said to have standing, a plaintiff must have suffered a concrete injury or be on the verge of suffering one, according to Washington-based legal publisher BNA.

>However, the court denied the employer’s request for attorneys’ fees, saying the lawsuit was not brought in bad faith. The participant’s suit “appears to have been prompted by a genuine concern that they might some day be held liable for unpaid medical bills. On the record in this case, I have found that [Bollig’s] concerns are too speculative to support standing, but I cannot conclude that their suit was intended to harass or vex [the employer],” the court said.

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Unpaid, Unbilled

>Dolly Bollig was covered under the ERISA-governed Christian Community Homes and Services’ health insurance plan when her son received medical services related to a liver transplant at Fairview University Medical Center costing over $100,000.   Following the procedure, the health plan refused to pay for the medical services.

>Bollig then informed her son’s medical provider she was eligible for Wisconsin Medicaid.   However, when the provider submitted the claim to Medicaid, the claim was denied because it was submitted more than a year after the provider was first notified the son was eligible for Medicaid. The provider never billed Bollig for her son’s medical services, and said it would never bill her.

>Regardless, Bollig brought a lawsuit under ERISA for monetary relief against her employer for the unpaid medical expenses.

The case is Bollig v. Christian Community Homes and Services Inc., W.D. Wis., No. 02-C-532-C, 7/10/03.

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