Tuesday, May 05, 2020

circumventing insurance can violate consumer protection law

Franks v Sykes, No. W2018-00654-SC-R11-CV, 2020 WL 2097544, -- S.W.3d --- (Tenn. May 1, 2020)

I usually try to stick to advertising-related UDAP claims but this practice was just so astonishingly awful that I could not resist.  Plaintiffs were injured in car accidents and received hospital treatment. Instead of billing plaintiffs’ insurance companies for the negotiated rates, the hospitals instead filed liens against the plaintiffs’ claims for damages for the “full amount” (scare quotes because of how badly medical billing works in this country). The Kentucky Supreme Court held that its state consumer protection law applied to health care providers when they are acting in their business capacities, although it doesn’t apply to treatment (which is not a “consumer transaction”).

Rule: “[W]hen a plaintiff alleges an injury caused by a health care provider’s business practices—including, but not limited to, deceptive practices in advertising, billing, or collections—the plaintiff may state a claim under the Act. When a plaintiff asserts a claim that an injury is caused by a health care provider’s professional conduct, such as a deviation from the applicable standard of medical care, then the Act does not apply because that claim would be based on medical negligence under the Tennessee Health Care Liability Act.”

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