Case Results

Class action brought against health insurance carrier of federal employee for seeking reimbursement of health insurance benefits paid when the injured employee recovered in settlement with the party who caused the wreck. Missouri law generally prohibits health insurance carriers from seeking such reimbursement. Insurance carrier argued that provision in Federal Employee Health Benefits Act (FEHBA) allowed terms of the private contract between federal government and insurer to supersede state law. Case went up on appeal to the Missouri Supreme Court and the U.S. Attorney General’s office argued in favor of the insurance carrier’s position. In a unanimous decision, the Missouri Supreme Court adopted Blake’s arguments and became the first state supreme court in the nation to hold that a state law prohibiting subrogation/reimbursement was not preempted by the terms of a FEHBA contract. Subsequently reversed and remanded by the United States Supreme Court.

Class Action against Kansas City area hospitals for refusing to submit auto accident claims to a patient’s health insurance. The case was successfully appealed to the Missouri Court of Appeals for the Western District, creating new consumer-friendly case law in Missouri and paving the way for global settlement in a companion case, Welschmeyer v. St. Luke’s, et al. The settlement was valued at over $4,000,000.00 and included settlement payouts to class members, waiver of pending hospital liens and future injunctive relief.

Class action prosecuted against St. Louis hospital group related to unfair billing practices. Hospital group was denying accident injury victims with health insurance the benefits of their insurance by refusing to submit hospital bills to the health insurance carrier for adjustment (reduction) and payment, opting instead to pursue the full amount of the bills pursuant to liens against third party recovery and medical payment benefits from auto insurance policies. 2,735 class members were eligible for an average class payment of $2,100, with the full settlement value of $2,100,000.00.