A Philadelphia judge has refused to reverse his ruling holding Allstate liable for not paying a medical device company used by auto accident victims.
Philadelphia Court of Common Pleas Senior Judge D. Webster Keogh denied Allstate’s post-trial motions in a case filed against it by Freedom Medical Supply under the Pennsylvania Motor Vehicle Financial Responsibility Law.
In four consolidated cases, Freedom claimed Allstate failed to pay bills for durable medical equipment. According to Keogh’s opinion, Allstate argued some of the claims were not medically necessary, although it provided no information supporting that conclusion.
Following Municipal Court and arbitration awards in favor of Freedom, Keogh presided over a four-day bench trial, finding in favor of Freedom.
In post-trial motions, Allstate said it was entitled to a jury trial. Keogh, however, disagreed because the statutes governing the case did not extend that right.
“Absent a statutory basis for a jury trial, appellant would only have the right if the particular cause of action existed at the time the constitution was adopted,” Keogh said. “Although a common law claim of breach of contract existed for at the time the constitution was adopted, causes of action under the MVFRL and the Pennsylvania Bad Faith Act did not.”
Keogh also said Allstate’s conduct was wanton in is failure to pay the patients’ medical bills, in violation of the MVFRL.
“Where an insurer refuses to pay for rehabilitative services or merchandise without first challenging the reasonableness or necessity before a [peer review organization], and a court determines the services or merchandise were medically necessary, ‘the insurer must pay to the provider the outstanding amount plus interest at 12 percent, as well as the cost of the challenge and all attorney fees,’” Keogh said, adding that if the court finds that conduct is wanton, it can impose treble damages.
Keogh said Allstate did not follow the PRO process and its reports were not applicable to the cases at hand.
“Additionally, at some point during the two-and-a-half year journey of these cases before this court, and subsequent to eight prior municipal court and arbitration awards in favor of appellee in these cases, appellant’s continued denials became wonton[sic],” Keogh said.
He added, “accordingly, treble damages are appropriate and were awarded in the instance matter. Appellee was awarded the outstanding balance in each of the four matters, interest at 12 percent, costs, attorneys’ fees, and treble damages totaling $72,762.”
Dean Weisgold represents the plaintiff and Kevin McNulty represents Allstate; neither responded to requests for comment.
(Copies of the 29-page opinion in Freedom Medical Supply v. Allstate Property & Casualty Insurance, PICS No. 18-1353, are available at http://at.law.com/PICS.)