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District Court Decision Highlights Importance of Carefully-Drafted Provider Assignment Clauses
K&L Gates Link to more items from this source
Feb. 5, 2016

"While the assignment conferred the Laboratories the right to collect benefits stemming from a 'collateral source,' the 'core focus' of the assignment was on the assignee's ability to recover benefits 'owed under any policy of insurance' and to pursue any rights to collect from the insurance company if for any reason the 'insurance company fails to make payments due.' Because a self-funded plan is not a form of insurance, the Court granted Cigna's motion to dismiss with respect to those claims. [This] decision is the latest in a number of cases in which a healthcare provider's ability to bring ERISA claims against insurers has turned on the language of the assignment, further underscoring the importance of careful drafting of those provisions." [BioHealth Medical Laboratory, Inc. et al. v. Conn. Gen. Life Ins. Co., No. 1:15-cv-23075 (S.D. Fla. Feb. 1, 2016)]

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