Insurance Company Game of “Slow pay, Low pay, No pay” finally exposed!
$421,000,000 Verdict: St. Charles Surgical Hospital vs. Blue Cross Blue Shield of Louisiana
A New Orleans civil district court jury returned a unanimous verdict against Blue Cross and Blue Shield of Louisiana (BCBSLA) for fraud and abuse of rights against St. Charles Surgical Hospital (SCSH) and Center for Restorative Breast Surgery (CRBS). After a three-week trial, the jury returned the verdict against Blue Cross and Blue Shield of Louisiana in less than two hours and awarded $421,000,000 in damages.
James Williams and “The Trial Team,” a special litigation section at New Orleans-based Chehardy Sherman Williams law firm, represented Drs. Scott Sullivan and Frank DellaCroce, world-renowned surgeons, and the hospital in the case. They presented evidence that Blue Cross committed fraud against the doctors and the hospital in failing to pay the claims of roughly 7000 breast cancer survivors for which Blue Cross and Blue Shield of Louisiana had given prior authorization. The jury found that Blue Cross and Blue Shield of Louisiana committed fraud and acted in bad faith when they placed the doctors on a secret list of healthcare providers being “targeted” for abusive treatment.
“This is a great day for patients in Louisiana who have long been frustrated with health insurance companies charging more but paying less,” said James Williams, leader of the Chehardy Sherman Williams Trial Team. Blue Cross and Blue Shield of Louisiana either slow-paid, low-paid, or no-paid all of their bills over an eight-year period, hoping to pressure the doctors and hospital to either come into their network or fail and go out of business. The average citizen couldn’t get away with that, and the jury found that neither should Blue Cross and Blue Shield of Louisiana.”
Matthew Sherman, Chehardy Sherman Williams Trial Team attorney who tried the case with Williams, said, “The jury’s finding of misconduct by Blue Cross and Blue Shield of Louisiana shows that the legal system will provide a remedy when insurance companies put their own interests ahead of that of the public. Physicians and patients have a right to expect Blue Cross and Blue Shield of Louisiana to uphold their promise to provide fair and accurate payment for services.”
At great expense and risk, the doctors did not pass any costs on to their patients. They merely wanted Blue Cross and Blue Shield of Louisiana to reimburse them for unpaid claims and they waited 8 years to finally receive that justice.