On the heels of announcing it had resumed covering patients seeking health care through University of Chicago Medicine, Land of Lincoln Health has asked a Cook County judge to dismiss a class action lawsuit brought by two of its former customers who alleged the provider of Obamacare health insurance policies had misled people into buying policies under false premises.
“There is no question of fact to resolve here,” Land of Lincoln Health wrote in its April 1 motion to dismiss. “The University of Chicago contracts are renewed for 2016. Plaintiffs cannot plead or prove otherwise nor would they want to.”
The lawsuit, brought by plaintiffs Daniel Blumenthal and Michael Hartzmark, who live in Chicago’s Hyde Park neighborhood, alleged Land of Lincoln had fraudulently led them to believe health care services they received through University of Chicago Medicine, for either themselves or their spouses, would be covered through Land of Lincoln policies in 2016. However, in early 2016, the men said they received notice Land of Lincoln would be dropping coverage for University of Chicago Medicine, effective March 1, indicating Land of Lincoln and University of Chicago had failed to reach agreement on reimbursement rates. The men said they then purchased additional coverage at a much higher cost to make sure they could continue to receive coverage for health care at University of Chicago, and filed suit, accusing Land of Lincoln of a “bait and switch.”
However, Land of Lincoln recently announced it had reached an agreement with University of Chicago Medicine, and had again added the university medical system to its roster of covered providers. The health insurer then moved to dismiss the legal action against it over the now-resolved dispute.
In its motion, Land of Lincoln said the court should dismiss the action because the renewal of University of Chicago and the insurer’s sustained efforts to negotiate the reimbursement agreement, belie the plaintiffs’ assertions the insurer intended to deceive or defraud its insured.
“Lincoln could not have engaged in consumer fraud or deceptive business practices as to any representation that the University of Chicago would be in network for 2016,” Land of Lincoln said in its motion. “Any such representations have turned out not to be true.”
Land of Lincoln conceded it “did erroneously notify some insureds who had claim histories using the University of Chicago’s services that they would no longer be in-network as of March 1,” explaining the “statements were erroneously made without any understanding of the University of Chicago provider contract termination provisions.”
But Land of Lincoln said the plaintiffs chose independent of Land of Lincoln’s actions to “leave the plan” and buy other, more expensive health insurance coverage.
“Any damages they purportedly incurred were based on their own choice, not any fraud by Lincoln,” the motions said. “Further, Lincoln could not be unjustly enriched as to these two named plaintiffs as they got what they bargained for – for the two months they were in the plan they received in-network care by the University of Chicago.”
Land of Lincoln is represented in the action by attorneys with the firm of Barnes & Thornburg, of Chicago.
Attorneys with the firm of Krislov & Associates, of Chicago, did not reply to requests for comment on Land of Lincoln’s recent actions and on plaintiffs’ intentions concerning their lawsuit.