Marque Medicos Archer, LLC v. Liberty Mutual Insurance Co.
2018 IL App (1st) 163351 (Ill. App., 2018)Words & Phrases
Worker's CompensationTrial Judge
James E. SnyderAppellate Judge
MasonHolding
Although court found insurer's conduct egregious, medical providers have no direct cause of action against worker's comp insurer for its delay in paying medical bills.Fact Summary
This case arises out of defendant-appellant Liberty Mutual Insurance Company’s (Liberty) alleged failure to fully pay plaintiffs-appellees, Marque Medicos Farnsworth, LLC, and Medicos Pain & Surgical Specialists, S.C. (collectively, the providers), for services they rendered to an injured employee of codefendant-appellant, Advanced Urethane Technologies, Inc., d/b/a REM Innovations, Inc., and/or Sleep Innovations, Inc. (Sleep Innovations). The trial court dismissed with prejudice the providers’ claims for breach of contract, breach of contract implied in law, breach of contract implied in fact, and recovery under section 155 of the Illinois Insurance Code (215 ILCS 5/155 (West 2012)). Because we conclude that the providers have no direct action against Liberty for its delay in paying medical bills, we affirm.
But as egregious as Liberty’s conduct appears to be, it does not translate into recognition of a direct action by providers against Liberty. Rather, when the legislature enacted section 8.2 of the Act by amendment in 2011, it simultaneously created a remedy for its violation. In particular, section 8.2(e-20) provides that after a final award by the IWCC, a provider may resume efforts to collect unpaid bills from the employee and “the employee shall be responsible for payment of any outstanding bills as well as the interest awarded under subsection (d) of this Section." 820 ILCS 305/8.2(e-20) (West 2012). At first blush, the ability to pursue the injured employee for payment of outstanding medical bills appears to run counter to the overarching purpose of the Act to protect the interests of injured workers. But the legislature may well have assumed that an employee who receives an award from the IWCC is the party responsible for paying outstanding medical bills from the award. When, as here, that is not the case, the methods of enforcing a workers’ compensation carrier’s obligation to pay outstanding medical bills are varied and somewhat circuitous.