Kaiser Sues for Cost of Treatment of Patient

10-18-2013 19:14:00

     HONOLULU (CN) - Kaiser has sued an insurance company for the cost of treating one person with E. Coli, saying it is the other insurance company's obligation, according to a complaint filed in the United States District Court for the District of Hawaii.
     Kaiser Foundation Health Plan Inc. has sued Island Insurance Company Limited for declaratory judgment, Medicare Secondary Payer law violations and subrogation.
     Kaiser seeks a ruling that Island Insurance illegally "deflect[ed]" its primary financial obligation to provide to non-parties Chon Hon Ki and Peppa's Korean BBQ with liability insurance, after an unnamed party acquired an E.Coli infection from eating their take-out food and required hospitalization.
     Kaiser says it is an approved Medicare Advantage Organization, and there are 14 million people enrolled in MA plans.
"Medicare Secondary Payer law creates a federal coordination of benefits scheme, in which workers' compensation, liability insurance (and self insurance), and no fault insurance are primary, and Medicare benefits are secondary."
     Instead, the secondary-payer plaintiff assumed full liability for the medical bills but has not yet been reimbursed by Island Insurance.
     Dianne Winter Brooking and Melissa M. Uhl of Alston Hunt Floyd & Ing in Honolulu represent Kaiser.