SAN DIEGO – A health care facility alleges an insurance company has not paid its claims for coverage it provided to a member.
Sharp Memorial Hospital filed a complaint on Oct. 5 in the U.S. District Court for the Southern District of California against Regence Bluecross Blueshield of Utah and Does 1-10 alleging breach of contract and other counts.
According to the complaint, the plaintiff alleges that on Oct. 1, 1985, it entered into an agreement to provide services at discounted rates to defendant's members, which was amended from time to time. It alleges it provided extensive, life-saving health care services to a patient/member from Aug. 28, 2014, through Jan. 7, 2015, resulting in total billed charges of more than $1,600,000. The suit states that despite agreement to pay some amount for emergency services, the plaintiff has not received any payment on the claim.
The plaintiff holds Regence Bluecross Blueshield of Utah and Does 1-10 responsible because the defendants allegedly failed to pay plaintiff the sums due under the agreement, despite repeated demands for payment for completion of services.
The plaintiff requests a trial by jury and seeks judgment against defendant; damages in excess of $1,031,932; interest; declaratory relief; costs; attorney's fees; and other relief as the court deems just. It is represented by Jennifer A. Hansen of Hooper, Lundy & Bookman PC in San Diego.
U.S. District Court for the Southern District of California Case number 3:16-cv-02493