Synergy Blog

From Roger Baron: Nevada Supreme Court Authorizes Tort Claim against ERISA entities

Reprinted with permission from Roger Baron

“Yesterday the Nevada Supreme Court handed down its decision in Lynam v Health Plan of Nevada, No. 56165 (March 21, 2012).  The insured was infected with hepatitis C in the course of medical treatment.  He brought a tort claim against a number of entities operating in and through the Health Plan of Nevada, alleging common-law negligence in that he was referred to a medical facility which did not meet “quality assurance program” required by Nevada statute.  The Defendants persuaded the trial court to dismiss the claim on the basis of ERISA preemption.  This decision reverses and remands.  The Nevada Supreme Court holds that ERISA preemption does not extend to “traditional police powers of the state” and makes a distinction between an ERISA plan which “facilitate[s] the selection of providers” and an ERISA plans which “lease[s] out its existing network of providers” or which “purchase[s] an insurance plan from a MCO or HMO.”  The insured should be given the opportunity on remand to prove that “to prove that [the health plan] merely leased out their network providers or issued an insurance policy” and thereby avoid federal preemption.  This decision is unanimous by the court, with one justice not participating.”

To view the decision click HERE

 

TESTIMONIALS

"I just want to thank Synergy for their great work in getting a health insurance lien resolved. The health insurance company refused to reduce their lien a penny from a motorcycle accident involving my client who was not wearing a helmet, a fact that would have hurt our award in front of a jury. Synergy put tremendous pressure on this company, and after months of bombarding this insurance company with statutory requests and threats, they were able to get them to give in and reduce the lien significantly. The cost was minimal in relation to the hard work they put in, and the savings my client received. Client was very happy, and it allowed me to close out a case that I had resolved over 6 months before. Keep them in mind if you are dealing with a smug insurance adjuster who felt confident he would not have to reduce a lien, like I was dealing with. Thank you very much Synergy."

Jeffrey A. Adelman, Esq.
Adelman & Adelman, P.A.

"I have been very impressed by the results achieved by Synergy Lien Resolution Services. They saved my client over $108,000 in reducing a difficult ERISA lien. Their expertise was invaluable and resulted in a very happy client. Best money I ever spent. I wholeheartedly recommend them. You are doing your client a disservice if you don’t hire them to help you with your liens."

Armando Payas, Esq.
Payas Law

WordPress Image Lightbox