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Dubious Claims Against Health Plans Defeated and Sanctions Awarded Against Plaintiff

We represented the group health plan of a national insurance company as well as the plan’s individual fiduciary in litigation brought by the owner of a mental health facility seeking to recover payment for benefits he alleged had been provided under the plan. We investigated and determined that this individual had been soliciting participants for dubious services by offering free airfares to his facility’s location in California.  When claims were denied, he then sued hundreds of health plans in an effort to collect, filing complaints that alleged dozens of causes of action. We defended his action brought in a federal court in Illinois, and were able to secure dismissal of his case on grounds of res judicata and collateral estoppel. The plaintiff appealed, and we prevailed in the Seventh Circuit. In addition, we were able to secure sanctions against the plaintiff for his litigious conduct, and a published opinion in which the Seventh Circuit warned other federal courts about the plaintiff’s “pattern of repetitious and meritless litigation.”

Simon v. Allstate Employee Group Medical Plan, 263 F.3d 656 (7th Cir. 2001).


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