By Andrew Deeley, Supervising Attorney, Consumer Defense Unit
Mrs. Mary Smith (fictitious name), a senior in her 60s, was sued by a debt collector for the cost of anesthesia she received during a relatively minor foot surgery to remove a foot bunion. Mrs. Smith was under the impression that any out-of-pocket expenses would be limited to just a couple hundred dollars at most and was taken by surprise when she was sued for services allegedly totaling $6,400. The debt was sold to a debt buyer who subsequently filed the lawsuit against her. Mrs. Smith, along with her husband, attempted multiple times to correct the issue on their own with no success as they experienced frustrating phone calls and received the run around.
After lengthy discovery, armed with facts
As is often the case, Mrs. Smith and her husband were intimidated by the lawsuit and were concerned a lien could be placed on their home. While disagreeing with the amount of the debt, they were willing to enter a settlement just to avoid the worst case scenario. After our initial meeting, I convinced them of the merits of their case, that we should fight it, and not make any decisions on settlement until we do a proper dive into discovery.
A lengthy discovery process ensued, made more difficult by the fact the surgery center had closed its doors, and the always difficult endeavor of trying to contact treating physicians. As facts were slowly starting to trickle in, I kept in contact with the plaintiff’s attorney who initially was not offering any real settlements. The plaintiff was standing firm at little over half of the sued amount.
Nevertheless, we equally stood firm and kept digging. After a crash course in medical billing (thanks to CLA SoCal Health Unit attorney Gerrie Schipske), we uncovered some strong supporting facts for our client. Reviewing medical records, we revealed the wrong procedure code was being billed. We also discovered supplementary evidence suggesting there was a cap for all out-of-pocket expenses a vendor could charge patients at the facility. In addition, I finally was able to speak with the treating surgeon who then furnished us with one angry declaration.
Armed with compelling facts, I drafted a letter of our findings, with supporting documents, to opposing counsel. In response, the opposing counsel contacted me to tell me he needed to speak with the plaintiff. At this point, I replied with one final ploy, stating that my clients are very likable and that I intended to request a trial by jury.
An offer to settle
Although the plaintiff did not offer a dismissal of the case, they did offer my client a settlement that would cost them approximately $600 (the same number Mrs. Smith was initially informed her surgery would cost out of pocket). I advised Mrs. Smith we had a great case, but I could make no guarantees of the outcome of the trial. Not wishing to make any court appearances and risking a trial, Mrs. Smith opted for signing the settlement. Mrs. Smith and her husband were extremely grateful and relieved to be done with the stress and anxiety of the lawsuit.
