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Emigh v. West Calcasieu Cameron Hospital

Court of Appeals of Louisiana, Third Circuit

November 2, 2017

AARON EMIGH, ET AL.
v.
WEST CALCASIEU CAMERON HOSPITAL, ET AL.

         APPEAL FROM THE FOURTEENTH JUDICIAL DISTRICT COURT PARISH OF CALCASIEU, NO. 2009-4845 HONORABLE G. MICHAEL CANADAY, DISTRICT JUDGE

          J. Lee Hoffoss, Jr. Claude P. Devall Donald W. McKnight Hoffoss Devall, LLC Counsel for Plaintiffs/Appellees: Aaron Emigh Glynn Able Benoit Laura Allison Delouche

          Michael G. Hodgkins Veron, Bice, Palermo & Wilson, LLC Counsel for Plaintiffs/Appellees: Aaron Emigh Glynn Able Benoit Laura Allison Delouche

          Steven Broussard Aaron Broussard Broussard & Hart, LLC Counsel for Plaintiffs/Appellees: Aaron Emigh Glynn Able Benoit Laura Allison Delouche

          Robert E. Landry Peter J. Pohorelsky Scofield, Gerard, Pohorelsky, Gallaugher & Landry Counsel for Defendant/Appellant: West Calcasieu Cameron Hospital

          Errol J. King, Jr., Layna C. Rush, Daniel P. Guillory, Baker, Donelson, Bearman, Caldwell & Berkowitz, PC, Counsel for Defendant/Appellant: UnitedHealthcare Insurance Company

          Jonathan M. Herman, Brian C. Roux, The Herman Law Firm, Counsel for Defendant/Appellant: Louisiana Health Services and Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana

          Charles A. O'Brien, Allison N. Pham, Counsel for Defendant/Appellant: Louisiana Health Services & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana

          Robert S. Kleinschmidt, Jr. Attorney at Law Counsel for Defendant/Appellee: R. J. Moss Enterprises, Inc.

          PHYLLIS M. KEATY JUDGE

         Plaintiffs filed this putative class action suit against various defendants, alleging violations of La.R.S. 22:1874, also known as the "Balance Billing Act." Several of the defendants (hereafter "Appellants") appeal a trial court judgment certifying this matter as a class action. Just over two years ago, the Louisiana Supreme Court determined that "the class action is superior to any other available method for a fair and efficient adjudication of the common controversy over the disputed billing and lien practices." Baker v. PHC-Minden, L.P., 14-2243, p. 1 (La. 5/5/15), 167 So.3d 528, 532. Because Appellants have failed to distinguish this matter from Baker or other cases where this court endorsed the use of the class action procedure in cases involving alleged violations of the Balance Billing Act, [1]we affirm.

         FACTS AND PROCEDURAL HISTORY

         This lawsuit began when Aaron Emigh filed a petition for damages against West Calcasieu Cameron Hospital (WCCH), alleging that he had received medical treatment, after which WCCH refused to file a claim with his health insurance company and hired a third-party collection agency to collect payment from him directly, in an attempt to double bill him and his insurance provider. Emigh filed a first amending and supplemental petition in July 2010, wherein he sought to have the matter certified as a class action. By way of a second amending and supplemental petition filed in June 2011, Glynn Able Benoit and Laura Allison DeLouche were named as additional putative class representatives. The second amending petition also named the following entities as additional defendants: Highmark, Inc. d/b/a Highmark Blue Shield (Highmark); Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana (BCBS); United Healthcare Insurance Company (United); and R.J. Moss Enterprises, Inc. d/b/a Credit Services of Southwest Louisiana (Credit Services).[2]

         Plaintiffs each received treatment at WCCH after being injured in a MVA. At the time of his accident, Emigh was insured through his employer by a BCBS plan that was administered by Highmark, Benoit was insured by his employer's self-funded plan that was administered by United, and DeLouche had a direct policy of insurance issued by BCBS.

         After a two-day hearing, the trial court certified this matter as a class action pursuant to La.Code Civ.P. art. 591 by judgment dated November 10, 2016. Written reasons for judgment were issued approximately one month later. The judgment was appealed by WCCH, BCBS, and United. WCCH asserts the following errors:

1. The trial court erred in finding that plaintiffs satisfied the requirements of typicality and adequacy of representation set forth in La. Code Civ. Proc. art. 591(A)(3) and (4) for maintaining a class action.
2. The trial court erred in finding that plaintiffs could maintain this action as a class action where plaintiffs seek mental anguish and/or emotional distress damages, and thereby individualized questions of causation and injury will predominate over common issues making class certification inappropriate under La.Code Civ. Proc. art. 591(B)(1)(3) and Louisiana jurisprudence.
3. The trial court erred in adopting without modification the class definition proposed by the plaintiffs, as plaintiffs' proposed class definition would allow individuals who have suffered neither injury nor any alleged violation of the Balanced Billing Act to recover damages in this matter, and therefore does not meet the standards of definability established by La. Code Civ. Proc. art. 591(A)(5) and Louisiana jurisprudence.

         In its sole assignment of error, BCBS alleges that "The District Court erred in certifying the plaintiff class because DeLouche failed to satisfy all of the elements for class certification." United presents the following assignment of error:

Did the District Court incorrectly grant Plaintiffs' request for class certification of Benoit's claims against United, when: a) for each purported class member, there could be any number of different contracts, all of which may contain different provisions, which could be relevant to the claims asserted against United; b) Benoit has been made whole relating to his claim and, is therefore, not an adequate class representative in this action because he has suffered no damage; and c) Plaintiffs fail to offer a definable class as it relates to their claims against United[?]

         DISCUSSION

         Standard of Review

A trial court has wide discretion in deciding whether to certify a class. Subject to the manifest error standard, its factual findings can only be reversed upon finding, based on the entire record, no reasonable factual basis for the factual finding and the factfinder is clearly wrong. However, we review its ultimate decision of whether or not to certify the class under the abuse of discretion standard.

Baker, 167 So.3d at 538 (citations omitted).

         Law

         In Ford v. Murphy Oil U.S.A., Inc., 96-2913, 96-2917, 96-2929, p. 4 (La. 9/9/97), 703 So.2d 542, 544 (citation omitted), the supreme court explained:

The class action is a nontraditional litigation procedure permitting a representative with typical claims to sue or defend on behalf of, and stand in judgment for, a class of similarly situated persons when the question is one of common or general interest to persons so numerous as to make it impracticable to bring them all before the court. The purpose and intent of class action procedure is to adjudicate and obtain res judicata effect on all common issues applicable not only to the representatives who bring the action, but to all others who are "similarly situated, " provided they are given adequate notice of the pending class action and do not timely exercise the option of exclusion from the class action.

         Louisiana Code of Civil Procedure Article 591, titled "Prerequisites; maintainable class actions, " provides in pertinent part:

         A. One or more members of a class may sue or be sued as representative ...


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