Ohio Judge Stays Bad Faith Action Pending Arbitration In Health Care Payment Row

Carlton Fields
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[author: Matthew Burrows - Law Clerk]

A district court in Ohio granted defendant Pan-American Life Insurance Company’s (“Pan-American”) motion to stay pending arbitration finding a valid and enforceable arbitration provision within the pertinent group health policy. Plaintiffs Joan and Thomas Kirkland filed an action for breach of contract and bad faith arising from Pan-American’s denial of medical benefit payments. Plaintiffs alleged that defendant failed to uphold representations it made to pay for certain health procedures and office visits. Defendant sought arbitration of bad faith pursuant to the group health policy’s arbitration provision (the parties previously settled the breach of contract claim). The court found that the enforceable arbitration provision allowed for the arbitration of bad faith for a number of reasons. Plaintiffs had a duty to read the group health policy and further had an option to cancel within the prescribed time limit. The court also found that the policy did not lack mutuality. The court noted that the arbitration provision is applicable to both parties for “all claims or controversies” under the policy, including claims for bad faith. Kirkland v. Pan-Am. Life Ins. Co., No. 2:14-cv-2536 (S.D. Ohio Sep. 3, 2015)

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