Betts v. Brnovich

District Court, D. Arizona·Decided February 23, 2023·No. 2:22-cv-01186·Unknown

Opinion

WO

Shane Betts, No. CV-22-01186-PHX-JJT

Plaintiff, ORDER

v.

Mark Brnovich, et al.,

Defendants. At issue are six Motions to Dismiss (Docs. 23, 25, 26, 28, 29, 37) filed by all the named Defendants in this matter. Also at issue are two Motions for Sanctions (Docs. 57, 58) filed by pro se Plaintiff Shane Betts. In the Amended Complaint (Doc. 9, Am. Compl.), Plaintiff recounts the facts giving rise to his current claims as well as the history of a state court lawsuit that underpins the present lawsuit, and the Court has done its best to piece together the facts alleged. Plaintiff was a participant in the Southwest Airlines Group Employee Welfare Benefit Plan for health care coverage, which is regulated under the Employee Retirement Income Security Act, 29 U.S.C. § 1001 et seq. (ERISA), and administered by UnitedHealthcare. After a motor vehicle accident in September 2015, Plaintiff received medical treatment from Defendant Dr. Samuel Carr, DC, who was a health care provider within the network of Plaintiff’s health care Plan. Plaintiff had treated with Dr. Carr in the past, and Dr. Carr had always collected payment from Plaintiff’s Plan under the terms of the Plan. Dr. Carr recommended that Plaintiff hire an attorney acquaintance of Dr. Carr, Defendant Joseph Silence, to pursue his personal injury claim against the other driver. After Plaintiff hired Mr. Silence, Dr. Carr and his wife, Defendant Tammy Carr, on behalf of their business—Defendant Samuel Carr DC PC LLC (collectively, “the Carrs”)—filed and recorded medical liens under A.R.S. § 33-931 for the costs of Plaintiff’s medical treatment, for which Mr. Silence accepted liability for the costs of medical care on behalf of Plaintiff without his permission. The Carrs mailed these liens to Mr. Silence, and Plaintiff was unaware of them, all the while believing that the Carrs were billing and collecting payment for his medical treatment from his Plan. In December 2015, Plaintiff was in an even more severe motor vehicle accident, and he continued to treat with Dr. Carr and to be represented by Mr. Silence. He alleges he stopped making progress in Dr. Carr’s care and requested to stop treatment in April 2016; treatment ended in May 2016. Plaintiff claims Dr. Carr then falsified a release that claimed to have healed Plaintiff, which was not disclosed to Plaintiff and which the Carrs used to show medical necessity for the liens. After completing treatment with Dr. Carr, other medical treatment revealed Plaintiff had a torn labrum in his hip that required surgery. Plaintiff terminated Mr. Silence as his counsel in July 2016 after Mr. Silence refused to correct a false insurance claim he filed on Plaintiff’s behalf. Upon his termination, Mr. Silence filed an attorney’s charging lien on Plaintiff’s personal injury claim. At this point, Mr. Silence also informed Plaintiff of the medical liens he had secured with the Carrs. The Carrs confirmed that they filed the liens to secure debts with the third-party car insurance company, Amica. In August 2016, Plaintiff filed claims for the costs of his medical treatment with the ERISA Plan using medical bills the Carrs provided, and the Plan denied them because an “incorrect or inappropriate primary diagnosis code was used.” (Am. Compl. ¶ t.) Plaintiff timely appealed the denial to the Plan and received this response:

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