Betts v. Brnovich

CourtDistrict Court, D. Arizona
DecidedFebruary 23, 2023
Docket2:22-cv-01186
StatusUnknown

This text of Betts v. Brnovich (Betts v. Brnovich) is published on Counsel Stack Legal Research, covering District Court, D. Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Betts v. Brnovich, (D. Ariz. 2023).

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

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

10 Plaintiff, ORDER

11 v.

12 Mark Brnovich, et al.,

13 Defendants. 14 15 16 At issue are six Motions to Dismiss (Docs. 23, 25, 26, 28, 29, 37) filed by all the 17 named Defendants in this matter. Also at issue are two Motions for Sanctions (Docs. 57, 18 58) filed by pro se Plaintiff Shane Betts. 19 I. BACKGROUND 20 In the Amended Complaint (Doc. 9, Am. Compl.), Plaintiff recounts the facts giving 21 rise to his current claims as well as the history of a state court lawsuit that underpins the 22 present lawsuit, and the Court has done its best to piece together the facts alleged. Plaintiff 23 was a participant in the Southwest Airlines Group Employee Welfare Benefit Plan for 24 health care coverage, which is regulated under the Employee Retirement Income Security 25 Act, 29 U.S.C. § 1001 et seq. (ERISA), and administered by UnitedHealthcare. 26 After a motor vehicle accident in September 2015, Plaintiff received medical 27 treatment from Defendant Dr. Samuel Carr, DC, who was a health care provider within the 28 network of Plaintiff’s health care Plan. Plaintiff had treated with Dr. Carr in the past, and 1 Dr. Carr had always collected payment from Plaintiff’s Plan under the terms of the Plan. 2 Dr. Carr recommended that Plaintiff hire an attorney acquaintance of Dr. Carr, Defendant 3 Joseph Silence, to pursue his personal injury claim against the other driver. After Plaintiff 4 hired Mr. Silence, Dr. Carr and his wife, Defendant Tammy Carr, on behalf of their 5 business—Defendant Samuel Carr DC PC LLC (collectively, “the Carrs”)—filed and 6 recorded medical liens under A.R.S. § 33-931 for the costs of Plaintiff’s medical treatment, 7 for which Mr. Silence accepted liability for the costs of medical care on behalf of Plaintiff 8 without his permission. The Carrs mailed these liens to Mr. Silence, and Plaintiff was 9 unaware of them, all the while believing that the Carrs were billing and collecting payment 10 for his medical treatment from his Plan. 11 In December 2015, Plaintiff was in an even more severe motor vehicle accident, and 12 he continued to treat with Dr. Carr and to be represented by Mr. Silence. He alleges he 13 stopped making progress in Dr. Carr’s care and requested to stop treatment in April 2016; 14 treatment ended in May 2016. Plaintiff claims Dr. Carr then falsified a release that claimed 15 to have healed Plaintiff, which was not disclosed to Plaintiff and which the Carrs used to 16 show medical necessity for the liens. After completing treatment with Dr. Carr, other 17 medical treatment revealed Plaintiff had a torn labrum in his hip that required surgery. 18 Plaintiff terminated Mr. Silence as his counsel in July 2016 after Mr. Silence refused 19 to correct a false insurance claim he filed on Plaintiff’s behalf. Upon his termination, 20 Mr. Silence filed an attorney’s charging lien on Plaintiff’s personal injury claim. At this 21 point, Mr. Silence also informed Plaintiff of the medical liens he had secured with the 22 Carrs. The Carrs confirmed that they filed the liens to secure debts with the third-party car 23 insurance company, Amica. 24 In August 2016, Plaintiff filed claims for the costs of his medical treatment with the 25 ERISA Plan using medical bills the Carrs provided, and the Plan denied them because an 26 “incorrect or inappropriate primary diagnosis code was used.” (Am. Compl. ¶ t.) Plaintiff 27 timely appealed the denial to the Plan and received this response:

28 1 We have determined that these claims were denied correctly. The claims are denied because of the inappropriate billing of services. We have sent request 2 to the provider for correct billing. Per the provider contract, you are not 3 responsible for these claims. If the provider does not agree with this determination, they can submit an appeal on their behalf. 4 5 (Am. Compl. ¶ w.) A second appeal to the Plan concluded similarly. (Am. Compl. ¶ x.) 6 Plaintiff alleges Tammy Carr later testified to receiving the requests to correct the diagnosis 7 codes, and she never corrected them. 8 In December 2017, before the surgery to correct his hip, Plaintiff asked the third 9 party auto insurance company, Amica, to confirm it would cover what Plaintiff claimed 10 was ongoing medical treatment from the December 2015 accident. Amica refused based 11 on Dr. Carr’s release claiming to have healed Plaintiff by May 2016. After Plaintiff secured 12 coverage by the Plan for the surgery, Plaintiff “settled with Amica” his personal injury 13 claim from the December 2015 car accident. (Am. Compl. ¶ ee.) 14 Plaintiff contends the medical liens filed and recorded by the Carrs with the aid of 15 Mr. Silence defrauded Plaintiff of the protections afforded under the Plan terms and 16 ERISA. Under the terms of the Plan and the related in-network contract, the Plan pays 17 medical providers directly for medical claims, and “[i]f Provider collects payment from, 18 brings collection action against or asserts a lien against a Member for Covered Services 19 rendered (other than for applicable Member Expenses), Provider shall be in breach of this 20 agreement.” (Am. Compl. ¶ j.) Plaintiff claims that the liens filed by both the Carrs and 21 Mr. Silence against Plaintiff’s settlement fund were invalid. 22 An Arizona Court of Appeals decision, which Plaintiff attached to the Amended 23 Complaint, recounts the procedural history of the related dispute in the Arizona judicial 24 system. (Doc. 9 at 78–80, Ariz. Ct. App. Decision dated Nov. 30, 2021.) The medical lien, 25 comprised of the medical bills owed to the Carrs, was for $8,574, and the attorney services 26 lien, comprised of Mr. Silence’s contingency fee of 30% of an offer from the insurer to 27 settle Plaintiff’s claim, was for $9,000. After Plaintiff settled with Amica for $34,244.10, 28 Amica agreed to pay Plaintiff $16,670.10 but filed an interpleader action in the superior 1 court for an allocation of the remainder. Dr. Carr and Mr. Silence filed crossclaims against 2 Plaintiff for breach of contract, and Mr. Silence also requested the reasonable value of his 3 services under a quantum meruit theory. 4 The lawsuit proceeded to mandatory arbitration, wherein the arbitrator ruled in favor 5 of Dr. Carr and Mr. Silence on the breach of contract and quantum meruit claims. Plaintiff, 6 appearing pro se, appealed to the superior court, and the case proceeded to a two-day bench 7 trial, in which the court admitted over 50 exhibits and heard the testimony of five witnesses. 8 The court gave Plaintiff half the trial time, and Dr. Carr and Mr. Silence split the rest. The 9 court entered judgment for Dr. Carr and Mr. Silence and denied Plaintiff’s motions for a 10 new trial and relief from judgment. The court also awarded Dr. Carr and Mr. Silence their 11 attorneys’ fees. 12 Plaintiff then appealed to the Arizona Court of Appeals. On November 30, 2021, 13 the three-judge appellate panel entered a decision affirming the superior court. Specifically, 14 that court concluded in relevant part that Plaintiff’s argument that the liens were invalid 15 was irrelevant, because the court decided the case not by enforcing the liens, but rather by 16 resolving crossclaimants’ breach of contract and quantum meruit claims. The court also 17 found no merit to Plaintiff’s argument that Dr. Carr should have billed the Plan directly for 18 Plaintiff’s medical treatment. The court focused on the language of the contract between 19 Plaintiff and Dr.

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Betts v. Brnovich, Counsel Stack Legal Research, https://law.counselstack.com/opinion/betts-v-brnovich-azd-2023.