Blue Cross & Blue Shield v. Jemsek Clinic, P.A. (In Re Jemsek Clinic, P.A.)

441 B.R. 756, 2010 Bankr. LEXIS 4585, 2010 WL 5128366
CourtUnited States Bankruptcy Court, W.D. North Carolina
DecidedSeptember 22, 2010
Docket18-20098
StatusPublished
Cited by1 cases

This text of 441 B.R. 756 (Blue Cross & Blue Shield v. Jemsek Clinic, P.A. (In Re Jemsek Clinic, P.A.)) is published on Counsel Stack Legal Research, covering United States Bankruptcy Court, W.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blue Cross & Blue Shield v. Jemsek Clinic, P.A. (In Re Jemsek Clinic, P.A.), 441 B.R. 756, 2010 Bankr. LEXIS 4585, 2010 WL 5128366 (N.C. 2010).

Opinion

MEMORANDUM OPINION GRANTING IN PART AND DENYING IN PART DEFENDANTS’ MOTION FOR (1) AN ORDER STRIKING SETTLEMENT OF JEMSEK DEFENDANTS’ COUNTERCLAIMS; (2) AN ORDER REINSTATING DEFENDANTS’ COUNTERCLAIMS; AND (3) FOR SANCTIONS

J. CRAIG WHITLEY, Chief Judge.

THIS MATTER was before the Court on January 19, 2010 for a hearing on Defendants’, Joseph Gregory Jemsek, M.D. (“Jemsek”) and the Jemsek Clinic P.A. (collectively, the “Jemsek Defendants”) Motion for (1) an Order Striking Settlement of Jemsek Defendants’ Counterclaims, (2) for an Order Reinstating Defendants’ Counterclaims, and (3) for Sanctions (“Motion”). Motion, Docket No. 144. That Motion has been amended twice to delete additional and alternate requests for relief. The same is now confined to a request for sanctions against Plaintiff Blue Cross And Blue Shield Of North Carolina (“BCBSNC”), albeit sanctions of breathtaking proportions. Both sides extensively briefed these matters prior to and following the hearing.

I. INTRODUCTION

A. The Jemsek Defendants’ Motion

The Motion maintains that, over the course of this adversary proceeding (“Adversary Proceeding”), BCBSNC intentionally concealed from this Court, the Jemsek Defendants, and their creditors the fact that it was simultaneously defending substantially identical claims to the Jemsek Defendants’ counterclaims in a federal class action in the Southern District of Florida. That multidistrict class action litigation (“MDL”) was encaptioned Rick Love, M.D., et al. v. Blue Cross and Blue Shield Association, et al. (formerly Thomas, et al. v. Blue Cross and Blue Shield Association, et al.), Case No. l:03-cv-21296-FAM, 2008 WL 4097607 (the “Love Case ”).

Further, the Motion asserts that BCBSNC maintained this subterfuge until after the Florida class action was settled (the “Settlement”), the opt-out period ran, and it was too late for the Jemsek Defendants to even participate in the Settlement.

Finally, the Motion avers that in order to conceal the existence of the class action, BCBSNC violated a variety of applicable court rules and/or legal duties, including: a) the Federal Rules of Civil Procedure discovery rules; 1 b) the procedural rules applicable to MDL; 2 and c) the Federal Rules of Bankruptcy Procedure (the “FRBP”). 3

The Motion maintains that, as a proximate result of BCBSNC’s subterfuge, the Jemsek Defendants and their creditors lost all but two of their counterclaims; *763 counterclaims which have an alleged aggregate value exceeding $20 million. 4 The Jemsek Defendants also assert that, as a result of the concealment, they needlessly expended hundreds of thousands of dollars of precious estate funds defending their counterclaims in two different federal judicial districts and a circuit appeal. Finally, the Motion alleges that this fraud on the court occasioned a tremendous waste of time for this Court, the U.S. District Court for the Southern District of Florida (the “Florida Court”) and the Eleventh Circuit Court of Appeals.

The Jemsek Defendants argue the concealment constituted a fraud upon a tribu-nales) and occasioned significant harm on the Jemsek Defendants, their creditors, and this Court. Therefore, extraordinary relief is sought by the Motion: a) dismissal of BCBSNC’s claims against the Debtor, with prejudice; b) a monetary award equal to the value of the Jemsek Defendants’ lost counterclaims; and c) reimbursement of the Jemsek Defendants’ costs and attorneys’ fees.

B. The BCBSNC Response(s)

BCBSNC denies concealing anything from the Jemsek Defendants and the court(s). BCBSNC argues that the Jem-sek Defendants’ motion is fatally flawed because they received the Settlement notice in time to opt out of the class.

Further, BCBSNC denies any rule violations or any acts to mislead the court(s). The insurer argues that it has not asserted the Settlement as a defense in this Adversary Proceeding and, therefore, was not obliged to plead the Settlement and injunction as an affirmative defense in its Reply. For the same reason, BCBSNC contends it was not required to disclose the Settlement in its Rule 26(a) Initial Disclosures. Fed.R.Civ.P. 26(a). BCBSNC believes it has responded fully and accurately to all written discovery requests propounded by the Jemsek Defendants. It alleges the existence of the Love Case was not responsive to any of those discovery requests.

II. FACTUAL BACKGROUND & PROCEDURAL HISTORY

At the hearing, this Motion was presented upon generally uncontested facts, mostly documentary evidence gleaned from the court records of the two actions and from correspondence. Neither side presented live witness testimony, although several supporting affidavits were presented without objection. Response of BCBSNC to Second Amendment, Docket No. 158 at Ex. C.

A. The Adversary Proceeding

This action began in September 2006 when BCBSNC sued the Jemsek Defendants in North Carolina Superior Court. Blue Cross and Blue Shield of North Carolina v. Jemsek Clinic, P.A. & Joseph G. Jemsek, M.D., No. 06-CVS-18432. BCBSNC’s claims arise from medical treatments provided by the Jemsek Defendants to BCBSNC members suffering from Lyme disease. Complaint, Docket No. 2 at 9-15 (the “Complaint”). BCBSNC asserts that the Jemsek Defendants improperly submitted and were paid for hundreds of insurance claims for these patients. The Complaint seeks recovery of all sums previously paid to the Jemsek Defendants and damages under a variety of legal theories: breach of contract, fraud, unfair trade practices, negligent misrepre *764 sentation, among other state law claims. Complaint, Docket No. 2 at Ex. A Part 3.

Shortly after the Superior Court case was filed, the Jemsek Defendants filed Chapter 11 and removed the state action to this Court. On January 24, 2007, the Jemsek Defendants filed their Answer, as well as nine counterclaims against BCBSNC (the “Counterclaims”), ranging from breach of contract to tortious interference with a business relationship. Answer, Docket No. 5. The Counterclaims seek an affirmative recovery from BCBSNC in excess of $20 million. Id. at 28. The Adversary Proceeding has been vociferously litigated and, despite best efforts to move the matter along, remains in its discovery phase.

B. The Love Case

Unbeknownst to the Jemsek Defendants, at the time that BCBSNC initiated this Adversary Proceeding, it had been heavily engaged for several years defending the Love Case in Florida. Similar to several of the Jemsek Defendants’ counterclaims in our proceeding, the

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Bluebook (online)
441 B.R. 756, 2010 Bankr. LEXIS 4585, 2010 WL 5128366, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blue-cross-blue-shield-v-jemsek-clinic-pa-in-re-jemsek-clinic-pa-ncwb-2010.