Robert W. Milas, M.D. v. Society Insurance and Angela Bonlander

Court of Appeals of Iowa·Decided November 8, 2017·No. 16-2148·Published

Opinion

IN THE COURT OF APPEALS OF IOWA

No. 16-2148

Filed November 8, 2017

ROBERT W. MILAS, M.D., Plaintiff-Appellant,

vs.

SOCIETY INSURANCE and ANGELA BONLANDER, Defendants-Appellees.

Appeal from the Iowa District Court for Scott County, Henry W. Latham II (trial and motion to recuse) and Nancy S. Tabor (motion for summary judgment), Judges.

Plaintiff appeals following judgment entry in his claims for fraudulent misrepresentation and breach of contract. AFFIRMED.

Anthony J. Bribriesco, Andrew W. Bribriesco, and William J. Bribriesco of Bribriesco Law Firm, P.L.L.C., Bettendorf, for appellant.

Guy R. Cook and Aaron W. Lindebak of Grefe & Sidney, P.L.C., Des Moines, for appellees.

Considered by Danilson, C.J., McDonald, J., and Blane, S.J. Tabor, J., takes no part.

MCDONALD, Judge.

A treating physician brought an action for breach of contract, negligent misrepresentation, and fraudulent misrepresentation against a workers’ compensation insurance carrier and its claims adjuster after the claims adjuster approved an elective surgery for the physician’s patient but the carrier declined to pay the physician’s entire fee for the elective surgery. The district court dismissed the misrepresentation claims on summary judgment. The claim for breach of contract was tried to a jury. The jury found in favor of the physician and awarded contract damages. The physician timely filed this appeal. He contends the district court erred in dismissing his fraudulent misrepresentation claim and erred in declining to submit the issue of punitive damages to the jury. He also contends the district court should have granted his motion for recusal.

I.

In January 2012, Rickey Fitzgerald seriously injured himself while performing work for Barker Apartments and filed a workers’ compensation claim. Fitzgerald became dissatisfied with the medical care received, and he petitioned for alternate care with Dr. Robert Milas. The workers’ compensation commissioner granted the petition, and Dr. Milas became Fitzgerald’s treating physician. Dr. Milas recommended Fitzgerald undergo a cervical fusion to treat Fitzgerald’s neck and back injuries. Dr. Milas sent a fee estimate to the workers’ compensation insurance carrier, Society Insurance, in the amount of $14,325.87. A claims adjuster, Angela Bonlander, signed the estimate. The signed estimate provided, “SIGNATURE FROM REPRESENTATIVE AT SOCIETY INSURANCE WILL BE THE AUTHORIZATION FOR SURGERY.”

After receiving the signed estimate, Dr. Milas performed the cervical fusion. He submitted a bill to Society Insurance for $14,325.87. Society Insurance provided the bill to a third-party auditing service, Health Systems International (HSI). Upon the recommendation of HSI, Society Insurance issued a check to Dr. Milas for $1620.52. Dr. Milas rejected the check and demanded he be paid in full. Two years later, Society Insurance sent Dr. Milas another check for $4958.03. Dr. Milas rejected that payment.

Dr. Milas brought this action against Society Insurance and Bonlander.

Dr. Milas asserted claims for negligent misrepresentation, fraudulent misrepresentation, and breach of contract. Society Insurance moved for summary judgment on all counts. The district court granted Society Insurance’s motion for summary judgment on the fraudulent misrepresentation claim, concluding there was no evidence showing the defendant had the intent to deceive Dr. Milas in authorizing the elective surgery.

The matter proceeded to trial on the negligent misrepresentation claim and the breach-of-contract claim. The first trial ended during the plaintiff’s opening statement after the district court granted a motion for mistrial. Society Insurance subsequently filed a second motion for summary judgment, seeking dismissal of the negligent misrepresentation claim. The district court granted the motion, concluding the defendants were not in the business of providing information and were entitled to judgment as a matter of law.

The matter proceeded to trial on the claim for breach of contract. Prior to the second trial, Dr. Milas moved to recuse the presiding judge. The district court denied the motion. Dr. Milas sought interlocutory review of the order denying the

motion. That, too, was denied. The jury returned a verdict finding Dr. Milas and Society Insurance entered into a contract and finding Dr. Milas and Bonlander had not entered into a contract. The jury found Society Insurance breached the contract and awarded Dr. Milas $14,325.87. Dr. Milas now appeals.

II.

In his first claim of error, Dr. Milas argues the district court erred in dismissing his claim for fraudulent misrepresentation. Dr. Milas contends Society Insurance, in signing the estimate, made a false representation that it would pay the proposed surgical fees knowing it intended to negotiate the fees at a later date. He contends this is a triable issue of fact.

This court reviews a district court’s grant of summary judgment for correction of errors at law. See Boelman v. Grinnell Mut. Reins. Co., 826 N.W.2d 494, 500 (Iowa 2013). A district court properly grants summary judgment when there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. See id. at 501. An issue of fact is material if “the dispute is over facts that might affect the outcome of the suit, given the applicable law.” Weddum v. Davenport Cmty. Sch. Dist., 750 N.W.2d 114, 117 (Iowa 2008). “An issue of fact is ‘genuine’ if the evidence is such that a reasonable finder of fact could return a verdict or decision for the nonmoving party.” Huck v. Wyeth, Inc., 850 N.W.2d 353, 362 (Iowa 2014). “We can resolve a matter on summary judgment if the record reveals a conflict concerning only the legal consequences of undisputed facts.” Boelman, 826 N.W.2d at 501. The burden is on the moving party to show it is entitled to judgment as a matter of law. Sallee v. Stewart, 827 N.W.2d 128, 133 (Iowa 2013).

There are seven elements of fraudulent misrepresentation: (1)

representation, (2) falsity, (3) materiality, (4) scienter, (5) intent to deceive, (6) justifiable reliance, and (7) resulting injury or damage. Air Host Cedar Rapids, Inc. v. Cedar Rapids Airport Comm’n, 464 N.W.2d 450, 453 (Iowa 1990). Scienter and intent to deceive are closely related elements of fraudulent misrepresentation, and the same general analysis applies for each. See Van Sickle Constr. Co. v. Wachovia Comm. Mortg., Inc., 783 N.W.2d 684, 688 (Iowa 2010). “Scienter and intent to deceive may be shown when the speaker has actual knowledge of the falsity of his representations or speaks in reckless disregard of whether those representations are true or false.” Id. (citation omitted).

On the summary judgment record, Dr. Milas failed to create a triable issue of fact on these two elements. There was no evidence in the summary judgment record showing the defendants made a false representation, had actual knowledge of a false representation, or spoke in reckless disregard of whether any representation was true or false. The fact that Society Insurance’s employee, Angela Bonlander, knew the claim would be submitted to a bill review company does not by itself show a misrepresentation because notwithstanding a contract obligation to pay a sum certain there is no harm in later asking if a contract obligee is willing to take a lower payment. The statement by Bonlander that she knew Society Insurance intended to negotiate the fees notwithstanding her signature to authorize the surgery was not presented until trial.

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