Court reviews a worker's compensation case involving a fraud upon the court

CHEYENNE DUFFER v. KEYSTOPS, LLC. (Tenn. Ct. App. August 1, 2012)

This appeal arises out of a personal injury suit, wherein the plaintiff and Dewayne Duffer filed suit against a trucking company for injuries suffered in an accident and for loss of consortium as a result of the accident. Plaintiff’s employer intervened to recover worker’s compensation benefits paid to plaintiff.

Soon thereafter, the trucking company discovered that plaintiff was male, had filed the action using an assumed female identity, and had lied throughout the discovery process. The trucking company filed a motion for summary judgment.

The court granted the motion and dismissed plaintiff’s and employer’s complaints, finding that plaintiff had committed a fraud upon the court and that employer had failed to file suit within the applicable statute of limitations because plaintiff’s complaint was rendered void ab initio. Plaintiff and employer appeal. We affirm the dismissal of plaintiff’s complaint but reverse the dismissal of employer’s complaint.

Opinion available at:
https://www.tba.org/sites/default/files/dufferc_080112.pdf

Court reviews a claim against an employer for retaliatory discharge

FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE, ET AL. v. WILLIAM R. HILL, ET AL. (Tenn. Ct. App. August 9, 2011)

Defendant allegedly suffered an on-the-job injury to his knees over the course of several years, and Plaintiffs paid workers' compensation benefits on his behalf. However, after Defendant was videotaped building a barn, his employment was terminated and suit was filed against him for fraud. Defendant then filed a counter-complaint alleging, among other things, retaliatory discharge. The trial court granted Plaintiffs' motion for summary judgment with regard to the retaliatory discharge claim, and we affirm and remand.

Opinion available at:
http://www.tba2.org/tba_files/TCA/2011/federated_080911.pdf

Court Reviews a Summary Judgment Motion in a Medical Malpractice Case Related to Treatment and Fraudulent Billing of a Patient

DEBORAH LYNN DAVIS v. JACK E. SCARIANO, JR., M.D. ET AL. (Tenn. Ct. App. June 28, 2011)

The plaintiff, Deborah Lynn Davis, appeals from a grant of summary judgment to the defendants, Dr. Jack E. Scariano, Jr., and his group, West Knoxville Neurological Associates. Except when the context requires otherwise, we will refer to the defendants collectively as "Dr. Scariano."

Davis sued Dr. Scariano alleging medical malpractice and fraud related to the doctor's treatment of her and to the billing of her account. Dr. Scariano moved for summary judgment. After granting Davis several continuances, the trial court heard the motion and granted it based on Dr. Scariano's filings and the plaintiff's failure to present evidence establishing a disputed issue of material fact. Davis appeals. We affirm.

Opinion available here:
http://www.tba2.org/tba_files/TCA/2011/davisd_062811.pdf

Healthcare Fraud - Reforms May Lead to More Whistleblowers and Lower Costs

We often hear prospective jurors say they are hesitant to find in favor of plaintiffs because it may cause a rise in the cost of goods, services, and especially insurance.  While there are many arguments to the contrary, we cannot, at length, debate the issue during jury selection.  If we could, we would point out that, unlike legitimate tort claims, healthcare billing fraud costs consumers billions of dollars annually.  Fortunately, as Bloomberg reports, healthcare reform laws may make it easier for those aware of such fraud to report it without fear of employer retaliation.

When a worker reports such fraud, they are often referred to as a whistleblower, and the suit which may follow is referred to as a qui tam action.  Qui tam is an action brought by an informer which seeks a penalty for acts such as healthcare billing fraud and provides that the informer may recover some funds for his or her efforts.  The remainder of the fund goes to the state or other institutions which were affected by the fraud.  Such cases deter fraud and recover millions, and sometimes billions, of dollars which go back into the system to defray costs.