Fourth Circuit Rules for Plaintiff Over $40 Medical Bill
Here's an update on Samuel Juniper's lawsuit against his employer, M&G Polymers USA, LLC. If you’ve forgotten, Juniper successfully sued M&G last year after Aetna, M&G’s health insurer, denied $40 in charges for three venipunctures, then provided Juniper with various and conflicting reasons for the denials. I wrote about the lawsuit in this post.
On October 10, the Fourth Circuit Court of Appeals affirmed the Southern District of West Virginia’s ruling in Juniper's favor. The Fourth Circuit adopted the district court's reasoning in an unpublished per curiam opinion. Juniper v. M&G Polymers USA, LLC, 2008 WL 4538161 (4th Cir. 2008).
District Judge Robert C. Chambers had accepted Magistrate Judge Maurice G. Taylor, Jr.'s recommended decision that Juniper's motion for summary judgment be granted and M&G's be denied. The court found that the "decision [to deny the charges] was arbitrary, not supported by evidence, inconsistent with earlier interpretations of the plan and not reasonable." Juniper v. M&G Polymers USA, LLC, 495 F.Supp.2d 590 (S. D. W. Va. 2007).
The ContractsProf Blog posted about the decision, which it described as "David Defeats Goliath." And the ABA Journal reported that Juniper intends to frame his $40 check when he receives it.
