Kaiser Can't Find Payment Record, So $ Sits in Trust, Woman Claims
OAKLAND, Calif. (CN) - A woman wants to repay Kaiser for medical services as required under an insurance policy, but the company refuses to confirm payment, she claims in court.
Kaysome Suvanaseng was involved in a rear-end collision in February 2010 while driving on U.S. Highway 101 in Marin County. Another driver, John Heenan, caused the crash.
As a result of the collision, Suvanaseng was taken to Marin General Hospital where she received treatment for injuries.
She says Kaiser Permanente Insurance Company paid over $24,000 of the $37,000 bill under Suvanaseng’s policy. She also submitted a claim to Heenan’s insurance company, receiving $80,000 through a June 2011 settlement.
A third-party liability reimbursement clause in her Kaiser policy states that “if defendants paid insurance benefits for treatment that plaintiff required as a consequence of a third-party’s negligence, the defendants would be entitled to reimbursement of those benefits in the event that plaintiff recovered funds from a claim against the negligent third-party,” according to the complaint.
Suvanaseng claims, however, that it has been over two years and Kaiser still cannot locate records of the $24,270.82 payment.
To ensure she has the money to pay Kaiser once they locate the payment record, Suvanaseng says she has put over $46,000 in a trust. The money, however, cannot be touched until Kaiser confirms payment.
“Despite dozens of attempts by plaintiff to ascertain a ‘correct’ reimbursement claim amount from the defendants, defendants have been completely unable to provide the plaintiff with such information,” the complaint states. “On that subject, plaintiff’s counsel has supplied the defendants with documentation from their own files evidencing the $24,270.82 payment to Marin General Hospital. In response, the defendants have bounced the paperwork and correspondence on this matter between multiple departments, keeping the conclusion of plaintiff’s claim in limbo for over two years.”
Suvanaseng says Kaiser is in breach of the insurance contract and is seeking $25,000 in special damages and $10,000 for emotional distress. She also wants a judicial declaration that “defendants have waived any interest in reimbursement for the $24,270.82 payment to Marin General Hospital.”
The plaintiff is represented by Max Arnold and Barrick Arnold in Chico.