Vishva Dev, M.D., Inc. v. Blue Shield of Cal. Life and Health Ins. Co. (Aug. 31, 2016, B270094) __ Cal.App.4th __ [2016 WL 4538397]
Vishva Dev, M.D., Inc. (Dev) provided emergency medical services to three patients who were insured by Blue Cross entities. Dev did not have a contract with Blue Cross, but he billed Blue Cross tens of thousands of dollars for the emergency services. Blue Cross issued Explanation of Benefits (EOB) letters stating that about 10 percent of the billed amounts would be paid, offering to consider additional information, and informing Dev of its optional internal appellate process. Dev appealed, securing a small additional payment for services to one patient. Dev then filed a quantum meruit action against Blue Shield. The action was filed more than two years after Blue Shield issued its EOB letters, but less than two years after the internal appeals were completed. The trial court granted summary judgment to Blue Shield on the ground that Dev’s lawsuit was untimely under the two-year statute of limitations in Code of Civil Procedure section 339.
The Court of Appeal affirmed. Because Blue Shield’s EOB letters unequivocally refused to pay the amount Dev billed, those letters triggered the two-year statute. The court held that the limitations period was not tolled by Blue Shield’s willingness to consider additional information, or by Dev’s pursuit of Blue Shield’s voluntary internal appellate process.
Thomas Watson
htwatson@horvitzlevy.com
Horvitz & Levy LLP
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