Thursday, January 8, 2015

Pennsylvania Supreme Court Agrees to Address Important First Party Benefits/Attorney's Fees Issue

On December 31, 2014, the Pennsylvania Supreme Court granted Travelers' Insurance Company’s Petition for Allowance of Appeal in the first party benefits peer review case of Doctor’s Choice Physical Medicine & Rehabilitation Center, P.C. (LaSelva), v. Travelers Personal Ins. Co., No. 512 MAL 2014 (Pa. 2014).  The Court framed the issues to be reviewed as follows:  

"(1) Whether the Superior Court improperly interpreted § 1797 of the MVFRL,the Supreme Court case of Herd Chiropractic v. State Farm, and its own case of Levine v. Travelers, to allow attorneys’ fees even when an insurer has utilized the peer review process? 

(2) Whether the Superior Court improperly interpreted and misapplied §1797(b)(4) by holding that the insurer must oversee the statutory compliance of peer review organizations with 31 Pa.Code § 69.53(e)?"

As such, this eventual Pennsylvania Supreme Court decision will serve to clarify the issue of – whether a plaintiff can get attorney’s fees if a peer review process utilized by a carrier is found to be statutorily non-compliant.
For more background on this case, click this LINK to the Tort Talk post summarizing the trial court's opinion.
To view the Pennsylvania Supreme Court's Order granting this appeal, click HERE.

I send thanks to Attorney Brigid Q. Alford of the Camp Hill, PA office of Marshall, Dennehey, Warner, Coleman & Goggin for bringing this news to my attention.

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