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Pratt v. Air Evac Lifeteam

United States District Court, W.D. Missouri, Southern Division

July 16, 2018

DORIS ERGLE LINDSEY PRATT, Individually and on behalf of all other Similarly situated persons, Plaintiff,
v.
AIR EVAC LIFETEAM and AIR EVAC EMS, INC., Defendants.

          ORDER

          DOUGLAS HARPOOL, UNITED STATES DISTRICT JUDGE.

         Before the Court is Defendants' Motion for Summary Judgment. (Doc. 13).

         The parties submitted initial briefing and sur-replies regarding this motion. (Docs. 14, 19, 24, 27, and 29). On November 8, 2017, the Court held a hearing on this motion (Doc. 33), after which Defendant filed supplemental briefing. (Doc. 35). Thereafter, the Court permitted the parties to engage in limited discovery concerning certain issues pertaining to the motion. (Doc. 36). After completing discovery, the parties submitted final briefing regarding the motion. (Docs. 44, 45, and 46). The matter is now ripe for review.

         LEGAL STANDARD

         Summary judgment is proper if, viewing the record in the light most favorable to the non-moving party, there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(a); Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). “Where there is no dispute of material fact and reasonable fact finders could not find in favor of the nonmoving party, summary judgment is appropriate.” Quinn v. St. Louis County, 653 F.3d 745, 750 (8th Cir. 2011). Initially, the moving party bears the burden of demonstrating the absence of a genuine issue of material fact. Celotex, 477 U.S. at 323. If the movant meets the initial step, the burden shifts to the nonmoving party to “set forth specific facts showing that there is a genuine issue for trial.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). To do so, the moving party must “do more than simply show there is some metaphysical doubt as to the material facts.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986).

         BACKGROUND

         This action arises from a dispute concerning the right of an air ambulance service to seek repayment for its services from certain insurance benefits following an automobile crash in which Plaintiff required the use of the air ambulance services.

         Air Evac EMS, Inc., advertises and sells memberships related to its services. Plaintiff purchased a membership with Air Evac. In November 2008, she renewed that membership and signed a contract setting out the terms and conditions of her membership. A handful of provisions in that contract are relevant to this case:

. Air Evac EMS, Inc. (d/b/a Air Evac Lifeteam and d/b/a Texas Lifestar) (“AEL”) offers memberships that provide prepaid protection against AEL air ambulance costs that are not covered by a member's insurance or medical benefits, subject to the following terms and conditions
. 3. Members who have insurance or other benefits that cover the cost of ambulance services are financially liable for the cost of services up to the limit of any available insurance or benefit coverage. In return for payment of the membership fee, AEL will consider all air ambulance costs not covered by any insurance or benefits available to the member to have been fully prepaid. AEL reserves the right to bill directly the appropriate insurance or benefits provider for services rendered, and members authorize their insurer or benefits provider to pay any covered amounts to AEL directly. Members agree to remit to AEL any payment received from insurance or benefits providers for air medical services provided by AEL, not to exceed regular charges. . . .
. I authorize my insurer or benefits provider to pay any covered amounts to AEL directly.
. These terms and conditions supersede all previous terms and conditions between a member and AEL, including other writings, or oral representations, relating to the terms and conditions of membership abuse of the program.

         At roughly the same time that Plaintiff received the membership contract, she also received a letter from Air Evac encouraging her to renew her membership.[1] That letter states, in pertinent part:

. To avoid any lapse in your membership, we encourage you to take time now and renew your membership.
. Your membership means that Air Evac will work on your behalf with your medical benefits provider to secure payment for your medical emergency flight. Whatever your medical benefits provider pays will always be considered payment in full for your flight.

         In December 2009, Plaintiff was in an automobile accident in Russellville, Alabama. As a result of the accident, Plaintiff was severely injured and her elderly mother was killed. Plaintiff required the use of Air Evac's services for transportation to a hospital in Huntsville, Alabama.

         On February 4, 2010, Air Evac submitted to Alfa Insurance a “Notice of Claim of Debt” regarding a claim identified as #D07-1001. Alfa Insurance had previously identified this claim as relating to Plaintiffs automobile accident. That claim pertained to a policy held by Rachel Ergle, Plaintiff s mother. Alfa Insurance identified Plaintiff as a “covered person” under that policy. The Alfa Insurance policy in Rachel Ergle's name stated, regarding “medical payments coverage”:

. If this coverage is shown on your declaration, we will pay reasonable expenses incurred for necessary medical and funeral services because of bodily injury caused by a car accident and sustained by a covered person.

         On February 22, 2010, Air Evac sent to Plaintiff a letter indicating Air Evac submitted a claim to Plaintiff's health insurance carrier, Blue Cross and Blue Shield of Alabama, in the amount of $18, 249.68 for the cost of the air ambulance flight. Blue Cross paid Air Evac $8, 294 for its services. Following receipt of this payment, Air Evac provided Alfa Insurance with a “Partial Satisfaction of Lien” acknowledging the payment and indicating that $9.955.68 remained unpaid. That “lien”[2] remains in place today.

         In April 2010, Plaintiff filed a lawsuit arising out of the automobile accident naming as Defendants Courtney Lindsey, David Lindsey, Alfa Insurance, and State Farm Insurance. The claim directed at Alfa Insurance demanded that Alfa pay the policy limits of the uninsured/underinsured motorist benefits of an automobile insurance policy applicable to Plaintiff's vehicle. In August 2010, Air Evac wrote to Plaintiff's counsel in that case and requested an assignment of benefits. Air Evac and Plaintiff's counsel exchanged letters discussing the matter over the course of the following months. Ultimately, in March 2011, Plaintiff's counsel concluded that Plaintiff owed no money to Air Evac based on her membership. Air Evac responded that the automobile insurance coverage was applicable to the Air Evac membership agreement and that Air Evac had a right to collect based on that coverage.[3] The record before the Court does not show any further contact between Plaintiff and Air Evac, or Plaintiff's counsel and Air Evac, until the commencement of this action by Plaintiff.

         During the course of the limited discovery permitted in this matter, the parties deposed two Air Evac employees, Joshua Redfield and Patricia Thompson. Their testimony indicated that, to date, Plaintiff's account has not been officially zeroed out or the balance otherwise waived. However, that is due to the hold placed on Plaintiff's account as a result of active litigation. Both employees testified that Air Evac has not pursued any attempt to collect the remaining balance in the years since Plaintiff's then-counsel refused to pay Air Evac from the proceeds of Plaintiff's claim against Alfa Insurance. Furthermore, both employees testified that Air Evac has no intention of attempting to collect the remaining balance on Plaintiff's account, and that it is waiving the remaining balance, regardless of the outcome of the litigation pending before this Court.

         The lien Air Evac sent to Alfa Insurance concerning Claim #D07-1001 has not been rescinded. However, Patricia Thompson testified that Alfa Insurance refused to acknowledge the lien and Alfa Insurance had already paid the proceeds of that claim to Plaintiff following a settlement. Air Evac contends it has not rescinded the lien because Air Evac ...


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