PHILADELPHIA – A Philadelphia attorney is pursuing action against a local insurance company which he believes denied him reimbursement for a policy accommodation encouraging healthy lifestyles among its policyholders.
John J. Branigan Esq. of Philadelphia filed suit in the Philadelphia County Court of Common Pleas on Sept. 27 versus QCC Insurance Company (an affiliate of Independence Blue Cross), also of Philadelphia.
Branigan and his family are policyholders of the defendant, at an annual cost of $36,000. QCC offers their insureds a “healthy lifestyle” accommodation where insureds are offered a $150 reimbursement if they visit a fitness center at least 120 times in the policy period. Throughout this tenure, plaintiff belonged to the Sporting Club at the Bellevue at a monthly rate of $115.
Subsequently, a number of unsuccessful online attempts were made by the plaintiff to show proof of his eligibility for the reimbursement and apply for it, along with later being told that he could not mail the proofs in, according to the lawsuit, the suit says.
Branigan then filed a small claims complaint along with another complaint regarding vision benefits, but eventually decided to drop that second claim, the suit says.
“Defendants, by and through Jennifer Gallagher, Associate Deputy General Counsel continued the first hearing and the matter was then listed for June 1, 2016. On May 31, 2016, plaintiff was consulting clients when Ms. Gallagher called to ‘resolve the above matter’. Through an assistant, Ms. Gallagher was told to leave a message with her proposed resolution. Ms. Gallagher left no message,” the suit says.
On the day of the hearing, Branigan received a phone call from counsel, Gerard Dugan, who informed him that the defendant’s offer to settle the case was $150, the suit says. Branigan asked if the defendant was paying the costs of filing the lawsuit, and learned they were not, the suit says. Meanwhile, a small claims hearing took place in which the judge awarded benefits in the amount of $150, plus court costs of $128 to plaintiff, for a total award of $278, the suit says.
Branigan believes QCC failed to investigate his claim properly, intentionally denied him coverage, failed to make a timely settlement offer and failed to pay him all sums due him, among numerous other charges.
For counts of breach of contract, bad faith, violation of the Unfair Trade Practices and Consumer Protection Law, intentional and negligent misrepresentation, common law bad faith, the plaintiff is seeking three times the actual damages in excess of $50,000 for all relevant damages, including all compensatory, incidental, consequential and punitive damages sustained in an amount not yet fully determined but proven to be at time of trial, to be determined together of interest, counsel fees and costs.
The plaintiff is representing himself in this matter.
Philadelphia County Court of Common Pleas case 170903158
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nickpennrecord@gmail.com