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America November 14, 2022 4 mins read

Medical Staffing Co. Sues Excess Insurer for $10M to Help Pay $42.5 Settlement

America ı By Samuel Lopez

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Emergency room

This is the case of TeamHealth Holdings Inc. et al. v. Ironshore Specialty Insurance Co. et al., in the U.S. District Court for the Eastern District of Texas.

Team Health Holdings Inc., a medical staffing business says it is owed $10 million in excess insurance coverage to help compensate for what it has already paid to settle an over-billing lawsuit bought by the government in 2016.

Attorneys for TeamHealth allege that a Liberty Mutual unit ignored them for several months before it refused to fund the settlement agreement.

TeamHealth is represented by attorneys Jennifer H. Doan and Kyle R. Akin of Haltom & Doan and J. Alexander Purvis and E. Todd Presnell of Bradley Arant Boult Cummings LLP.

TeamHealth also argued in its complaint that Ironshore Specialty Insurance Co. should pay out the total limit for their excess professional liability coverage to assist in funding a $42.5 million settlement that the staffing company reached to resolve the underlying suit that said Team Health over-billed patients for emergency room services.

This coverage dispute originates from a lawsuit filed on behalf of the U.S. government, against TeamHealth in Texas federal court. The lawsuit accused TeamHealth of over-billing for emergency room services performed by its client hospitals in a fraudulent effort to obtain "grossly overpaid reimbursements" from sources such as Medicare and Medicaid.

TeamHealth filed a lawsuit against its insurance broker, Alliant Insurance Services Inc., claiming that the broker should be responsible for the $10 million excess insurance payment if Ironshore is not ordered to do so.

TeamHealth is a physician practice in the U.S. founded in 1979 and based in Knoxville, Tennessee, pursuing medical outsourcing, including physician staffing and billing services to emergency rooms.

Attorneys for TeamHealth said that its primary insurer, AIG has already paid its total $10 million dollar policy limit, which triggered Ironshore's coverage obligations under a $10 million excess policy.

The complaint says, "When TeamHealth asked Ironshore to provide the coverage that TeamHealth paid for, Ironshore asked questions and then 'ghosted' TeamHealth, leaving TeamHealth to fend for itself."

TeamHealth claims that Ironshore ultimately denied coverage for the settlement, but based the denial on what it called a "self-serving interpretation of notice and consent provisions despite contrary facts, law, and logic."

Attorneys for TeamHealth argue that the underlying suit was filed under seal and that it did not receive a copy of the filed complaint until September 2018, and that’s when it says it notified its insurers.

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Samuel Lopez
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With over 20 years of experience in the legal and insurance sectors, Samuel applies his profound legal acumen to investigate and accurately report on the facts.

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