November 4, 2009

Blue Cross Blue Shield Is Not Too Big To Sue

As a Delaware trial lawyer, I'm proud that our court system allows parents to fight for the rights of their children. And I'm also proud that our system lets David go after Goliath, and win.

How many times have you gotten angry when your insurance company refused to pay for your medical treatment? Well, a group of parents in Michigan decided to take on BCBS when it refused to cover behavioral therapy for children with autism spectrum disorder. The case recently settled for over $1 million, and under the settlement, Blue Cross will pay for behavioral therapy rendered to over 100 children in the last six years.

According to BCBS, it had denied coverage claiming that the therapy was "experimental." Incredibly, during the lawsuit it was discovered that BCBS had internal documents that said:

"Applied behavioral analysis (ABA) is currently the most thoroughly researched treatment modality for early intervention approaches to autism spectrum disorders and is the standard of care recommended by the American Academy of Pediatrics, National Academy of Sciences Committee and the Association for Science in Autism Treatment."

Blue Cross' own documents further acknowledged that "The earlier the disorder is diagnosed, the sooner the child can be helped through treatment interventions."

If you believe a claim you submitted to your health insurance company was improperly denied, contact a Delaware trial lawyer to find out whether your rights have been violated.

Posted by Charles Snyderman | | Email This Post

Posted In: Litigation

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November 18, 2008

The Law of Defamation in Delaware

A Delaware business owner recently asked me to explain the law of defamation. Defamation is a written or oral statement that harms the reputation of another person. To be considered harmful, the statement must lower the person in the eyes of the public or cause others not to associate or deal with him. We've all heard the words “libel” and “slander.” Libel is written defamation, and slander is oral defamation.

As a Delaware business attorney, I've found that there are defenses you can raise if you’re sued for defamation. The most absolute defense is truth. In other words, if a statement is true, you can tell as many people as you like even though the statement ruins a person’s reputation.

The average businessman is not the only one who becomes involved in a defamation lawsuit. Consider the following headlines you may have seen:

JERRY SEINFELD AND WIFE SUED FOR DEFAMATION

ROGER CLEMENS FILES DEFAMATION LAWSUIT OVER ALLEGATIONS OF USE OF PERFORMANCE ENHANCING DRUGS

WITNESS IN OJ SIMPSON TRIAL SUES DR PHIL FOR DEFAMATION

OPRAH SUED FOR DEFAMATION BY FORMER HEAD OF SCHOOL IN SOUTH AFRICA

DAN RATHER SUES CBS FOR DEFAMATION

In order for there to be defamation, the statement has to be made to someone other than the person the statement is about. In the law, this is known as "publication."

The person claiming that he was defamed has to prove that the statement he’s complaining about was in fact defamatory. However, there are 4 categories of statements that are automatically considered to be defamatory. They are statements that (1) malign someone in a trade, business or profession, (2) impute a crime, (3) imply that a person has a “loathsome” disease, and (4) impute the unchastity of a woman.

I mentioned earlier that truth is an absolute defense. There are also conditional privileges or defenses even if the statement turns out not to be true. For example, if you communicate to the police a suspected crime, that’s allowed. A statement that’s made in the course of the defamed person’s employment and it’s made on behalf of the employer, it’s considered privileged. Statements made by witnesses in a courtroom setting and the legal arguments made by attorneys in court are also privileged.

There are exceptions to everything, including exceptions. Under Delaware law, these conditional privileges must be exercised in good faith. So, even though a communication to the police is usually considered protected, there’s an exception if the statement was known to be false and it was made with malice or an intent to harm the defamed person.

Posted by Charles Snyderman | | Email This Post

Posted In: Litigation

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August 16, 2008

Recovering Attorney's Fees

Let’s say your company is owed money by one of your customers, and despite all your efforts to work with them, they fail to pay you what’s owed. Or, suppose you have a dispute with someone and it can’t be resolved without going to court. You start thinking about hiring a lawyer and filing a lawsuit to recover what’s owed. Would you think twice about suing if you knew you’d be required to pay the other side’s attorney’s fees if you lose the case?

In Delaware like in many other states, it’s believed that the risk of having to pay the other side’s attorney’s fees should not deter you from going to court to enforce your legal rights. For this reason, the general rule is that you don’t get reimbursed your attorney’s fees if you win, but you don’t have to pay the other side’s attorney’s fees if you lose. However, as is the case with most general rules, there are exceptions.

You can recover your attorney’s fees from the losing party if (1) your contract provides for reimbursement of attorney’s fees if you win your lawsuit, or (2) there’s a statute that awards attorney’s fees to the prevailing party.

Maybe it’s time to take a look at the contracts you use to see whether they contain a provision requiring the other side to pay your attorney’s fees if you have to go to court.

Posted by Charles Snyderman | | Email This Post

Posted In: Litigation

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