DLA Piper represents Horizon Healthcare Services in dismissal of insurance lawsuit

DLA Piper has represented Horizon Healthcare Services in the dismissal of a suit by the Association of New Jersey Chiropractors and two individual chiropractors, which was recently upheld by a New Jersey appellate court. 

Plaintiffs alleged that Horizon’s privileging policy, which limits the types of services it will reimburse, violated a New Jersey law requiring group health insurance policies to reimburse services performed by chiropractors if those same services would be reimbursed when performed by other healthcare professionals. 

The New Jersey Superior Court’s Appellate Division affirmed the lower court’s holding that the chiropractors did not have standing to bring the suit because chiropractors are not consumers, which is the class of people that the law in question was intended to protect.

Furthermore, the court held that Horizon had not violated the law because the law governs group health insurance policies, not provider agreements, which is what the privileging policy concerns.

The plaintiffs also alleged breach of contract and the covenant of good faith and fair dealing, as well as a violation of the monopolisation provision of the New Jersey Antitrust Act. The appellate court affirmed the lower court’s dismissal of these claims as well, stating that the plaintiffs failed to present sufficient evidence to support either claim. 

The DLA Piper team representing Horizon consisted of Andrew Bunn and Kristen Pacio of the firm’s New Jersey litigation group.

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