Fallsnewspress.com - Falls School Board votes to pay $100,000 in insurance settlement

by Steve Wiandt

Reporter

Cuyahoga Falls -- The Falls Board of Education approved paying $100,000 in a settlement over a medical claim that was disputed during a switch in health insurance providers.

The action follows a disagreement among the Falls School District, Medical Mutual of Ohio and Select Medical Corp. over who was responsible for paying a large medical claim that was filed around the time the district switched from Medical Mutual of Ohio to Anthem Blue Access for its employees' health insurance in 2006, said District Superintendent Dr. Edwin Holland.

The claim was for services rendered by Select Medical at its Akron location. Holland said the claim was filed before the district switched providers, which was April 1, 2006, and was "in the process of being processed" at that time. The dispute arose over which provider was responsible to pay because, according to Holland, the claim was "still in the pipeline."

A civil suit citing breach of contract was filed in August 2007 in the Summit County Common Pleas Court by Select Medical Corp. of Columbus against the Falls School District, Falls School District Health Plan and Medical Mutual of Ohio. The release and settlement agreement, approved unanimously July 8 by the Board, states the school district shall pay Select $100,000.

The $100,000 payout will not affect the district's budgetary projections, district Treasurer Kathryn Sines told the Falls News-Press. "It will be paid from the insurance fund," she said, "This has been pending litigation and has been considered."

In thanking the Board for approving the settlement, Holland said, "That closes a pretty challenging chapter for us." All parties involved have agreed to the settlement, Holland told the Falls News-Press on July 10. "We wanted to protect our employees and protect our funds and do what was right. It's a fair settlement," added Holland.

"I thought the outcome was reasonable for all parties," Stephen R. Kleinman, Select Medical Corp.'s attorney, told the Falls News-Press. "The settlement made sense from a legal and business point of view."

Holland said the claim was as high as $165,000 without any discount at one point and the parties mutually agreed on a smaller amount.

Because a settlement agreement was imminent, the case never went to trial, Holland said. The agreement calls for each party to pay its own costs, expenses and attorneys' fees.

Because work on this case is not yet complete, Holland said he did not know the cost of the district's attorneys' fees. There will not, however, be any more money owed to Select Medical after the $100,000 is paid, he added.

Although the settlement was approved unanimously, a board member said he would have liked time to review the agreement. "I wish we would've gotten this ahead of time so we could read it," Dave Rump remarked during the special Board meeting that took place on July 8.

"We got it today," Holland replied. "It was something that if we don't act on it this week, it will cost us more." He said there was a last-minute settlement issue that had just been resolved.

According to Holland, the district hired law firm Brouse McDowell of Akron because it specializes in insurance claims. "They worked out the details of it to ensure that the settlement is closed and there is no further recourse or ramifications."

E-mail: swiandt@recordpub.com

Phone: 330-688-0088 ext. 3141