Brown v. Gadsden Regional Medical Center LLC

          MEMORANDUM OPINION

          KARON OWEN BOWDRE CHIEF UNITED STATES DISTRICT JUDGE.

         Plaintiffs Marilyn Brown and Aaron R. Grindstaff sued Gadsden Regional Medical Center (GRMC); Triad Holdings V, LLC; Triad of Alabama, LLC; and Professional Account Services, Inc. for breach of contract, conversion, breach of implied contract, and breach of fiduciary duty. Each count also alleged conspiracy. On September 18, 2017, this court entered an Order granting Defendants' “Motion to Dismiss, or in the Alternative, Motion for Summary Judgment, ” (doc. 14), dismissing all claims. (Doc. 34).

         On October 4, 2018, the Eleventh Circuit affirmed in part, vacated in part, and remanded this case. (Doc. 39). Specifically, the Eleventh Circuit affirmed this court's dismissal of Plaintiffs' breach of express contract claim and conversion claim. But the Eleventh Circuit vacated this court's entry of judgment in favor of GRMC on Plaintiff's breach-of-fiduciary-duty claim because this court sua sponte granted summary judgment in favor of GRMC without providing Plaintiffs with notice and an opportunity to respond to the motion for summary judgment. The Eleventh Circuit remanded the breach-of-fiduciary-duty claim back to this court for further proceedings.

         On October 10, 2018, this court entered an Order notifying Plaintiffs of the court's intent to sua sponte address the breach of fiduciary duty claim on summary judgment. (Doc. 40). GRMC subsequently filed a motion for summary judgment on the breach of fiduciary duty claim on November 12, 2018. (Doc. 43). Plaintiffs responded to both the court's order regarding sua sponte review and GRMC's motion for summary judgment on the breach of fiduciary duty claim on December 3, 2018. (Doc. 45). GRMC then filed its reply on December 17, 2018. (Doc. 46). The motion is now ripe for review.

         I. Background

         This case centers on Ms. Brown's and Mr. Grindstaff s claims that GRMC improperly placed liens on their automobile insurance medical-payments ("med-pay") benefits instead of seeking payment directly from then personal healthcare insurance provider. Blue Cross Blue Shield.

         Blue Cross and GRMC have several provider agreements hi which the hospital agrees to submit bills of member patients directly to Blue Cross for reimbursement. XXXXX

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         On March 23, 2012, Ms. Brown was admitted to GRMC for emergency medical services following an automobile accident. (Doc. 15-1 at 2). Her hospital bills totaled $11, 978.00. (Doc. 22-11 at 3). Michael Cotton, the Chief Financial Officer of GRMC, stated that GRMC's records contain no indication that Ms. Brown or her daughter informed GRMC that Ms. Brown had Blue Cross insurance dining that visit. (Id.). Instead, GRMC claims it received information that the alleged at-fault driver's automobile insurance would be responsible for the medical bills, which Ms. Brown neither admits nor denies. (Doc. 14 at 9; Doc. 21 at 8). On April 16, 2012, GRMC filed a Notice of Hospital Lien regarding Ms. Brown's medical expenses. (Doc. 1-8 at 15).

         On September 11, 2012, Ms. Brown arrived at GRMC for a pre-operation examination, dining which GRMC alleges she indicated for the first time that she had private health insurance through Blue Cross. (Doc. 14 at 9). Ms. Brown states that-while she neither admits nor denies the truthfulness of whether she hidicated she had private health insurance dining her fust visit- GRMC knew by September 2012 that she was insured by Blue Cross. (Doc. 21 at 8; Doc. 45-1 at 2). She does not explain how GRMC allegedly knew of her insurance by September 2012.

         GRMC claims that Ms. Brown maintained that the at-fault driver's automobile insurance would cover the medical expenses, even during her September 11, 2012 examination. (Doc. 14 at 9). After Ms. Brown's September 17, 2012 surgery, GRMC alleges that it submitted her expenses to Blue ...