UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF CALIFORNIA
May 5, 2009
GUY TILLOTSON; PLAINTIFF,
VALLEY PAVING, INC.; BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY; BLUE SHIELD OF CALIFORNIA; CHOICE ADMINISTRATORS, INC DBA CALIFORNIA CHOICE BENEFIT ADMINISTRATORS DBA CALIFORNIA ADMINISTRATORS INSURANCE SERVICES; AND DOES 1 TO 100, INCLUSIVE DEFENDANTS.
STIPULATION/REQUEST FOR A STAY OF THE ACTION AND ORDER THE PARTIES TO THIS ACTION HEREBY STIPULATE TO AND REQUEST THE FOLLOWING:
This case arises out of Plaintiff's, Guy Tillotson, allegations of breach of contract, ERISA violations, Breach of Good Faith and Fair Dealing and Breach of Fiduciary Duty based upon the denial of healthcare claims submitted arising from a heart attack that Mr. Tillotson allegedly suffered while on the job. Mr. Tillotson was employed by Defendant VALLEY PAVING, Inc. and alleges the Defendants wrongfully denied payment of healthcare bills.
Defendants, and each of them, deny these allegations.
The Plaintiff currently has a pending worker's compensation case on the issue of whether or not the heart attack/condition, which gave rise to Plaintiff's treatment bills, constitutes an industrial injury. The trial on that matter took place on April 27, 2009. The ruling is due to be issued within 90 days. In the event Plaintiff is successful in the worker's compensation trial and the injury is considered industrial, that worker's compensation carrier would become obligated to pay the outstanding medical bills, past and future, at issue in this case due to the denial of the health insurance claim. If the outstanding healthcare bills were paid and the worker's compensation carrier treated the heart attack/condition as an industrial injury for purposes of past and future care, the damages sought in this action would be satisfied and Mr. Tillotson would dismiss this action.
If this matter is not stayed, the parties will be forced to engage in significant discovery and general litigation of the case in order to meet the deadlines set forth in the scheduling order. These expenses may ultimately not be necessary and it would not be necessary to further burden the court with an active case which may be resolved in another forum. Plaintiff has no intention of continuing pursuit of this matter if the damages are covered by worker's compensation.
Therefore, to avoid expense and in the interest of judicial economy, the parties have stipulated to and hereby request a stay of this matter pending final resolution on the issue of the industrial nature of Mr. Tillotson's heart attack/condition and the payment of past and future medical expenses related to the heart attack/condition.
DATED: _4-30-09_______ MANATT, PHELPS & PHILLIPS, LLP By: ___/S/ BRAD SEILING____________________ BRAD SEILING
Attorneys for Defendants Blue Shield of California; Blue Shield of California Life and Health Insurance Company
DATED: 4/30/09 MASTAGNI, HOLSTEDT, AMICK, MILLER, JOHNSEN & UHRHAMMER
AMANDA UHRHAMMER Attorneys for Plaintiffs DATED: 4/29/09 MAIRE & BEASLEY
PATRICK DEEDON Attorneys for Defendant Choice Administrators, Inc. dba California Choice Benefit Administrators DATED: 4/30/09 GORDON & REES LLP
ANGIE BICKEL Attorneys for Defendant MCHUGH-LEAVITT INSURANCE AGENCY, INC., dba NORCALLEAVITT INSURANCE SERVICES
Having reviewed this stipulation and all other relevant materials IT IS HEREBY ORDERED that this matter is stayed for no more than 180 days to allow for final resolution of the issue of whether or not the injury which gave rise to the medical bills at issue in this case is industrial in nature and whether the past and present medical expenses are covered by and through the Plaintiff's Worker's Compensation case. Plaintiff is to notify the Court immediately of any resolution of these issues in the worker's compensation case.
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