HEALTHCARE
REPRESENTATIVE CASES
- Plaintiff filed an action against Defendant health insurance company, alleging claims for unfair competition and false advertising in connection with Defendant’s sale, marketing, and rendering of medical services. Plaintiff alleged that through its misleading and deceptive material representations and omissions, Defendant had employed a fraudulent, unlawful, and/or unfair scheme designed to induce persons to enroll in its health plans by misrepresenting that its primary commitment is to maintain and improve the quality of healthcare provided. Plaintiff alleged that Defendant had been aggressively engaged in implementing undisclosed systemic internal policies that are designed to discourage Insurer’s primary care physicians from delivering medical services and to interfere with the medical judgment of healthcare providers, directly contrary to Defendant's representations. Defendant moved for an order compelling Plaintiff to arbitrate his claims and staying the action pending completion of arbitration. Defendant argued that Plaintiff, who obtained health coverage through his employer, was required to arbitrate his claims under several provisions of the subscriber agreement between his employer and Defendant.