Settlement Bars Doctor’s Claims Against Insurer

(CN) - A dermatologist can't sue his insurer for allegedly driving away business, because he agreed not to sue in a class-action settlement, the 11th Circuit ruled.

Dr. Robert Kolbusz was part of a class action accusing Blue Cross and Blue Shield and its member plans of denying, delaying and reducing payments to physicians.

When the parties settled, the doctors agreed to release Blue Cross plans from all claims stemming from the class action and settlement.

But Kolbusz sued his insurer, Health Care Service Corp., for breach of contract, tortious interference and defamation, claiming the company drove away business by refusing to pay for covered services and then lying to patients about the reason. The insurer allegedly told them that Kolbusz performed non-medically necessary procedures, provided wrong billing information and was under investigation.

The district court threw out Kolbusz's breach of contract claims, saying they were barred by the settlement, but said the dermatologist could pursue the tortious interference and defamation claims.

The Atlanta-based appeals court reversed, ruling that Kolbusz had released those claims in the settlement as well. They were related to the class action, the court ruled, because the claims were based on improper practices of the Blue Cross insurance group.

The 11th Circuit reversed the lower court's order denying the insurer's motion for an order forcing Kolbusz to explain why he should not be held in contempt for suing after the settlement. The circuit sent the case back to the district court.

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