CompFox AI Summary
This case concerns CIGA's liability for lien claims from Coast Plaza Doctors Hospital and Valley Plaza Doctors Hospital. CIGA argued it was not obligated to pay because the hospitals "assigned" their claims to Innovative Medical Management for collection, which CIGA contends is an excluded claim under Insurance Code section 1063.1(c)(9)(B). The Board affirmed the WCJ's finding that no true legal assignment occurred, as Innovative was merely hired for collection services and the hospitals retained ownership and control. Therefore, the lien claims were not excluded from coverage as assignee claims.
Full Decision Text1 Pages
This case concerns CIGA's liability for lien claims from Coast Plaza Doctors Hospital and Valley Plaza Doctors Hospital. CIGA argued it was not obligated to pay because the hospitals "assigned" their claims to Innovative Medical Management for collection, which CIGA contends is an excluded claim under Insurance Code section 1063.1(c)(9)(B). The Board affirmed the WCJ's finding that no true legal assignment occurred, as Innovative was merely hired for collection services and the hospitals retained ownership and control. Therefore, the lien claims were not excluded from coverage as assignee claims.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.