In Contemptible, John B. Hackert, MD describes his complicated civil court case against Cigna Health and Life Insurance Company.
The case was apparently initiated in 2018 and arose from Hackert’s transition from a primary “colorectal surgeon…to assisting only.” On that point, Hackert notes only that his reason for the career change has “the makings of another story.”
Before transitioning, Hackert contacted Cigna to “discuss contracting” and was informed that he would be considered “non-PAR, (non-participating). Hackert thought this meant that Cigna would pay him “a reasonable amount for his services without the formality of maintaining a written contract.” Instead, Cigna reimbursed some claims at 16 % of their fee schedule (for a two-hour assist, for instance, he was paid $66.41) and sometimes didn’t pay him at all. When Cigna failed to remedy the situation, Hackert sought relief from the courts.
With any case, a remedy that may appear to be fair at the outset, may not survive the pleadings, evidence, rules and procedures required by the judicial system. Here, summary judgment was declared in favor of the defendant concerning some of the pleadings, and Hackert, who represented himself, settled with Cigna without gaining equitable remuneration for his services. Although Hackert doesn’t disclose his reasons for settling, Cigna’s counterclaim alleging, among other points, “Unjust Enrichment” and “overpayment of plan benefits,” along with the prospect of paying Cigna’s court and attorney fees, might have led him to abjure his appellate rights. Hackert, indeed, states at the outset that Cigna’s counterclaim was designed to intimidate him “into dropping the case.”
Although Hackert gives lucid explanations for the many legal terms, rules and actions involved in the proceedings (i.e. subject matter jurisdiction, assignment of benefits, constructive trust, etc.), the book remains densely technical. As such, it will likely appeal only to law students and those considering litigation. To help these readers, an appendix containing the author’s and Cigna’s pleadings and the court orders would be useful additions.
Also available as an ebook and audio book.
