Refund plea has no basis in contract

Trial Notebook

By Steven P. Garmisa

Hoey & Farina

Posted April 17, 2014 2:39 PM

By the time the Kolbe & Kolbe health insurance plan figured out that an employee’s sick baby did not qualify as a beneficiary, it had already paid a Wisconsin hospital $1.7 million for 11 months of treatment. Demanding a refund under a provider agreement that was silent on the question of refunds, the tardy health plan — claiming it had an implied right to repayment — sued the hospital in federal court based on the Employee Retirement Income Security Act (ERISA) and Wisconsin contract law …

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