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Appeals court overturns attorney fee award for lawyers who proved Blue Cross engaged in illegal activity

Ilene and Michael Tinman sued Blue Cross Blue Shield arguing that it illegally refused to pay hospital emergency bills after reviewing their disabled son's "final diagnosis."  Blue Cross must pay for emergency care where it is appropriate and by law the insurer is not allowed to base its coverage decisions on a subsequent discharge diagnosis.  The Tinmans argued that Blue Cross followed an illegal policy that affected an entire class of hospital admitees; ultimately they prevailed at trial and their victory entitled them to be awarded attorney fees.

The trial judge conducted a hearing on the fee issue and ultimately awarded the Tinmans' lawyers $655,000.00 in fees.  Blue Cross appealed.  It was fortunate enough to draw a panel that included insurance-friendly judges Kirsten Kelly and Henry Saad.  They overturned the award of fees and sent the case back to the trial judge.  They acknowledged that the court had taken "vast testimony from prior evidentiary hearings" on the relevant issues and instructed the judge that he must make more specific findings to support a fee award.

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