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Federal judge allows lawsuit against faith-based healthcare company to proceed

ST. LOUIS RECORD

Friday, November 22, 2024

Federal judge allows lawsuit against faith-based healthcare company to proceed

Lawsuits
Insurance11

A federal judge is allowing a class-action lawsuit to proceed against Trinity HealthShare and its affiliate Aliera Companies, which is accused of operating as an insurer while benefiting from being classified as a healthcare sharing ministries under the Affordable Care Act (ACA).

“The Court finds Trinity is on notice of the allegations pending against it and that Plaintiffs have pled a claim under the Missouri Merchandising Practices Act (MMPA) to survive a motion to dismiss,” U.S. District Judge Douglas Harpool wrote. “The Court also finds Plaintiffs have pled enough regarding their claim for breach of fiduciary duty and unjust enrichment to survive a motion to dismiss.”

The lawsuit, filed in the Southwestern Division of the Western District of Missouri, further alleges that Trinity HealthShare and Aliera Companies sold deceptive health care plans to Missouri residents that didn’t effectively cover medical care or reimburse expenses as purchasers had believed.

“The Court finds Plaintiffs have pled enough to proceed with their claims against Defendants and the allegations meet the federal notice pleading requirement,” Judge Harpool stated. 

Plaintiffs are asking the court to impose a constructive trust and for restitution. 

“The defendants are spending so much money on lawyers defending this case and similar cases in Washington State and California that we've got a little bit of fear that they're going to spend all their money on lawyers and there's not going to be any to pay the people who are injured,” Jay Angoff, a partner with Mehri & Skalet law firm, said.

As previously reported in the St. Louis Record, Angoff filed the lawsuit against Aliera and Trinity on behalf of George T. Kelly for allegedly not covering any of his medical expenses even though Plaintiff Kelly paid $344.44 monthly.

Trinity HealthShare filed a motion to stay discovery while it appeals Judge Harpool’s decision to deny their motion to dismiss to the 8th Circuit

“That gives us a lot of work to do over the holiday vacation to respond to both motions,” Angoff, the former Missouri Insurance Commissioner, told the St. Louis Record. “It also just shows how desperate they are to keep the case out of court. The last thing in the world they want is to have a jury or a judge decide this case.” 

Defendant Trinity in its motion argued that the court should exercise its discretion to stay discovery in order to avoid the risk of inconsistent rulings.

“Trinity further moves this Court for an order staying the trial of the action until mediation and arbitration has been had in accordance with the terms of the dispute resolution provision,” attorney Ginger K. Gooch wrote on behalf of Trinity. 

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