Not Surprisingly, $80 Attorney’s Fee is Still the Maximum
February 24, 2010
Skal Surgical Medical Supplies and St. Paul Travelers Insurance
AAA Case No. 412009044640 (Charles Sloane, awarded February 17, 2010)
This is a unique decision, in that it doesn’t actually deal with benefits or denials or health services… no, this one only talks about how much money applicant’s attorney wanted to collect.
Applicant’s attorney, apparently during discussion leading up to the payment by respondent, sought a 20% attorneys fee of $143.00 plus reimbursement of the filing fee, instead of the $80.00 fee set out by arbitration rules because, as he contended, the case was not yet in conciliation.
However, the applicant had already filed its AR-1 and respondent paid the disputed amount, plus interest, 20 days after AAA had received the AR-1. The respondent only agreed to pay $80.00 in fees, since the payment was upon filing and the case was therefore, they argued, in conciliation.
Arbitrator Sloane found that the respondent, under the arbitration rules, was under no obligation to pay any more than the $80.00 for a case settled in conciliation and prior to a hearing. As the respondent paid the claim due within the conciliation period, that the applicant’s attorney was entitled to nothing more than $80.00, plus the $40.00 filing fee.
Although this case seemed pretty clear cut – the regulations and arbitration rules do state exactly how much is due to an applicant’s attorney (i.e. 65-3.10; 65-4.5(s)(2); 65-4.6; AAA rule r.2., etc), the arbitrator did not find any “malfeasance” on the part of the applicant’s attorney, and costs were not, in what would have been quite an ironic twist, awarded to the respondent.
One Comment
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Roy Mura
Bethany Mazur
Scott Mancuso
The real question is what facts changed from the time of the original denial, or in other words what “good faith” basis was there for the original denial, that they are now conceding.