Midwest Neurosurgeons, LLC v. Abell

• Decision Date: 21 November 2022
• Docket Number: 5-21-0394
• Citation: 2022 IL App (5th) 210394 U
• Parties: MIDWEST NEUROSURGEONS, LLC, Plaintiff-Appellant, v. MARY ELLEN ABELL, Defendant-Appellee.
• Court: United States Appellate Court of Illinois

2022 IL App (5th) 210394-U

MIDWEST NEUROSURGEONS, LLC, Plaintiff-Appellant,
v.
MARY ELLEN ABELL, Defendant-Appellee.

No. 5-21-0394

Court of Appeals of Illinois, Fifth District

November 21, 2022

This order was filed under Supreme Court Rule 23 and is not precedent except in the limited circumstances allowed under Rule 23(e)(1).

Appeal from the Circuit Court of Williamson County. No. 21-L-81 Honorable Jeffrey A. Goffinet, Judge, presiding.

JUSTICE BARBERIS delivered the judgment of the court. Justices Welch and Cates concurred in the judgment.

ORDER

BARBERIS, JUSTICE

¶ 1 Held: We affirm the circuit court's dismissal of medical provider's breach of contract action, where medical provider was not a third-party beneficiary to a settlement contract entered into by employer and employee pursuant to the Workers' Compensation Act.

¶ 2 Plaintiff, Midwest Neurosurgeons, LLC (Midwest), filed a breach of contract action against defendant, Mary Ellen Abell, seeking to recover the costs of medical services and treatment Midwest provided to Abell's employee, Cheryl Lyell. Midwest alleged that it was a third-party beneficiary to a settlement contract entered into by Abell and Lyell, wherein Abell and Lyell agreed to settle Lyell's claim filed pursuant to the Workers' Compensation Act (Act) (820 ILCS 305/1 et seq. (West 2020)). Abell filed a motion to dismiss pursuant to sections 2-615 and 2-619 of the Code of Civil Procedure (Code) (735 ILCS 5/2-615, 2-619 (West 2020)), arguing, inter alia,

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that the Act prohibited medical providers from maintaining private causes of action against employers for medical services provided to employees who filed claims pursuant to the Act. The Williamson County circuit court granted Abell's motion and dismissed Midwest's action for failure to state a claim. Midwest appeals, arguing that the court erred by granting the motion to dismiss because it pled a recognized cause of action under Illinois law. We affirm.

¶ 3 I. Background

¶ 4 On February 25, 2011, Lyell sustained work-related injuries. Lyell filed a claim against Abell pursuant to the Act seeking benefits for her injuries. While her claim remained pending, Lyell received medical care and treatment for her injuries at Midwest on multiple dates in 2011.

¶ 5 On February 14, 2013, Abell and Lyell entered into a settlement contract, wherein they agreed to settle Lyell's claim arising under the Act. The Illinois Workers' Compensation Commission (Commission) approved the settlement contract on February 15, 2013. Neither Abell nor Lyell filed a petition for review of the Commission's approval of the settlement contract.

¶ 6 On July 2, 2021, Midwest filed a breach of contract claim against Abell seeking to recover the costs of the medical services and treatment that it provided to Lyell in 2011. Midwest alleged that it was an intended third-party beneficiary of the settlement contract, wherein Abell agreed to "pay, directly to the providers, the causally-related medical expenses incurred up to 9/26/12." In support, Midwest attached to the complaint a redacted copy of the settlement contract, which included the following provision:

"Respondent agrees to pay, directly to the providers the causally-related medical expenses incurred up to 9/26/12 [redacted]. Respondent also agrees to pay, directly to the provider, the unpaid medical expense incurred prior to the date of settlement at Neurology of Southern

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Illinois, Ltd. (Dr. Lori M. Guyton). All medical expenses will be paid pursuant to prearranged cost-containment agreements or the Illinois Medical Fee Schedule."

Midwest further alleged in the complaint that Abell breached the settlement contract by failing to pay Lyell's medical expenses and that, as a direct result of Abell's breach, it incurred damages in the amount of $67,438.97, "plus interest at the rate of 1% per month that began to accrue as set forth in 820 ILCS 305/8.2." Midwest alleged that the accrued interest on the unpaid medical bills totaled $79,569.29 at the time the complaint was filed and, thus, requested that the circuit court enter judgment against Abell for the sum of $147,053.26. In support, Midwest referenced and attached a document that listed, inter alia, the following information: the service and billing dates for the medical treatment Lyell received at Midwest; the total amount billed for the services; the insurance payments Midwest received; and interest calculations.

¶ 7 On October 1, 2021, Abell filed a motion to dismiss pursuant to sections 2-615 and 2-619 of the Code arguing, inter alia, that the Act prohibited medical providers, such as Midwest, from maintaining private causes of action against employers for medical services provided to employees who filed claims pursuant to the Act. On October 12, 2021, Midwest filed a response arguing that it adequately pled its status as an intended third-party beneficiary to the settlement contract and that its breach of contract claim was a viable, recognized claim under Illinois law. On October 27, 2021, Abell filed a reply reiterating her argument that Midwest had no direct cause of action against her as Lyell's employer.

¶ 8 On October 29, 2021, the circuit court held a hearing on Abell's motion to dismiss where the parties presented arguments consistent with the previous filings. After considering the parties' arguments, the court stated that it was unable to locate legal authority in support of Midwest's

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position that a medical provider was allowed to maintain a direct action against an employer for medical services provided to an employee who filed a claim under the Act. The court permitted Midwest to submit a memorandum to provide further law on the issue.

¶ 9 On November 5, 2021, Midwest submitted its memorandum arguing that Illinois law recognized third-party breach of contract claims, and that no provision of the Act expressly prohibited medical providers from recovering from employers amounts of medical services that employers contractually agreed to pay. Midwest further argued that the settlement contract did not violate public policy, and that dismissal of the claim would frustrate the purpose of the Act.

¶ 10 On November 8, 2021, the circuit court granted Abell's motion and dismissed the matter for failure to state a cause of action. The record on appeal does not include a written order but contains a docketing entry setting forth the court's ruling. In the docket entry, the court indicated that it was unable to locate legal precedent that allowed a medical provider to maintain a direct action against an employer...