JANUARY 2013 BAD FAITH CASES: COURT REJECTS BAD FAITH CLAIM AGAINST HEALTHCARE CARRIER THAT REPORTED PHYSICIAN FOR DISCIPLINARY MEASURES (Bucks County Common Pleas)

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In Ahmad v. Aetna, Inc., a physician sued a healthcare insurance carrier for defamation and tortious interference, alleging that the carrier acted in bad faith by initiating an insurance fraud investigation and reporting the physician for disciplinary action under N.J.S.A. 45:1-35, which immunizes healthcare entities from suit for reporting allegations of physician misconduct.

The court rejected a claim that the carrier acted in bad faith, finding: (1) that the carrier was not improperly exerting financial pressure upon the physician to repay insurance reimbursements related to the physician’s alleged fraud and (2) the carrier’s less than thorough investigation alone did not amount to bad faith.

Date of Decision: May 18, 2012

Ahmad v. Aetna, Inc., No. 02-07002-29, 2012 Pa. Dist. & Cnty. Dec. LEXIS 222, Bucks County Court of Common Pleas (Pa. County Ct. 2012) (Fritsch, J.)

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