Before MGM made Dorothy Gale a household name, before Michael Jackson moonwalked the Yellow Brick Road, and before the wickedly talented Idina Menzel belted out on Broadway, waaay back in 1900, Lyman Frank Baum conceived of a fanciful fairy world called “Oz”, laden with wizards, witches, and anthropomorphized animals. Of course, what is lesser-known, is that the original story had the infamous Wizard of Oz, displace the monarch, King Pastoria, to take over the world, based on deception and misdirection.
Unfortunately for me, some of the cases I file are in the jurisdiction of Oz.
Button-Bright, a wealthy young man was injured while working on a hot-air balloon, in the Land of Oz, and had to receive medical treatment at The Marvelous Oz Hospital. He was treated well, recuperated, and thankful for his care. Unfortunately for Button-Bright, his insurance carrier, Philadelphia Insurance Company, was not accepted at Marvelous Oz Hospital. As such, Marvelous Oz Hospital retained my office to file suit against Button-Bright.
Button-Bright, while wealthy, was also quite precocious, and didn’t think he needed an attorney. So, on the first date of the trial conference, Button-Bright appeared, and made the blanket statement that “I have insurance, so I shouldn’t have to pay for anything.” Judge Oscar Diggs was the presiding Judge, and asked for any evidence that Button-Bright had. Button-Bright produced a blurry photocopy of an undated, unsigned, single page document, purportedly on Philadelphia Insurance letterhead, which said:
“To Whom It May Concern: It has come to our attention that you are billing our Member for monies that are not his or her responsibility. You are prohibited from collecting monies up front or balance billing Philadelphia Insurance members above their cost share responsibility, where applicable, or other covered services…”
The document then went on to list four scenarios in which a patient could be billed.
“Services are determined by Philadelphia Insurance to be not-covered.
Services are excluded from Philadelphia Insurance coverage.
Service was incurred when not actively enrolled as a Member of Philadelphia Insurance.
Service exceeds or exhausts the applicable benefit limit.”
Calmly, I explained that since Marvelous Oz Hospital was not a participating medical provider with Philadelphia Insurance, there was no contractual agreement.
Judge Oscar Diggs’s eyes widened, as if I had just tossed a bucket of water on him. He looked at Button-Bright and screamed, “Then let me ask Button-Bright! Did Philadelphia Insurance determine the services to be non-covered?”
Button-Bright sheepishly replied, “Nope.”
Judge Diggs continued to inquire. “Were the services excluded?”
Button-Bright stated, “I don’t think so.”
“Were you actively enrolled in Philadelphia Insurance when the services were rendered?”
Button-Bright smugly asserted, “Of course.”
“Did you exceed or exhaust your applicable benefit limit?”
Button-Bright affirmatively exclaimed, “Never!”
Judge Diggs looked at me, eyes piercing me like a winged monkey’s talon. “Counselor, you have no basis to charge Button-Bright. Case dismissed!”
Aside from the fact that clearly, *I* wasn’t charging Button-Bright, I plead to Judge Diggs to explain the basis of his wicked decision, since the letter was devoid of any signatory, never identified Marvelous Oz Hospital, and most importantly, was the very epitome of hearsay.
Judge Diggs paused, and cowardly muttered, “It’s not hearsay”.
I began to explain the definition, as heartfelt as I could. “But Judge, hearsay is an out of court statemen…”
Judge Diggs roared. “Counselor, it’s not hearsay! It’s from Philadelphia Insurance! It’s reputable! Philadelphia Insurance is a national company. You cannot attack Philadelphia Insurance’s authenticity! Pay no attention to the insurance company behind the curtain!” Lightning flashed, thunder crashed, and the room shook.
I asked Judge Diggs for a written decision, and he rendered one right from the bench. “Based on the uncontrovertable correspondence presented by the Defendant, Plaintiff is prohibited from proceeding against Defendant. Said correspondence is hereby made a part of the record. Case dismissed with prejudice.”
Clearly, I wasn’t going to accept this. I sought to appeal Judge Diggs’s ruling. The Hospital whole-heartedly agreed, and even paid me in rubies to prosecute the appeal. I didn’t have to have a genius brain to reiterate to the Appellate Court of Oz, the overly broad handed and humbug way that Judge Diggs dismissed my case
I received a short decision, a tiny time later. “Even assuming the authenticity and admissibility of the correspondence, at this juncture, it did not conclusively establish a defense as a matter of law, warranting the drastic measure of an unsolicited dismissal prior to trial. Dismissal is overruled, and case is restored to the calendar.”
The next time the matter was heard, it was before Judge Glinda, who did not fall victim to the illusions, and granted us a judgment based on Button-Bright’s admissions.
Unfortunately, Button-Bright soon left the Land of Oz, and has not been seen since. And Judge Diggs left Oz as well, presumably back to Nebraska.
Timothy Wan is the CEO of the firm Smith Carroad Levy Wan & Parikh, and can be reached at email@example.com. L. Frank Baum actually wrote fourteen novels about Oz, and the ruler of Oz was Princess Ozma, who appeared in all of them, except the first, which is the one which was adapted into the MGM movie in 1939.