Commercial Law World - Issue 4, 2017 - 27

Tales From The Front

The Wonderful Wizard What?!

by Timothy Wan, Esq.
Member Board of Governors
National Education
Committee Chair
Past Chair of the Eastern
Region
Past Chair of the Young
Members╩╝ Section
Contributing Editor of the
Board of Associate Editors
Timothy Wan is CEO of the
firm Smith Carroad Levy
& Wan, in Commack, New York,
and can be reached at
twan@smithcarroad.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.
www.smithcarroad.com

B

efore 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?"
CLLA.ORG

27


http://www.smithcarroad.com http://www.CLLA.ORG

Table of Contents for the Digital Edition of Commercial Law World - Issue 4, 2017

Contents
Commercial Law World - Issue 4, 2017 - Cover1
Commercial Law World - Issue 4, 2017 - Cover2
Commercial Law World - Issue 4, 2017 - Contents
Commercial Law World - Issue 4, 2017 - 2
Commercial Law World - Issue 4, 2017 - 3
Commercial Law World - Issue 4, 2017 - 4
Commercial Law World - Issue 4, 2017 - 5
Commercial Law World - Issue 4, 2017 - 6
Commercial Law World - Issue 4, 2017 - 7
Commercial Law World - Issue 4, 2017 - 8
Commercial Law World - Issue 4, 2017 - 9
Commercial Law World - Issue 4, 2017 - 10
Commercial Law World - Issue 4, 2017 - 11
Commercial Law World - Issue 4, 2017 - 12
Commercial Law World - Issue 4, 2017 - 13
Commercial Law World - Issue 4, 2017 - 14
Commercial Law World - Issue 4, 2017 - 15
Commercial Law World - Issue 4, 2017 - 16
Commercial Law World - Issue 4, 2017 - 17
Commercial Law World - Issue 4, 2017 - 18
Commercial Law World - Issue 4, 2017 - 19
Commercial Law World - Issue 4, 2017 - 20
Commercial Law World - Issue 4, 2017 - 21
Commercial Law World - Issue 4, 2017 - 22
Commercial Law World - Issue 4, 2017 - 23
Commercial Law World - Issue 4, 2017 - 24
Commercial Law World - Issue 4, 2017 - 25
Commercial Law World - Issue 4, 2017 - 26
Commercial Law World - Issue 4, 2017 - 27
Commercial Law World - Issue 4, 2017 - 28
Commercial Law World - Issue 4, 2017 - Cover3
Commercial Law World - Issue 4, 2017 - Cover4
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