United States District Court, N.D. Illinois, Eastern Division
DAVID WHITE, KATHRIN BENDER, DIANE BOZEMAN, ROY CHERRY, GARY GILMORE, and STEVEN MAXWELL, Plaintiffs,
COVENTRY HEALTH CARE, INC., a Wholly-Owned Subsidiary of Aetna Inc., Defendant.
MEMORANDUM OPINION AND ORDER
R. Wood, United States District Judge
David White, Kathrin Bender, Diane Bozeman, Roy Cherry, Gary
Gilmore, and Steven Maxwell were employed as firefighters and
paramedics with the Chicago Fire Department
(“CFD”). Plaintiffs allege that Defendant
Coventry Health Care, Inc. (“Coventry”)
unjustifiably induced the City of Chicago
(“City”) to breach a collective bargaining
agreement between it and the CFD Union Local No. 2
(“Union”). Before the Court is Coventry's
motion to sever or, in the alternative, to bifurcate the
claims in this lawsuit. (Dkt. No. 10.) For the reasons
detailed below, Coventry's motion is denied.
case concerns allegations of tortious interference with a
contract. As alleged in the Complaint, the City and the Union
are parties to a collective bargaining agreement. (Compl.
¶ 2, Dkt. No. 1-1). For the past 30 years, each
iteration of the collective bargaining agreement entered into
between the City and the Union has contained the following
provision: “The [City] further agrees to pay all
hospital and medical costs of an employee incurring a duty
connected injury, illness or disability.” (Id.
¶ 3.) Under the collective bargaining agreement, payment
of all hospital and medical costs is dependent upon “a
certificate by the chief physician of the department . . . as
to the reasonableness of charges made for services
rendered.” (Id. ¶ 14.) The CFD's
chief physician is the CFD Medical Director. (Id.
¶ 15.) And “[i]n case of an injury which is
attributable to duty, after initial emergency medical
treatment, any subsequent medical care must have the approval
of the [CFD] Medical Director to be reimbursable.”
(Id. ¶ 16.)
about November 20, 2008, the City contracted with Coventry to
provide claim-review services. (Id. ¶¶ 7,
8.) Before Coventry began its work for the City, the CFD
Medical Director would simply heed the advice and
recommendations of an employee's treating physician.
(Id. ¶ 12.) After the Coventry started working
for the City, however, recommendations from CFD
employees' treating physicians would go through
Coventry's nurses and associated physicians for review of
the “medical necessity” of the prescribed medical
care. (Id. ¶ 18.) The nurses and associated
physicians never actually saw, examined, or spoke to the
patient-employee prior to making a recommendation.
(Id. ¶ 19.)
respect to the six Plaintiffs, each sustained a duty-related
injury as a CFD uniformed employee between June 24, 2008 and
April 16, 2009. (Id. ¶ 32.) Shortly after each
Plaintiff sustained his or her injury, the CFD Medical
Director provided each with the name of a Chicago-area
physician. (Id. ¶ 33.) Each of those treating
physicians issued medical care requests ranging from surgical
procedures to occupational therapy. (Id.
¶¶ 23, 36, 53.) After reviewing the medical care
requests, Coventry issued “not medically
necessary” determinations. (Id. ¶ 23.) In
making those determinations, Coventry's nurses and
associated physicians utilized review criteria known as
Official Disability Guidelines (“ODG”).
Coventry's application of the ODG was medically
unjustified and caused delay, denial, and discontinuation of
delivery of medical care to Plaintiffs and others.
(Id. ¶ 114.) Indeed, during the 2009 calendar
year, Coventry sent out 173 medical care determination
letters, and in 78% of those letters Coventry determined that
the requested treatment was “not medically
necessary.” (Id. ¶ 24.) Because of the
“not medically necessary” determinations, duty
injuries sustained by firefighters and paramedics, the six
Plaintiffs included, were left to fester as the injured
employees could not receive the medical care recommended by
their physicians. (Id. ¶ 29.) The lack of
timely care caused damages to each Plaintiff. (Id.
seeks severance of Plaintiffs' individual claims and
bifurcation of the liability and damages phases of their
trials. The Court considers each request in turn.
Severance of Claims
Federal Rule of Civil Procedure 21, the “misjoinder of
parties is not a ground for dismissing an action, ”
although a court may add or drop a party or sever claims.
Fed.R.Civ.P. 21. A Court may “sever any claims that are
‘discrete and separate' in the interest of judicial
economy and to avoid prejudice.” Vermillion v.
Levenhagen, 604 F. App'x 508, 513 (7th Cir. 2015);
see also Rice v. Sunrise Express, Inc., 209 F.3d
1008, 1016 (7th Cir. 2000) (“It is within the district
court's broad discretion whether to sever a claim under
Rule 21.”). Generally, however, parties may be joined
in a lawsuit if “they assert any right to relief
jointly, severally, or in the alternative with respect to or
arising out of the same transaction, occurrence, or series of
transactions or occurrences.” Fed.R.Civ.P. 20(a)(1)(A).
evaluating whether a particular factual scenario creates
“a single transaction or occurrence for purposes of
[Federal Rule of Civil Procedure 20], a case-by-case approach
is generally pursued because no hard and fast rules have been
established.” Adkins v. Ill. Bell Tel. Co.,
No. 14-cv-01456, 2015 WL 1508496, at *7 (N.D. Ill. Mar. 24,
2015) (quoting Bailey v. N. Trust Co., 196 F.R.D.
513, 515 (N.D. Ill. 2000)). Courts interpret the term
“single transaction or occurrence” as including
“a series of many occurrences, depending not so much
upon the immediateness of their connection as upon their
logical relationship.” Lozada v. City of
Chicago, No. 10-cv-01019, 2010 WL 3487952, at *2 (N.D.
Ill. Aug. 30, 2010) (quoting Mosley v. Gen. Motors
Corp., 497 F.2d 1330, 1333 (8th Cir. 1974)). A
“logical relationship” between a series of
separate occurrences may be established by “a variety
of factors, including whether the alleged conduct occurred
during the same general time period, involved the same people
and similar conduct, and implicated a system of
decision-making or widely-held policy.” Birdo v.
Dave Gomez, 214 F.Supp.3d 709, 722 (N.D. Ill. 2016)
(quoting Adkins, 2015 WL 1508496, at *7).
Additionally, a particular factual scenario may constitute a
single transaction or occurrence when “separate trials
would result in delay, inconvenience and added expense to the
parties and the court because of the likelihood of
overlapping proof and duplication in testimony.”
McDowell v. Morgan Stanley & Co., 645 F.Supp.2d
690, 694 (N.D. Ill. 2009) (internal quotation marks omitted).
argues here that Plaintiffs' claims arise out of
different transactions and occurrences because Plaintiffs:
(1) were injured at different times and under different
circumstances; (2) suffered different types of injuries; (3)
were treated by different physicians at different facilities;
and (4) were prescribed different courses of treatment.
Coventry further contends that no company-wide practice is
identified in the Complaint because the claims were reviewed
on an individual basis by different Coventry personnel and
based on different criteria.
despite Coventry's arguments to the contrary, Plaintiffs
have adequately alleged a single transaction or occurrence
pursuant to Rule 20. All Plaintiffs were injured within the
same ten-month time-period and were denied medical treatment
by Coventry shortly thereafter. Plaintiffs allege that
Coventry unjustifiably denied them medical care in order to
save the City money, thereby increasing its own value to the
City. According to Plaintiffs, that denial of medical care
resulted from Coventry's policies and practices-namely,
reliance on the ODG to determine whether recommendations made
by orthopedic specialists were medically necessary. Thus,
Plaintiffs are not challenging the discretionary decisions of
the individual nurses and physicians who reviewed their
medical prescriptions; instead, Plaintiffs claim that all
Coventry recommendations were flawed (regardless of the
physician or nurse involved) because the system employed to
make those determinations was medically unjustified. Overall,
Plaintiffs have alleged similar conduct occurring during the
same general time period. Further, the alleged conduct
implicates a common system of decision-making employed by all
Coventry nurses and physicians. As such, Plaintiffs have
established a logical relationship between their separate
medical denials and joinder of their claims is proper.
alternatively contends that even if joinder is proper under
Rule 20, the Court should nonetheless exercise its discretion
under Rule 21 to sever Plaintiffs' cases based on both
judicial economy and prejudice to Coventry due to jury
confusion. According to Coventry, severance will allow
Plaintiffs and Coventry to streamline their cases by avoiding
unnecessary discovery issues. The Court is not persuaded by
this argument. All Plaintiffs allege that their medical
claims were denied pursuant to Coventry's company-wide
policy. All Plaintiffs claim that the denial of their claims
not only violated the collective bargaining agreement but
also was based on medically-unjustifiable ODG criteria. If
separate trials were held for each Plaintiff, much of the
same evidence regarding the common-scheme and Coventry's
knowledge of the collective bargaining agreement would need
to be repeated at each trial. Thus, judicial economy would be
better served by conducting one consolidated trial on these
overlapping actions. Although Coventry argues that requiring
a jury to hear evidence and make factual determinations
concerning six separate ...