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| Case Name | Palm Medical Group, Inc. v. State Compensation Insurance Fund | |
|---|---|---|
| Date | 03/25/2008 | |
| Note | Defendant 'possessed power so substantial over the market for the treatment of occupational injuries in the Fresno area in 2001-2002 that the failure to admit an ordinary, competent medical provider to its PPN would significantly impair that provider's ability to practice occupational medicine in the Fresno area and, so, Defendant owed Plaintiff a duty of fair procedure in acting on its application to the PPN. | |
| Citation | A114651 | |
| WCC Citation | WCC 33302008 CA |
CERTIFIED FOR PUBLICATION IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FIRST APPELLATE DISTRICT DIVISION THREE PALM MEDICAL GROUP, INC. , Plaintiff and Appellant, v. STATE COMPENSATION INSURANCE FUND, Defendant and Appellant. Ct. No. 421984) Palm Medical Group, Inc. (Palm), an occupational medical clinic located in Fresno, was denied admission into the preferred provider network (PPN) operated by State Compensation Insurance Fund (SCIF), a California public enterprise fund operating throughout the state as a nonprofit workers' compensation insurer. SCIF is the largest workers' compensation insurance carrier in the State of California. [¶] (b) State Compensation Insurance Fund's reasons for rejection of Palm Medical Group's application for admission to the Preferred Provider Network were arbitrary and unreasonable?"The jury answered "no" to subparagraph (a) and "yes" to subparagraph (b), and was directed to question number three which read, "Do you find by a preponderance of the evidence that if fair procedures had been provided by State Compensation Insurance Fund in connection with Palm Medical Group's 2001-2002 application for admission to State Compensation Insurance Fund's Preferred Provider Network, that Palm Medical Group should have been admitted into the Preferred Provider Network?"
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