Miami Law Firm Clinches $17 Million Professional Negligence Settlement Against Major Accounting Firm
The failed HMO, Physicians United Plan, at one time reported revenue of $375 million. Attorneys succeeded in settling claims against the accounting firm, RSM US LLP, for professional negligence.
June 12, 2020 at 02:21 PM
3 minute read
A major international accounting firm paid $17 million as part of a settlement to the receiver for an insolvent health maintenance organization, or HMO.
John Genovese, a partner at Genovese, Joblove & Battista in Miami, led a team that scored a settlement in an ongoing receivership case involving a failed health care maintenance organization, Physicians United Plan. Genovese and his team worked on behalf of the Florida Department of Financial Services as receiver for the failed HMO that at one time reported revenues of $375 million.
The case is a reminder for insureds and firms involved in transactions with insurance companies to be cautious about their solvency.
Genovese succeeded in settling claims against the accounting firm, RSM US LLP, for professional negligence, by obtaining a $17 million settlement payment and a waiver of millions of dollars in claims by the accounting firm against the receivership estate.
Thomas Selby, a partner at Williams & Connolly in Washington who represented RSM US, did not respond to request for comment.
RSM US is one of the largest accounting firms in the U.S. It focuses on middle-market clients, offering them audit, tax and consulting services.
Prior to the receivership, Physicians United Plan was a Florida-based Medicare Advantage prescription drug health maintenance organization that provided health services for a fixed annual fee. The organization had about 50,000 Medicare subscribers, according to the Florida Department of Financial Services.
"This case arose from banks' financing transactions, which helped disguise the true financial conditions of the HMO insurance company," Genovese said. "And the HMO marketed a product that was intended to disguise the true financial condition of the HMO."
Read the Order Granting Motion for Settlement Agreement and Release:
On June 9, 2014, Florida Department of Financial Services was appointed as the receiver of Physicians United Plan, which was immediately ordered into rehabilitation and had to liquidate within less than a month.
Florida Department of Financial Services filed an initial complaint for damages against RSM, then known as McGladrey, on Feb. 17, 2016, that sought to recover damages due to RSM's alleged "acts and omissions" in its auditing of the company, according to the settlement agreement filed with the Leon County Circuit Court.
When the Leon County Circuit Court held a case management conference last January, Florida Department of Financial Services stated it would amend its pleadings. About a month later, a settlement agreement between the receiver and RSM was filed with the court for approval.
Genovese said winning the case was not easy.
"Whenever there's litigation involving a major accounting firm represented by a high-quality law firm, any litigation of that sort is a challenge," Genovese said. "The challenge is always showing an accounting firm has knowledge of the financial conditions of the company that wasn't consistent with what was being filed with the regulator."
Despite the challenge, Genovese claimed there is a lesson for lawyers if they find themselves representing a client like RSM.
He said, "Lawyers generally need to assess the risk for each of their clients facing litigation and recognize that it's in both sides' best interests to receive a fair settlement, rather than having lengthy litigation with an uncertain outcome."
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