Sign In
Events
Newsletters
Search

Close

Close Search

Cancel

SEARCH
MY LAW.COMNEW

Aetna Workers' Comp Access LLC v. Coliseum Med. Ctr.

The State Board of Workers' Compensation did not have exclusive jurisdiction over the medical care providers' claims against the defendant because the allegations did not implicate the benefits to be paid to any individual injured employee, but instead alleged a systemic failure within the network administered by the defendant.

X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

These four related appeals involve the administration and payment of workers’ compensation claims and the duties and potential liabilities of the network administrator and insurers within that network. Appellant Aetna Workers’ Comp Access, LLC “Aetna” is the network administrator of the Aetna Workers Compensation Access network and has entered into contracts with Appellees Coliseum Medical Center and six other Georgia hospitals the “Providers”,1 which provide medical care for employees injured on the job. Appellant Builders Insurance “Builders”, Liberty Mutual Insurance Company “Liberty Mutual”, and Travelers Indemnity Company “Travelers” are workers’ compensation insurers collectively the “Payors” who are responsible for compensating the Providers for services rendered to covered workers. Appellants Sedgwick Claims Management Services, Inc. “Sedgwick” and MediCor Managed Care, LLC “MediCor” act as claims administrators on behalf of the Payors collectively the “Claims Administrators”.

These appeals raise three issues: 1 whether the State Board of Workers’ Compensation has jurisdiction over this dispute as opposed to the superior court; 2 whether an exculpatory clause in the contract between Aetna and the Providers precludes the Providers’ claims against Aetna; and 3 whether the trial court properly denied Sedgwick, MediCor, Builders, and Liberty Mutual’s motions to dismiss on the grounds that they were not a party to the contract between Aetna and the Providers.2 For the reasons set forth below, we affirm.

Trending Stories

 
Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.

LEARN MORE

More From ALM

Premium Subscription
With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now
Team Accounts
Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now
Bundle Subscriptions
Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now
Go to CLE Center
Southeastern Legal Awards 2025
May 01, 2025
Atlanta, GA

The Daily Report is honoring those attorneys and judges who have made a remarkable difference in the legal profession.


Learn More
GlobeSt. Healthcare Real Estate 2024
December 02, 2024 - December 03, 2024
Scottsdale, AZ

Join the industry's top owners, investors, developers, brokers and financiers for the real estate healthcare event of the year!


Learn More
ThinkAdvisor LUMINARIES Awards 2024
December 11, 2024
Las Vegas, NV

This event shines a spotlight on how individuals and firms are changing the investment advisory industry where it matters most.


Learn More
Go to Events Go to Webcasts
(NEW) JUNIOR-MID LEVEL LITIGATION ASSOCIATE WANTED FOR ELITE LITIGATION BOUTIQUE FIRM (Atlanta, GA)

Our client, a boutique litigation firm established by former BigLaw partners, is seeking to hire a junior-mid level associate their rapidly ...


Apply Now ›
CORPORATE ASSOCIATE - CT or Remote

Shipman & Goodwin LLP is seeking an associate to join our corporate and transactional practice. Candidates must have four to eight years...


Apply Now ›
Senior Associate - Boutique -A&D (NYC)

SENIOR ASSOCIATE ATTORNEY, BOUTIQUE LAW FIRM, CORPORATE LAW We provide strategic advisory and legal services to the world's leading archite...


Apply Now ›
Go to Lawjobs