Out-of-network balance-billing is a legal and ethical controversy that is affecting the landscape of health-care litigation on a national level as well as here in New Jersey. Especially in the arena of “surprise” medical bills from out-of-network providers rendering emergency medical services, balance-billing litigation is an area of massive concern both for insurers and their insureds (hereinafter “members”). This is especially true in cases where out-of-network providers seek facially excessive fees for seemingly routine procedures.
This article explores the joinder ramifications of out-of-network providers initiating litigation against either an insurer or its member. If a case is brought solely against the insurer, in certain scenarios it may behoove the insurer to attempt to join its member in the case to protect its own interests. On the other end of the spectrum, in cases brought solely against a member, there are instances where the insurer may have a contractual duty to attempt to intervene and substitute on behalf of the member and hold that member harmless.
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