Substantial Case Results
North Cypress Medical Center Operating Company, Ltd., et al. v. Cigna Healthcare; Connecticut General Life Insurance Company, et al., Case No. 12-20695, in the United States Court of Appeals for the Fifth Circuit, March 10, 2015.
Mr. Sutter handled the case both during the district court proceedings and on Appeal to the Fifth Circuit, including oral argument. Mr. Sutter was successful in this landmark decision wherein the Federal Appeals Court ruled against Cigna and for the out-of-network provider’s ERISA right to sue, and with regard to the patient’s rights to obtain a discount from the out-of-network provider. The Fifth Circuit not only reversed the district court and found Article III constitutional standing exists but also, for the first time, provides very specific step-by-step ERISA legal guidelines to determine whether all of ERISA plans condition full coverage on the collection of a full deductible and co-insurance, and whether Cigna violated Federal ERISA law in its inconsistent or discriminative out-of-network practice compared to its in-network practice during its ERISA plan administration. The Fifth Circuit also found that “there are strong arguments that Cigna’s plan interpretation of the exclusion” “charges for which you are not legally obligated to pay” is not “legally correct.”
- Cigna Lost Court Appeal to Out of Network Providers and Patients (Insurance News)
- Cigna Loses Court Appeal (PR Web)
L.H.C. Nashua Partnership, LTD. v. PDNED Sagamore Nashua L.L.C.
United States District Court for the Southern District of Texas
We represented a real estate developer in a transactional dispute. The jury awarded damages in excess of $26 million.
Kings Park Apartments v. Clear Lake City Water Authority, et al.
Harris County District Court
We represented a real estate developer in a claim against the Clear Lake City Water Authority for breach of its commitment to provide water and sewage utilities to several apartment properties. The jury awarded actual and punitive damages in excess of $12.5 million to our client.
Chapman & Cole v. Itel
United States District Court for the Southern District of Texas
We represented the Plaintiffs in their claims against a large container manufacturer for breaches of contract, common law fraud and other intentional actions. The Court rendered a verdict of approximately $1.8 million in favor of our clients.
Brown Services, Inc., et al. v. American International Underwriters, American International Group, Inc., et al.
Matagorda County District Court
This was a bad faith insurance practice case in which $750,000.00was in controversy. The case was settled in favor of our clients for approximately $700,000.00.
The Jiffy Lube Franchisees of the Houston-Galveston Area v. Pennzoil Corporation, Jiffy Lube, Incorporated, et al.
Galveston and Harris County District Courts
We represented the Houston-Galveston area Jiffy Lube Franchisees in a breach of contract and fraud cause of action against the Defendants. The franchisees alleged damages in excess of $5 million. The case was settled in favor of our clients prior to trial.
Great Western Log Homes, Inc., et al. v. Texas Commerce Bank, et al.
Harris County District Court
We represented a homebuilder in a $3.5 million lender liability action against Texas Commerce Bank. After a trial was commenced, the case was settled in favor of our clients.
Winograd, et al. v. Chubb Insurance Company
Harris County District Court
Our clients asserted a $6.5+ million claim against an insurer based upon bad faith insurance practices. The case settled in favor of our clients for a confidential amount.
Judwin Properties, Inc. v. The Aetna, United States Fire Insurance Company, et al.
Harris County District Court and United States District Court for the Southern District of Texas
We represented the Plaintiffs in their claims for bad faith insurance practices. Our clients alleged damages in excess of$4 million. Both were settled in favor of our clients prior to trial.
Trumix Concrete Company, Inc. v. First Northwestern Bank of Houston, et al.
Harris County District Court
This was a lender liability/fraud case brought by Trumix against its bank for alleged wrongful acts of the Bank committed while Trumix was the debtor in a Bankruptcy proceeding pending in the Southern District of Texas. Notwithstanding the fact that Trumix was eventually liquidated, the cause of action was assigned to the debtor's principal and a settlement of $400,000.00 (uninsured dollars) was obtained from the Bank and its officers.
Odeco Drilling, Inc., et al. v. Baroid Equipment, Inc. f/n/a Shaffer, Inc., et al.
In the 333rd Judicial District Court of Harris County, Texas
We represented the Plaintiffs in a claim for damages resulting from an offshore semi-submersible drill ship's Riser Tensioner System. The Court entered Judgment in favor of our clients for approximately$6 million.
Jane Giller, et al. v. Enron Corp., et al.
In the 200th Judicial District Court of Travis County, Texas
This was a claim for severe burn injuries and/or death of three (3) individuals due to natural gas release in a cabin. The Court entered a take-nothing judgment as to our client, Enron Oil & Gas.
David Lankford vs. Weatherford Enterra, Inc., et al.
In the District Court of Upton County, Texas, 83rd Judicial District;
Karen Glenn, et al. vs. Weatherford Enterra, Inc., et al.
In the District Court of Upton County, Texas, 83rd Judicial District;
Earl Brem and Mary Brem vs. Weatherford Enterra, Inc., et al.
In the District Court of Upton County, Texas, 83rd Judicial District
These were claims for severe burns to three (3) individuals when a valve cover of a gas compressor failed, and the escaping gas caught fire. The court entered a take-nothing judgment as to our clients Weatherford Enterra, Inc. and Weatherford Enterra Compression Company.