Dental Practice Alleges Defamation by Insurer

On Friday a case was filed in the Illinois Northern District Court by James L. Orrington II and his practice against Humana Dental Insurance and its affiliates. The case is alleges that Humana defamed the plaintiff’s practice.

The plaintiff provides dental services in Illinois, per the complaint. The practice was previously in -network with Humana and listed on the insurer’s list of approved dental practices.

In June of 2019, the complaint claims that a dispute arose between Humana and the plaintiff regarding treatment of a long term patient, wherein a representative from Humana indicated that Humana would not cover the treatment for the patient unless a more invasive and permanent procedure was performed.

The plaintiff disputed the medical necessity of the more invasive procedure and disputed the propriety of Humana directing the type of treatment performed, the complaint said.

According to the plaintiff, after this procedure, Humana removed the practice from the list of approved providers “for cause.” Humana later rescinded that removal, then removed the practice “without cause.” The plaintiff also alleges that Humana made a report to the IDPFR which regulates dental practice, which the plaintiff alleges was made in retaliation for the practice’s actions.

The plaintiff argues that these actions have resulted in the practice’s professional liability carrier dropping them, higher premiums, and the requirement of counsel in connection with the IDPFR complaint. The plaintiff is suing for common law defamation, commercial disparagement, infliction of emotional distress, and abuse of process in regards to the administrative complaint. Plaintiff is represented by Chiacchio IP.