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Sterling v. Asplundh Tree Expert Co.

11/10/2004

ed a substantial amount of charges relating to hernia surgery undergone by Claimant. There seems to be no dispute that these charges pertaining to the hernia condition are unrelated to the claims at issue in this lawsuit and that they should not be paid by Asplundh.


It would seem that Asplundh has satisfied the first of the three-prong requirements set forth in Resweber, i.e., there has been a "false statement or representation" in the submission to Asplundh of the costs related to the hernia matter.


Asplundh has failed, however, in proving the second prong of Resweber, i.e., that the representation was "willfully made" by Claimant or his counsel. The WCJ denied this motion on this ground, stating that there had been no proof that Claimant or his counsel willfully made this false representation. Asplundh argued that certain "white outs" on the medical bills suggest a willful misrepresentation. The WCJ, however, stated that it was clear to her that these white outs were made by the hospital, not by Claimant or his counsel. Indeed, at the hearing before the WCJ on this issue, counsel for Asplundh stated that he was not suggesting that Claimant's counsel wrongfully misrepresented the medical costs. Furthermore, there is no proof in the record that Claimant, himself, had any personal involvement in submitting these bills to Asplundh. Consequently, there is no proof that either Claimant or his counsel willfully intended to make false statements regarding the medical bills.


For these reasons, we affirm the WCJ's denial of both of the motions in question. Court costs are to be divided by the parties.


AFFIRMED.






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