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Champion Billiards Cafe Inc. v. Hall12/4/1996
Opinion by Eyler, J.
Although two distinct issues are raised on appeal, the primary issue presented by this case is whether an employer may be held liable in tort for economic losses, i.e., medical expenses, incurred by an employee because the employer failed to forward timely the employee's application for health insurance coverage to the provider after undertaking to do so. We affirm the judgment in favor of the employee for reasons set forth below.
Facts
Appellee, Jill K. Hall, was employed as a bartender by appellant, Champion Billiards Cafe, Inc. Appellee attended a meeting of appellant's employees in September 1994, at which time appellant offered to enroll employees in a group insurance program provided by Optimum Choice, Inc. ("Optimum Choice"), a health insurance provider. Appellant would contribute no money towards the insurance, but offered to deduct premiums from employee paychecks and forward the money to Optimum Choice.
Along with other employees, appellee completed the necessary applications and authorizations, including an authorization for payroll deductions to pay the premiums; chose one of the coverage options provided; and designated a primary physician from a list supplied by Optimum Choice. All of the completed employee applications were accepted by appellee's supervisor to be sent by facsimile to Optimum Choice. Appellee believed that she had health insurance as of October 1, 1994.
Unknown to appellee, her supervisor did not send her application along with those of the other employees. There was conflicting testimony as to whether this was done accidentally or purposefully. The trial court determined that the supervisor knowingly withheld appellee's application because the supervisor believed that appellee's employment might be terminated.
Appellee was hit by a motor vehicle while riding her bicycle on October 21, 1994 and incurred medical expenses in the amount of $15,846.86. She submitted a claim to Optimum Choice, but it was denied. Through her supervisor, she learned that Optimum Choice had never received her application. The supervisor then submitted her application, but Optimum Choice refused reimbursement for expenses incurred prior to November 1, 1994, the effective date of coverage.
Appellee filed a complaint on May 4, 1992 in the Circuit Court for Montgomery County against appellant and Optimum Choice, the count against Optimum Choice being voluntarily dismissed prior to trial. Appellee sued appellant for breach of contract, negligence, negligent misrepresentation, and fraud, alleging that appellant had a duty both in contract and in tort to forward her insurance application to the provider. A bench trial was held on January 23 and 24, 1996 and, at the close of appellee's case, the trial court granted appellant's motion for judgment with respect to the fraud claim. By order filed January 31, 1996, the trial court found in favor of appellee on the negligence claim and entered judgment in appellee's favor in the amount of $15,636.36, the amount that Optimum Choice would have paid had appellee been insured.
Issues
The issues presented to us by appellant, as rephrased by us for clarity, are as follows:
1.
Did the trial court err in admitting certain documents into evidence?
2.
Did the trial court err in finding the existence of a tort duty owed by appellant to appellee?
Discussion
A. The Admission of Appellee's Medical Records
Over appellant's objection, appellee introduced into evidence various medical bills and collection letters from health care providers who
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