Candace Edgar prevails in Pa. Superior Court in medical benefits auto claim

Saxton & Stump attorney Candace N. Edgar recently prevailed in an appeal before the Pennsylvania Superior Court, returning thousands of dollars to her insurance company client.

After a lower court ruling, her client was forced to pay attorney fees in a case where it had initially stopped payment for a woman’s chiropractor treatments following a car accident. An independent peer review organization had determined that the woman no longer needed the treatment, but the lower court found for the injured woman. Part of the ruling included an award of attorney fees.

However, the Superior Court overturned the award of attorney fees, citing past Pennsylvania Supreme Court rulings that did not allow for attorney fees when an insurance company uses a peer review organization.

In addition to overturning the attorney fees decision, the Superior Court ordered a new trial for another issue in the case in favor of Edgar’s client. The Superior Court found, under Edgar’s argument, that an expert testimony for the chiropractic provider exceeded what the witness was allowed to speak about.