The Portland, Oregon, team of Peder Rigsby (Partner-Portland, OR), Matthew Casey (Of Counsel-Portland, OR), Mark Firmin (Associate-Portland, OR), and Sean McKean (Associate-Portland, OR) secured a defense verdict on behalf of Wilson Elser’s client, a health care insurer, before the Commercial Arbitration Tribunal of the American Arbitration Association. The matter involved a contract dispute between an Alaska hospital system and our client arising from alleged underpayments of health care claims. The disagreement concerned the reimbursement methodology the client used to pay the disputed claims, which involved technical health care provider reimbursement issues and contract interpretation principles under Alaska law. The hospital alleged the client underpaid the disputed claims by $550,000.
 
After a four-day hearing, the arbitrator issued a defense verdict in favor of our client, agreeing that the insurer did not breach the provider agreement with the hospital. Peder and the Wilson Elser team presented compelling evidence of nearly 20 years of consistent performance between the parties, supporting our client’s interpretation of the contract and demonstrating that the hospital never raised concerns during annual contract negotiations. Through expert testimony, the team also established that the client’s practices were consistent with industry standards. This significant win for the client avoided an adverse result that would have exposed the client to future claims well into the seven-figure range; the award forecloses that risk.