My name is James Fredrick Jensen I am a Canadian that lived in Belize on the Island of San Pedro, my Wife Janis Died in Belize and the health insurance company failed to provide any coverage. I found myself being sued by Belize Health Partners the hospital my wife Jan died at.
The health insurance company was Bupa based in Miami Florida.
I retained the services of Bailey & Wyant, PLLC, is a full-service law firm. Attorney Robert P. Martin was the attorney from Bailey & Wyant, PLLC.
Since that time I have made numerous attempts to contact the law firm and to have questions answered as it related to my case. All without a single response back from the law firm of Bailey & Wyant, PLLC, .
I have attached a document as one of the questions I have asked a number of time of Bailey & Wyant, PLLC,. An Attorney Bill Thompson of Florida was to represent my case and to file legal actions in Florida on my behalf. I have never found a filing from this person named Bill Thompson or have been able to find this attorney.
Attorney Charles R. "Chuck" Bailey of Bailey & Wyant, PLLC In numerous other posts I have supplied letters on your firms letter head, Bailey & Wyant, PLLC.
Now this documents is from an attorney that attempted to represent me in this matter of my wifes health insurance coverage.
Did your firm Bailey & Wyant, PLLC, youself Charles R. "Chuck" Bailey or Attorney Robert P. Martin of Bailey & Wyant, PLLC have a hand in aiding in the development of this case listed below?
Or did Bailey & Wyant, PLLC supply needed case information as requested by the law firm of LEOPOLD~KUVIN, P.A.?
"IN THE CIRCUIT COURT OF THE ______ JUDICIAL CIRCUIT IN AND FOR MIAMI-DADE COUNTY, FLORIDA " " JAMES JENSEN, as Personal Representative of the Estate Of JANIS JENSEN, Deceased, for the benefit of JIM JENSEN, surviving spouse, and the Estate of JANIS JENSEN, and JAMES JENSEN, individually, Plaintiff, vs. BUPA INSURANCE COMPANY, a Florida Corporation; USA MEDICAL SERVICES, a Florida Corporation, Defendants. __________________________________________/" " CASE NO: " COMPLAINT Plaintiff, James Jensen, as Personal Representative of the Estate of JANIS JENSEN, deceased, for the benefit of James Jensen, surviving spouse, and the Estate of Janis Jensen, and James Jensen, individually, sues the Defendants, Bupa Insurance Company, a Florida corporation, and USA Medical Services, a Florida corporation, and alleges: JURISDICTION This is an action for damages that exceed $15,000, exclusive of interest and costs. Plaintiff James Jensen is the duly appointed Personal Representative of the Estate of Janis Jensen. Plaintiff is authorized pursuant to section 768.20, Florida Statutes, to bring this wrongful death action against Defendants on behalf of decedent’s survivors as statutory beneficiaries and decedent’s estate. Janis Jensen is survived by her husband, James Jensen. ARE THERE ANY CHILDREN UNDER 25? Defendant Bupa Insurance Company is a Florida corporation that is headquartered in Miami, Florida. Its registered agent is Alfred Maltby, 7001 SW 97th Ave., Miami, Florida 33173. Bupa Insurance Company is a subsidiary of British United Provident Association Insurance Limited, a worldwide health and care organization incorporated in the United Kingdom, and was opened in Miami as a hub for the parent company’s Latina America and Caribbean operations. Defendant USA Medical Services is a Florida corporation that is headquartered in Miami, Florida. Its registered agent is Alfred Maltby, 7001 SW 97th Ave., Miami, Florida 33173. USA Medical Services is a member of the Bupa Group, the collection of companies owned by British United Provident Association Insurance Limited around the world. The business of USA Medical Services is to administer insurance policies issued by the different companies within the Bupa Group by approving or denying claims for benefits, coordinating the provision of medical services, and arranging for payments to medical providers. At all times material to this complaint, USA Medical Services acted as an actual or apparent agent of Bupa Insurance Company. RF&G Life Insurance Company Limited is incorporated in Belize, with its primary place of business located at Gordon House, One Coney Drive, Belize City, Belize, PO Box 661. At all times material to this complaint, RF&G acted as an actual or apparent agent of Bupa Insurance Company. At all times material to this Complaint, the decedent, Janis Jensen, was a resident of Belize, and a citizen of the United States. GENERAL ALLEGATIONS James and Janis Jensen moved from Minnesota to San Pedro, Belize to operate their own business. The Jensens were insured under a comprehensive medical insurance policy issued by BlueCross BlueShield BluePlus of Minnesota from April 1, 2007 to April 1, 2008, plan ID number XZ9926563, Group number Y5314-HA 001v. This plan provided 100% coverage for all of the Jensens’ medical expenses, up to a $5,000,000 lifetime maximum. The Jensen’s wanted to maintain comprehensive health coverage while living in Belize, so they purchased a Platinum Worldwide Plan, Major Medical Policy, from RF&G, policy number HW 0001, with an effective date of February 25, 2008 and an expiration date of February 24, 2009. The Jensen’s paid the semi-annual premium of $7,849.38 for this policy on February 27, 2008. When the Jensen’s purchased this policy they were advised by RF&G’s employees that the policy provided complete coverage for all medical and hospital expenses as of the effective date. This unlimited coverage was confirmed by Bupa in several emails to Mr. Jensen expressing that the coverage was “approved without restrictions.” On May 21, 2008, Mrs. Jensen became so ill that she needed to fly to Belize City for treatment. She checked into the hospital in Belize City on May 22, 2008. The hospital required the Jensen’s to make a deposit of $20,000 before it would provide any treatment to Mrs. Jensen. Soon after checking into the hospital, the doctors recognized that Mrs. Jensen’s was suffering from an intracranial hemorrhage, a very serious medical condition, and recommended that she be transported by air ambulance to the United States for treatment. Defendants not only denied the Jensens’ request that Mrs. Jensen be transported to the United States, they denied any coverage for Mrs. Jensen’s medical and hospital expenses, claiming in a letter dated May 23, 2008, issued by USA Medical Services, that there was a 90-day waiting period. Defendants also claimed in that letter that the effective date of the insurance policy was actually April 1, 2008. After Mrs. Jensen was hospitalized, RF&G provided Mr. Jensen with what it claimed was the written policy of insurance that laid out the terms and conditions of the Jensens’ medical insurance coverage. This written policy did purport to exclude coverage for medical conditions that first manifested within 90 days of the policy becoming effective. The policy also contains a provision waiving this waiting period if the insured was covered by another medical insurance policy for one continuous year prior to, and within thirty days of, the effective date of the instant policy. After Defendants denied coverage for Mrs. Jensen’s medical and hospital expenses, Mr. Jensen advised RF&G of Mrs. Jensen’s prior coverage with BlueCross BlueShield and provided RF&G with proof that Mrs. Jensen was insured for a continuous year under a policy that had not expired more than 30 days before the instant policy became effective. Nevertheless, Defendants continued to deny coverage for Mrs. Jensen’s medical and hospital expenses. Because Mrs. Jensen was not able to receive adequate treatment at the hospital in Belize for her intracranial hemorrhage, she died on June 30, 2008 at 54 years of age. Defendants continue to refuse to provide coverage for the medical and hospital expenses resulting from Mrs. Jensen’s treatment at the hospital in Belize City. The hospital, Belize Health Care Partners, sued Mr. Jensen in Belize for unpaid medical and hospital fees totaling $229,280. COUNT I FRAUD IN THE INDUCEMENT/FRAUDULENT MISREPRESENTATION AGAINST DEFENDANT BUPA Plaintiff realleges paragraphs 1 through 22 as if fully set forth herein. At all times material to this action, RF&G and its agents/employees were as agents or apparent agents of Defendant Bupa and acting within the course and scope of this agency or apparent agency. Therefore, Defendant Bupa is vicariously liable for the fraudulent misrepresentations of RF&G and its agents/employees under the doctrine of respondeat superior. RF&G knowingly made material misrepresentations of fact to Mr. and Mrs. Jensen in order to induce them to enroll in the Platinum Worldwide Plan, and Plaintiffs relied on such misrepresentations to their detriment. An employee/agent of RF&G misrepresented to the Jensens that the Platinum Worldwide Plan would cover all of the Jensens’ medical and hospital expenses as of the plan’s February 25, 2008 effective date, knowing that the Jensens would not have purchased the policy if they knew it contained a 90-day waiting period. Thus, RF&G intentionally misrepresented the terms of the policy to the Jensens in order to induce them to purchase the policy. The Jensens reasonably relied on RF&G’s misrepresentation to their detriment. As a direct and proximate result of the fraudulent misrepresentation for which Defendant Bupa is vicariously liable, Defendant Bupa is responsible for the death of Janis Jensen and for damages as set forth below: James Jensen, the surviving husband of Janis Jensen, deceased, has suffered and will continue to suffer the loss of his wife’s support and services, companionship, and protection; has experienced mental pain and suffering in the past and will continue to suffer such losses in the future; and has incurred medical and funeral expenses due to his wife’s death; The Estate of Janis Jensen has lost prospective net accumulations and has incurred medical and funeral expenses due to the Janis Jensen’s injury and death. Also as a direct and proximate result of the above-described material misrepresentations and omissions, Plaintiff was obligated to retain attorneys to represent his interests and those of his wife’s estate in this matter, to whom Plaintiff has agreed to pay reasonable attorneys’ fees and costs. Any and all conditions precedent to bringing this action have been met or waived. WHEREFORE, James Jensen, as personal representative of the Estate of Janis Jensen, Deceased, for the benefit of James Jensen, surviving spouse, and the Estate of Janis Jensen, demands judgment for compensatory damages and costs, plus pre-judgment interest on all out-of-pocket economic damages, and attorneys’ fees under section 641.28, Florida Statutes, against Defendant Bupa, and for whatever further relief this Court deems appropriate. Further, Plaintiff reserves the right to amend the complaint to add a claim for punitive damages pursuant to the requirements of section 768.72, Florida Statutes. COUNT II NEGLIGENCE AGAINST DEFENDANTS USA MEDICAL SERVICES AND BUPA Plaintiff realleges paragraphs 1 through 22 as if fully set forth herein. At all times material to this action, Defendant USA Medical Services and its agents/employees were as agents or apparent agents of Defendant Bupa and acting within the course and scope of this agency or apparent agency. Therefore, Defendant Bupa is vicariously liable for the negligence of USA Medical Services and its agents/employees under the doctrine of respondeat superior. At all times material to this action, RF&G and its agents/employees were as agents or apparent agents of Defendant Bupa and acting within the course and scope of this agency or apparent agency. Therefore, Defendant Bupa is vicariously liable for the negligence of RF&G and its agents/employees under the doctrine of respondeat superior. Defendant USA Medical Services and RF&G knew or should have known that the Jensens’ medical insurance policy covered the medical and hospital expenses incurred as a result of Mrs. Jensen’s medical condition, and knew or should have known that the waiting period was not applicable because Mrs. Jensen had the prior insurance coverage required by the policy. Defendant USA Medical Services and RF&G owed the Jensens a duty to administer and oversee their policy of medical insurance in good faith. Defendant USA Medical Services and RF&G breached this duty by denying coverage for Mrs. Jensen’s medical and hospital expenses, as well as denying coverage for Mrs. Jensen to be transported by air ambulance to the United States for treatment. As a direct and proximate result of the negligence of USA Medical Services and RF&G, for which Defendant Bupa is vicariously liable, Defendants USA Medical Services and Bupa are responsible for the death of Janis Jensen and for damages as set forth below: James Jensen, the surviving husband of Janis Jensen, deceased, has suffered and will continue to suffer the loss of his wife’s support and services, companionship, and protection; has experienced mental pain and suffering in the past and will continue to suffer such losses in the future; and has incurred medical and funeral expenses due to his wife’s death; The Estate of Janis Jensen has lost prospective net accumulations and has incurred medical and funeral expenses due to the Janis Jensen’s injury and death. Also as a direct and proximate result of the above-described negligence, Plaintiff was obligated to retain attorneys to represent his interests and those of his wife’s estate in this matter, to whom Plaintiff has agreed to pay reasonable attorneys’ fees and costs. Any and all conditions precedent to bringing this action have been met or waived. WHEREFORE, James Jensen, as personal representative of the Estate of Janis Jensen, Deceased, for the benefit of James Jensen, surviving spouse, and the Estate of Janis Jensen, demands judgment for compensatory damages and costs, plus pre-judgment interest on all out-of-pocket economic damages, and attorneys’ fees under section 641.28, Florida Statutes, against Defendants Bupa and USA Medical Services, and for whatever further relief this Court deems appropriate. Further, Plaintiff reserves the right to amend the complaint to add a claim for punitive damages pursuant to the requirements of section 768.72, Florida Statutes. COUNT III INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS AGAINST DEFENDANTS USA MEDICAL SERVICES AND BUPA Plaintiff realleges paragraphs 1 through 22 as if fully set forth herein. At all times material to this action, Defendant USA Medical Services and its agents/employees were as agents or apparent agents of Defendant Bupa and acting within the course and scope of this agency or apparent agency. Therefore, Defendant Bupa is vicariously liable for the intentional infliction of emotional distress committed by USA Medical Services and its agents/employees under the doctrine of respondeat superior. At all times material to this action, RF&G and its agents/employees were as agents or apparent agents of Defendant Bupa and acting within the course and scope of this agency or apparent agency. Therefore, Defendant Bupa is vicariously liable for the intentional infliction of emotional distress committed by RF&G and its agents/employees under the doctrine of respondeat superior. USA Medical Services and its agents/employees and RF&G and its agents/employees, all acting within the scope of their agency with Bupa, denied coverage for Mrs. Jensen’s medical treatment and interfered with her ability to get adequate medical treatment by denying coverage for her transport by air ambulance to the United States. USA Medical Services and its agents/employees and RF&G and its agents/employees engaged in this outrageous conduct even though they knew that it would cause Plaintiff James Jensen significant detriment and severe emotional distress because he was forced to helplessly watch as his wife slowly died from lack of access to adequate medical treatment. The conduct of USA Medical Services and its agents/employees and RF&G and its agents/employees was fraudulent and outrageous, going beyond all possible bounds of decency and is extreme, outrageous, shocking, atrocious and utterly intolerable in a civilized community. USA Medical Services and its agents/employees and RF&G and its agents/employees acted with reckless disregard for the high probability that their actions would cause severe emotional distress to Plaintiff James Jensen. As a direct result of the conduct of USA Medical Services and its agents/employees and RF&G and its agents/employees, for which Defendant Bupa is liable, Plaintiff James Jensen suffered severe emotional distress, as well as personal injury, damage and loss. Also as a direct and proximate result of the above-described negligence, Plaintiff was obligated to retain attorneys to represent his interests in this matter, to whom Plaintiff has agreed to pay reasonable attorneys’ fees and costs. Any and all conditions precedent to bringing this action have been met or waived. WHEREFORE, James Jensen, individually, demands judgment for compensatory damages and costs, plus pre-judgment interest on all out-of-pocket economic damages, against Defendants Bupa and USA Medical Services, and for whatever further relief this Court deems appropriate. Further, Plaintiff reserves the right to amend the complaint to add a claim for punitive damages pursuant to the requirements of section 768.72, Florida Statutes. COUNT IV LOSS OF CONSORTIUM Plaintiff realleges paragraphs 1 through 22 as if fully set forth herein. At all times material hereto, Janis Jensen and James Jensen were married to each other and living together as husband and wife. As a direct and proximate result of the above described actions committed by Defendants Bupa and USA Medical Services, Plaintiff James Jensen has been deprived of the comfort, society, services and the consortium of his wife. Also as a direct and proximate result of the above-described negligence, Plaintiff was obligated to retain attorneys to represent his interests in this matter, to whom Plaintiff has agreed to pay reasonable attorneys’ fees and costs. Any and all conditions precedent to bringing this action have been met or waived. WHEREFORE, Plaintiff James Jensen, individually, demands judgment for any and all compensatory damages allowed by law as well as any and all taxable costs allowed by law against Defendants Bupa and USA Medical Services, and further demands trial by jury. Respectfully submitted, LEOPOLD~KUVIN, P.A. 2925 PGA Boulevard Suite 200 Palm Beach Gardens, FL 33410 (561) 515-1400 CERTIFICATE OF SERVICE HEREBY CERTIFY that a true and correct copy of the foregoing was furnished by U.S. Mail, postage prepaid, this day of _____, _______ to . LEOPOLD~KUVIN, P.A. 2925 PGA Boulevard Suite 200 Palm Beach Gardens, FL 33410 (561) 515-1400 (561) 515-1401 (facsimile) By:
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