Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 1 of 29 Page ID #:4
`Case 2:21-cv-09269 Document1-1 Filed 11/29/21 Page 1of29 Page ID #:4
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`EXHIBIT A
`EXHIBIT A
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 2 of 29 Page ID #:5
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`ALAN NESBIT, ESQ. [SBN 310466]
`NESBIT LAW GROUP US LLP
`8383 Wilshire Boulevard Ste 800
`Beverly Hills, California 90211
`Tel: (323) 456-8605
`Fax: (323) 456-8601
`Email: anesbit@nesbitlawgroup.com
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`Attorney for Plaintiff,
`DEDICATED SLEEP LLC
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`SUPERIOR COURT OF THE STATE OF CALIFORNIA
`COUNTY OF LOS ANGELES, CENTRAL DISTRICT
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`DEDICATED SLEEP LLC,
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`Case No.:
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`Plaintiff,
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`v.
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`CIGNA HEALTH AND LIFE INSURANCE
`COMPANY, CIGNA HEALTHCARE OF
`CALIFORNIA INC, CIGNA HEALTHCARE
`OF ILLINOIS INC and DOES 1 through 20,
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`Defendants.
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`COMPLAINT FOR:
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`1. QUANTUM MERUIT;
`2. BREACH OF CONTRACT;
`3. FRAUDULENT
`MISREPRESENTATION and
`4. DECLARATORY RELIEF
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`[JURY TRIAL REQUESTED]
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`Damages: UNLIMITED: Over
`$25,000
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`Plaintiff, DEDICATED SLEEP LLC (hereinafter referred to as "DS") complains and
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`alleges, as follows:
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Electronically FILED by Superior Court of California, County of Los Angeles on 10/25/2021 04:28 PM Sherri R. Carter, Executive Officer/Clerk of Court, by Y. Tarasyuk,Deputy Clerk
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`Assigned for all purposes to: Stanley Mosk Courthouse, Judicial Officer: Dennis Landin
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`21STCV39324
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 3 of 29 Page ID #:6
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`GENERAL ALLEGATIONS
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`1. DS is, and at all times relevant, was a corporation organized and existing under
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`the laws of the State of Oregon.
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`2. DS is, and at all times relevant, was a specialty medicine group, consisting of
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`sub-contracted licensed medical physicians and licensed dental physicians who provide
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`healthcare and Durable Medical Equipment (DME) services to patients in need of medical care
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`for sleep disorders and related cranial facial problems. The licensed medical physicians and
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`dental physicians include, but are not limited to, California licensed and/or certified medical
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`professionals and professional entities (hereinafter collectively referred to as “Physicians”).
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`3. Physicians provided medical care, services, treatment, and/or procedures and
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`equipment and services to members, subscribers and insureds of defendants, CIGNA HEALTH
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`AND LIFE INSURANCE COMPANY, CIGNA HEALTHCARE OF CALIFORNIA INC,
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`CIGNA HEALTHCARE OF ILLINOIS INC and DOES 1 through 20,, (hereinafter referred to
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`as "DEFENDANT" or “DEFENDANTS”). In providing such care, services, treatment and/or
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`procedures, Physicians became contractually entitled to reimbursement, payment and/or
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`indemnification from DEFENDANTS for those services and supplies rendered.
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`4. Physicians submitted their claims and billings to DEFENDANTS for payment and
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`exhausted all administrative appeals as established by DEFENDANTS in an effort to secure
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`payment of their fees from DEFENDANTS, however, DEFENDANTS have failed and
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`otherwise refused to provide Physicians full payment or any payment at all.
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`5. DEFENDANTS are, and at all times relevant, were corporations established in
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`and/or otherwise licensed to do business in and were doing business in the State of California, as
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`medical health plan administrators and insurers. DS is informed and believes that
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`DEFENDANTS are licensed by the DMHC and/or Department of Insurance to transact the
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`business of insurance in the State of California and DEFENDANTS are, in fact, transacting the
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`business of administrating medical health plans and/or insurance in the State of California and
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`are thereby subject to the laws and regulations of the State of California.
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`6. The true names and capacities, whether individual, corporate, associate, or
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 4 of 29 Page ID #:7
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`otherwise, of DOES 1 through 20, inclusive, are unknown to DS, who therefore sues said
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`DEFENDANTS by such fictitious names. DS is informed and believes and thereon alleges that
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`each of the DEFENDANTS designated herein as a DOE is legally responsible in some manner
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`or to some extent for the events and happenings referred to herein and legally caused injury
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`and/or damage to DS. DS will seek leave of this Court to amend this Complaint to insert their
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`true names and capacities in place and stead of the fictitiously named DOES DEFENDANTS
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`when their names become known.
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`7. At all times herein mentioned, unless otherwise indicated, DEFENDANTS were the
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`agents and/or employees of each of the remaining DEFENDANTS and were at all times acting
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`within the purpose and scope of said agency and employment, and each DEFENDANT has
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`ratified and approved the acts of his agent. At all times herein mentioned, DEFENDANTS had
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`actual and/or ostensible authority to act on each other's behalf in certifying or authorizing the
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`provision of medical services; processing and administering the claims and appeals; pricing the
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`claims; approving or denying the claims; directing each other as to whether to pay and/or how to
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`pay claims; issuing remittance advices and explanations of benefits statements; and making
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`payments to Physician and its Patient.
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`FACTUAL BACKGROUND
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`8. This Complaint arises out of DEFENDANTS failure to make payments due and
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`owing Physicians for medical care, treatment, equipment and procedures provided to numerous
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`patients1 (who hereinafter are referred to as "Patients"), who were insureds, members,
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`policyholders, certificate-holders and/or were otherwise covered for health, treatment and
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`pharmaceutical expenses under one or more policies or certificates of insurance issued and
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`underwritten by DEFENDANTS.
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`9. None of the claims and/or causes of action in this Complaint are derivative of the
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`contractual rights of the Patients. In no way does DS seek to enforce the contractual rights of
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`the Patients through the Patients’ insurance contracts, policies, certificates of coverage, and/or
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`1 For privacy reasons and to comply with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the full names and identifying
`information pertaining to the patients has been withheld. This information will be disclosed to DEFENDANTS upon request.
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 5 of 29 Page ID #:8
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`any other written insurance agreements between DEFENDANTS and Patients. The claims and
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`causes of action herein are based solely upon the relationship and contractual interactions
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`between the Physicians and DEFENDANTS and upon the fact that the Patients were covered by
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`or administered by DEFENDANTS for the medical care and treatment provided him/her by the
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`Physicians.
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`10. DS is informed and believes, and on such information and belief, alleges that
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`the Patients were insured by DEFENDANTS either as a subscriber to coverage or as a
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`dependent of a subscriber to coverage under policies and/or certificates of insurance issued and
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`underwritten by DEFENDANTS. DS is informed and believes that the Patients entered into a
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`valid insurance agreement with DEFENDANTS for the specific purpose of ensuring that he/she
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`Patient would have access to medically necessary treatments, care, procedures and surgeries by
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`medical practitioners like the Physicians and ensuring that DEFENDANTS would administer or
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`pay for the health care expenses incurred by the Patient.
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`11. DS is informed and believes, and on such information and belief alleges, that
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`DEFENDANTS received, and continue to receive, valuable premium payments from the
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`Patients and/or other consideration from the Patients under the subject policies applicable to the
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`Patients.
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`12. At all relevant times, Physicians provided medically necessary and appropriate
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`services, care, treatment, and/or procedures to Patients who held valid insurance policies or
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`certificates issued by or administered by DEFENDANTS. A full schedule of the Patients and
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`treating Physicians (with the Patients’ name redacted) is attached hereto as Exhibit 1.
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`13. Physicians have a reputation for providing high quality care, treatment, and
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`procedures. Physicians’ charges for services are on par with the charges of other physicians in
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`the same general area for the same procedures and/or services. The Physicians' billed charges
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`are reasonable, usual, and customary and have been paid by DEFENDANTS for the same
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`services over the last 8 years.
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`14. The Physicians who provided medical services to Patients were "in-network
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 6 of 29 Page ID #:9
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`providers" who had preferred provider contracts or other contracts with DEFENDANTS at the
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`time that the subject care was rendered and/or treatments and/or equipment were performed and
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`provided.
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`15. It is standard practice in the healthcare industry that when a medical provider enters
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`into a written preferred provider contract with a health plan such as DEFENDANTS, that
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`medical provider agrees to accept reimbursement that is discounted from the medical provider's
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`total billed charges in exchange for the benefits of being a preferred or contracted provider.
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`Those benefits include an increased volume of business because the health plan provides
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`financial and other incentives to its members to receive their medical care and treatments from
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`the contracted provider, such as advertising that the provider is "in network," and allowing the
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`members to pay lower co-payments and deductibles to obtain care and treatment from a
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`contracted provider. When health plans such as DEFENDANTS receive claims from in-network
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`providers, they adjust the total charges submitted by the in-network provider and pay an agreed
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`upon contract (“capitated”) rate to the in-network provider.
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`16. Physicians offered and rendered medical services, care, equipment and
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`treatment, and/or procedures to the Patients, who were members, insureds, or subscribers of
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`DEFENDANTS, because the services Patients required were reasonable and necessary. For the
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`Patients’ claims at issue here, the Physicians did in fact provide such medical services, care,
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`treatment and/or procedures to the Patients. As part of discovery process, relevant Explanation
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`of Benefits (EOBs) will be provided showing Patients’ name. The relevant CPT codes
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`contained therein will show that each of these procedures was reasonable and necessary. Due to
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`HIPAA regulations such information cannot be provided in the absence of a protective order.
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`Because the medical services, care, treatment, and/or procedures rendered by the Physicians to
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`the Patients were covered by the contractual relationship, DEFENDANTS were required by
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`their own contracts to compensate the Physicians at their contracted rates.
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`17. Medical records pertaining to the medical services, care, treatment, and/or
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`procedures furnished by Physicians to the Patients were provided to DEFENDANTS by the
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`Physicians. All information requested by DEFENDANTS relating to the medical services, care,
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 7 of 29 Page ID #:10
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`treatment, and/or procedure provided by the Physicians to the Patients was similarly supplied to
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`DEFENDANTS by the Physicians.
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`18. At all relevant times, the Physicians submitted their claims to DEFENDANTS
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`accompanied with lengthy treatment reports, chart notes, receipts from patients for DME
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`received and other medical records relating to the care and treatment Physicians rendered to
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`Patients. No matter whether large or small, all of the Physicians' claims were submitted using
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`CPT codes, Healthcare Common Procedure Coding System ("HCPCS"), and modifiers, as
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`necessary.
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`19. At all relevant times, Physicians expected to be reimbursed by DEFENDANTS at
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`the lesser of its billed charges or the then contractual rate.
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`20. Rather than simply pay Physicians the lesser of their billed charges or contractual
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`rates, DEFENDANTS instead routinely and deliberately failed to reimburse Physicians' claims
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`at all, forcing Physicians to exhaust time and energy first identifying and then appealing the
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`improperly reimbursed claims. DEFENDANTS then went further and put all further claims for
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`treatment from Physicians into a Special Investigations Unit investigation (“SIU”) such that no
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`further payments were made during the period of the SIU, which remains ongoing, without any
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`reason for continuing the same.
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`21. DEFENDANTS have failed and refused to pay any monies, benefits, insurance
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`proceeds, to the Physicians in connection with the medically necessary services, care, treatment,
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`equipment and/or procedures rendered to the Patients by the Physicians. Further,
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`DEFENDANTS have never adequately explained how they calculated, justified, rationalized or
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`comprised their rejection of claims nor the instigation of an SIU.
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`22. Often, the refusal to pay the Physicians by DEFENDANTS for the exact same
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`procedures, treatments, equipment, or services were paid at contractual rates during the same
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`year and previous years.
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`23. DEFENDANTS have received claims from the Physicians for a number of years.
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`As such, DEFENDANTS knew the rates that Physicians charged for various services and indeed
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`contracted with Physicians to pay those rates. Moreover, DEFENDANTS knew, or should have
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 8 of 29 Page ID #:11
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`known, the amounts charged by other medical providers for medical services, care, and
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`treatment, since it had received, reviewed and processed, numerous claims prior to processing
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`the claims at issue in this litigation. It is standard practice in the healthcare industry for medical
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`providers (whether in-network or not) to submit claims and bills showing the total charges to
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`health plans such as DEFENDANTS and for DEFENDANTS to price those claims, based either
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`upon the total charges or the contractual rates offered to network providers.
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`24. Plaintiffs have also been disparaged by the pervasive under-reimbursement
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`scheme. When a patient refers to his/her evidence of coverage documents promulgated by
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`DEFENDANTS, he/she is led to believe that when he/she seeks in-network care their charges
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`will be paid by DEFENDANTS at the contracted rate. When a patient obtains in-network
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`treatment from providers such as the Physicians and the provider submits the bill to the insurer,
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`a patient learns for the first time that he/she will not be fully reimbursed because the doctor's
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`charges are alleged by DEFENDANTS to somehow breach the contractual arrangement. The
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`physician-patient relationship is undermined, as the physicians have been branded as charlatans
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`whose bills are inflated and unreasonable and the patient becomes responsible for the
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`outstanding bills.
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`25. At all relevant times, DEFENDANTS harmed Physicians by making improper
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`determinations that reduced or refused the contractual reimbursement amounts for in-network
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`providers without valid or compliant data to support such determinations. DEFENDANTS
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`further harmed the Physicians by refusing to pay legitimate billing for the exact same services,
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`billed and evidenced in exactly the same way as in previous years and in exactly the same way
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`as DEFENDANTS purchased rival organization EVICORE continues to bill and have claims
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`processed. As a result of these actions, the Physicians were financially harmed and forced to
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`exhaust significant time and resources appealing DEFENDANTS’ unlawful determination
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`through a process deliberately designed to deny, delay, and impede in-network physician
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`providers such as Physicians with a significant market share from obtaining their rightful
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`reimbursement.
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`26. Upon information and belief, DEFENDANTS used and continue to use flawed
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 9 of 29 Page ID #:12
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`Assessment procedures and data. The improper use of this data has caused both Patients and
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`Physicians to experience significant losses. Patients are harmed because payers like
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`DEFENDANTS are not reimbursing in-network services at all, which results in in-network
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`providers being forced to bill their patient for amounts charged, which exceed the amounts
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`DEFENDANTS covers. In-network providers like Physicians are harmed because they are not
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`always able to collect these balances from Patients and are forced to take a loss for their
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`services. Moreover, because in-network providers are often unaware of the scheme that results
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`in payers like DEFENDANTS failing to pay appropriate contractual rates, they are either
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`powerless to appeal any such improper determinations or their efforts to appeal these
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`determinations are futile. DEFENDANTS, by contrast, benefit from not paying in-network
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`providers such as Physicians any money at all. Therefore DEFENDANTS have unlawfully
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`retained money which otherwise belongs to the physicians for the services provided.
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`DEFENDANTS’ ambiguity regarding its method for processing perfectly legitimate claims
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`reflects their participation in this deceptive practice.
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`27. DEFENDANTS’ Explanation of Benefit statements were initially uninformative,
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`false, and misleading regarding the denial of the claims. Some sections of DEFENDANTS
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`organization pay in the same way as they previously done over the last 8 years. However
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`DEFENDANTS SIU investigation for just some of Physicians patients is nonsensical. This
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`ambiguity has resulted in the inconsistent application of processing to deny Physicians their
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`lawful reimbursement. Claims processing should be applied consistently by DEFENDANTS,
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`but instead are selectively used to deny lawful reimbursement to Physicians.
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`28. The Physicians' explanation of benefits and remittance advices received from
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`DEFENDANTS often state that their billed charges are refused. However, nowhere on the
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`explanation of benefit statements, remittance advices, or elsewhere in any other correspondence
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`sent to the Physicians do DEFENDANTS discuss or identify why.
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 10 of 29 Page ID #:13
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`FIRST CAUSE OF ACTION
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`FOR QUANTUM MERUIT
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`(AGAINST ALL DEFENDANTS)
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`29. Plaintiff incorporates all allegations set forth in the above paragraphs as though
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`fully set forth herein.
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`30. Physicians provided procedures, medical treatments, equipment and other medical
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`medical services to their Patients, thereby benefitting DEFENDANTS and their insured Patients.
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`31. DEFENDANTS have failed and refused to pay Physicians the appropriate amounts
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`incurred by Physicians in rendering medical services, care, treatment, equipment, and/or
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`procedures to Patients and have failed and refused to pay the contracted costs of those services.
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`32. At all times herein mentioned, DEFENDANTS were required by contract to pay,
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`agreed rates for the care provided by Physicians to the Patients, who were members or
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`subscribers of or administered by DEFENDANTS. Alternatively, DS is informed and believes
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`and thereon alleges that, at all times herein mentioned, and based on the circumstances of the
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`parties' relationship to one another, the services furnished by Physicians were furnished at the
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`implied request and/or insistence of the DEFENDANTS on behalf of the Patients.
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`33. DEFENDANTS are required to reimburse Physicians at a quantum meruit rate for
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`all services rendered to the Patients. The quantum meruit amount owed by DEFENDANTS to
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`the Physicians is determined according to the customary charges that would be billed by the
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`Physicians and/or other physicians in the absence of preferred provider or participating provider
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`contractual rates. Based upon the Patients’ request that the Physicians render treatment,
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`surgeries, procedures and medical services to the Patients, and the fact that DEFENDANTS
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`were benefitted by the provision of such services by the Physicians, an obligation on the part of
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`DEFENDANTS to make restitution to the Physicians arose.
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`34. In Regents of the University of California v. Principal Financial Group, 412
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`F.Supp.2d. 1037, 1042 (N.D. Cal. 2006), the federal trial court held that California law no
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`longer requires that a defendant be benefitted in order for a quantum meruit claim to lie. In
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`Earhart v. William Low Company, 25 Cal.3d. 503, 511, 158 Cal.Rptr. 887, 600 P.2d. 1344
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`9
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 11 of 29 Page ID #:14
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`(1979), the California Supreme Court abrogated the common law requirement that there be
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`benefit to the defendant in a quantum meruit claim, noting “that performance of services at
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`another’s behest may itself constitute ‘benefit’ such that an obligation to make restitution may
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`arise.” Thus, the fact that Mr. Donner was the direct beneficiary of the medical treatment “does
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`not bar plaintiff’s claim.” Thus, the fact that DEFENDANTS' neither directly requested the
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`treatment nor were the direct beneficiary of the treatment is not a bar to a claim for quantum
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`meruit.
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`35. The quantum meruit rate for the medical treatment the Physicians provided to
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`Patients is an amount to be determined at trial. This amount represents the usual, customary and
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`reasonable cost or charge for the services rendered by the Physicians. The Physicians have
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`submitted statements to DEFENDANT for these amounts, and have made repeated demands that
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`they be paid for the medical treatment provided to the Patients at usual, customary, and
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`reasonable rates.
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`36. DEFENDANTS have refused to pay, and continue to refuse to pay the Physicians
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`for the whole of the sums owed to the Physicians for the treatment, equipment, procedures and
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`medical services provided to the Patients, at usual, customary and reasonable rates.
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`Accordingly, there is now due and owing an unpaid sum, plus statutory interest.
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`SECOND CAUSE OF ACTION
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`FOR BREACH OF CONTRACT
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`(AS AGAINST ALL DEFENDANTS)
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`37. Plaintiff incorporates all allegations set forth in the above paragraphs as though
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`fully set forth herein.
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`38. DS is informed and believes and thereon alleges that, at all relevant times
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`herein, that Physicians and DEFENDANTS had entered into a Contract for the provision of in-
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`network medical services. A copy of the Contract is attached hereto and marked Exhibit 2.
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`39. DS is informed and believes that clause 3.1 of the Contract clearly defines the
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`10
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 12 of 29 Page ID #:15
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`DEFENDANTS obligations for payment for the specific purposes of (1) ensuring that the
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`Patients would have access to medically necessary treatments at healthcare facilities, and (2)
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`ensuring that DEFENDANTS would pay for the healthcare expenses incurred by the Patients.
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`40. DEFENDANTS knew or reasonably should have known that its insureds would
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`seek medical treatment from the Physicians.
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`41. DS is informed and believes that DEFENDANTS received and continue to
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`receive valuable premium payments from the Patients under the relevant policies of insurance.
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`42. Since Physicians agreed to treat the Patients for medically necessary treatment.
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`DEFENDANTS, according to contract, were required to pay Physicians at the agreed rate for
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`services rendered
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`43. In consideration for the Physicians' agreement to treat the Patients, DEFENDANTS
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`agreed to reimburse the Physicians for the expenses incurred by the Patients in the course of
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`being treated and undergoing surgeries and/or procedures rendered by the Physicians and agreed
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`to pay the Physicians a contracted rate for those services.
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`44. The Physicians provided medical treatment to the Patients. DEFENDANTS have
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`Failed and refused to pay, and continue to refuse to pay, the Physicians for the whole of the
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`sums owed to the Physicians at appropriate rates for the medically necessary treatment,
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`equipment and services provided to the Patients.
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`45. As a result of the foregoing breach, the Physicians have been damaged by
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`DEFENDANTS in the sum of $2,568,759.69. This is the total amount in respect of services
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`billed that have not been paid. A schedule of matters is attached as Exhibit 1. Accordingly, there
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`is now due and owing an unpaid sum, plus statutory interest thereon.
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`46.
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`Furthermore, as a result of failure to pay for such an extended period, Plaintiff has
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`lost approximately $1,577,000 of business (in addition to the amount not paid for services
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`rendered) due to work that otherwise would have been carried out but has not been due to
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`repeated nonpayment. This is calculated at an average of $83,000 per month since payments
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`stopped in April 2020, namely 19 months to date and continuing at $83,000.
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`11
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 13 of 29 Page ID #:16
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`THIRD CAUSE OF ACTION
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`FOR FRAUDULENT MISREPRESENTATION
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`(AGAINST ALL DEFENDANTS)
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`47.
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`Plaintiff incorporates by reference each and every allegation contained in each
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`paragraph above as though set forth at length.
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`48.
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`Plaintiff is informed and believes and thereon alleges that they were harmed because
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`DEFENDANTS intentionally made a false representation that they would pay for covered services
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`in the same way as they had done the previous 8 years. They intentionally made a false
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`representation that they would pay for Plaintiff’s services provided to their insureds and members.
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`They intentionally made a false representation that they would pay what was owed on receipt of
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`billing and records. The contract was signed in February 2020 and the denial of payments began
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`in April 2020 only 2 months later, despite 8 years of prior performance using exactly the same
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`services and methodology.
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`49.
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`The reality is that DEFENDANTS based on information and belief knew that these
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`representations were false. Prior to starting the contract, DEFENDANTS had already put in place
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`arrangements with EVICORE to provide exactly the same services as Plaintiff. DEFENDANTS
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`allowed EVICORE to bill for and thereafter be paid for exactly the same services as contracted
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`between Plaintiff and Defendant as covered services. At the same time DEFENDANTS began a
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`false investigation, which included automatically stopping payments for all the same services
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`carried out and billed by Defendant. This was done in a cynical attempt to decrease Plaintiff’s
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`market share and increase Evicore’s market share. They made these representations with the clear
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`intention that Plaintiff would rely upon them to provide DEFENDANT’S members and insureds
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`services and in particular to stop payments for DME that Plaintiff had paid for, ensuring the most
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`difficult financial impact from failing to pay for services.
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`50.
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`Plaintiff did reasonably rely on these representations and entered into the contract
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`and have subsequently been harmed.
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`12
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 14 of 29 Page ID #:17
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`51. Due to DEFENDANTS misrepresentations and falsehoods Plaintiff has received
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`significantly lower income from the bills in this scheme than could ever have been anticipated.
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`The specific amount is to be determined at Trial.
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`52.
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`Plaintiff’s reliance on DEFENDANTS’ representations was the substantial factor in
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`the subsequent lack of payments at all.
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`53.
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`In performing the acts alleged herein, Defendants acted fraudulently, maliciously,
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`and oppressively, all within the meaning of Civil Code §3294, hereby justifying an award of
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`punitive and exemplary damages in the amount of $25,000,000.
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`FOURTH CAUSE OF ACTION
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`FOR DECLARATORY RELIEF
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`(AGAINST ALL DEFENDANTS)
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`54.
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`Plaintiff incorporates by reference each and every allegation contained in each
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`paragraph above as though set forth at length.
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`55. An actual controversy and dispute now exists between DS and DEFENDANTS, in
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`that (i) DS contends that DEFENDANTS are responsible for making payments to DS for the
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`medical services that DS rendered to the patients at issue in DS’s Complaint and (ii)
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`DEFENDANTS contend that it has properly denied payment for the medical services rendered by
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`DS at issue in DS’s Complaint.
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`56. As a direct and proximate result of the above-described dispute between the parties,
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`and to resolve such dispute, DS requests an order for this Court declaring that DS’s carried out
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`the services, and must be paid for the medical services at issue in DS’s Complaint at the
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`contractually agreed rate and that no further such payments should be denied.
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`PRAYER FOR RELIEF
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`WHEREFORE, Plaintiff, DEDICATED SLEEP LLC prays for judgment against
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`DEFENDANTS as follows:
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`1. For compensatory damages in the sum of $4,145,759.69, plus statutory interest;
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`2. For punitive damages in the sum of $25,000,000;
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`13
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 15 of 29 Page ID #:18
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`3. For costs of suit herein; and
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`4. For such other and further relief the Court as deems just and appropriate.
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`DATED: October 25, 2021
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`Respectfully submitted,
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`By: ________________________
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`ALAN NESBIT
`Attorney for Plaintiff
`DEDICATED SLEEP LLC.
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`14
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`DEDICATED SLEEP LLC'S COMPLAINT
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`Case 2:21-cv-09269 Document 1-1 Filed 11/29/21 Page 16 of 29 Page ID #:19
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`Plaintiff, DEDICATED SLEEP LLC. hereby demands a jury trial as provided by law.
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`DEMAND FOR JURY TRIAL
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`DATED: October 25, 2021
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`Respectfully submitted,
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`By: ________________________
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`ALAN NESBIT
`Attorney for Plaintiff
`DEDICATED SLEEP LLC.
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`DEMAND FOR JURY TRIAL
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`Case 2