Sedgwick's Healthcare Practice Chair Named Outstanding Litigator

April 2008

David M. Humiston, chair of Sedgwick’s national Healthcare Practice Group, was selected by Nightingale's Healthcare News as an “Outstanding Healthcare Litigator” for 2007. The distinguished award was bestowed on just 12 trial attorneys nationwide.

This honor recognizes Humiston’s numerous 2007 litigation successes. His notable victories include serving as lead counsel in obtaining a defense verdict in a seven-month jury trial on behalf of a managed care client, an independent practice association (IPA) of some 300 affiliated physicians. The action raised a myriad of causes of action against Sedgwick’s client and attempted to put the managed care system of capitation and risk pool sharing arrangements on trial, contending care was denied to a terminally ill patient because of financial incentives. The duration of the case through the winter, spring and summer of 2007 allowed the movie "Sicko," Michael Moore's anti-managed care/U.S. healthcare system film, to play a part in the court's rulings as covered by the Daily Journal, CNN and other news media.

The five-year lawsuit resulted in seven amended complaints and alleged claims of negligence, willful misconduct, intentional misrepresentation, false promise, constructive fraud, fraud (concealment), elder abuse, wrongful death and unfair business practices in violation of Business and Professions Code section 17200 against the managed care defendants. This was the only reported jury defense verdict during 2007 brought by an enrollee of a health plan against a managed care entity and was the longest jury trial in Southern California in 2007. Recently, the trial court denied plaintiff’s motion for new trial and upheld the defense verdict.

Humiston also successfully obtained another defense trial verdict in a case brought by several specialty physicians for breach of contract, bad faith and unfair business practices against Sedgwick’s managed care client. Additionally, he successfully obtained dismissal in several wrongful death actions this past year. For example, Humiston obtained a summary judgment in a wrongful death case against a managed care entity. The allegations involved claims of alleged delay and denial of covered healthcare benefits that resulted in the death of the member. The summary judgment on behalf of Sedgwick’s client was upheld by the California Court of Appeal, Second District. Other early dismissal orders were obtained after successfully arguing MediCare preemption to the plaintiffs’ state law causes of action alleging bad faith, unfair business practices and fraud.

A Sedgwick partner resident in the firm’s Los Angeles office, Humiston represents health plans and managed care organizations in provider and member litigation. He handles diverse liability issues, including class action litigation pertaining to reimbursement, rescission, utilization review, benefits and claims determinations, ERISA, MediCare, IBNR, breach of contract and unlawful, unfair, or fraudulent business and advertising practices.

Humiston is a member of several healthcare organizations, including the ABA’s Health Law Section, the American Health Lawyers Association, and the California Society of Healthcare Attorneys. He served as the ABA Health Law Section’s Chair of the Managed Care & Insurance Interest Group for the 2004-2005, and 2005-2006 terms. For more than 20 years, Humiston has received an “AV” rating, the highest ranking for legal ability and general ethical standards as reported in the Martindale-Hubbell Law Directory.

The author of several published appellate opinions and articles that have contributed to California jurisprudence, Humiston is also editor-in-chief of the authoritative treatise, Managed Care Litigation, published by BNA Books. He is a coauthor of the book’s chapter, “State Law Challenges in Managed Care.” Humiston has been annually honored as a “Southern California Super Lawyer” since its inception in 2004 by the publishers of Los Angeles Magazine and the Journal for Law & Politics. He is also recognized in Who's Who in American Law and Who's Who in California.

Humiston received his B.A., magna cum laude, in economics, from the University of California at Los Angeles and his J.D. from the University of California, Hastings College of the Law.