Jesse Jones

First, a motorcycle crash, then medical bills, then collections. Now, a lawsuit.

Seattle, WA — How does someone get injured in an accident…

“My knee dislocated; I tore all my ligaments except my ACL.”

Have health insurance…

“My balance was always paid. Everything was good.”

And still get sued for almost $16,000?

Ask Andrea Vargas. But wait - she doesn’t know either.

“I went to the proper doctors and, you know, I followed all the things I’m supposed to do,” says Vargas. “And to then still be stuck with a bill that I shouldn’t have been. It’s pretty frustrating.”

See, Vargas is a member of Kaiser Permanente. It’s a Health Maintenance Organization, or HMO, which means if you pony up your premiums and copays and see their doctors, everything should be paid.

The Seattle resident says she never received a bill. And then, more than four years after her first treatment, she was served a lawsuit by a collection agency.

“I’m frustrated, I’m angry. I’m sad,” she says.

So Andrea decided to sue Kaiser and its collection agency, Evergreen Professional Recoveries. Jason Anderson is her lawyer.

“What my client is not able to get to the bottom of as of this day, is why she got sued in the first place,” says Anderson. “Why was she sued at all?”

This may be what’s at play here: many health insurers want their members to use any auto insurance coverage up before their medical benefits kick in.

Anderson says this case has been ongoing for months and Kaiser hasn’t presented that information to him or Andrea.

“So that’s what gives me pause as a lawyer because you’d think they would come right out and say that is why they believe she owes money,” says Anderson.

Kaiser’s response:

“Kaiser Permanente Member Services is available by phone, email, and chat to help our members understand their benefits and get the care they need. While we cannot speak to any individual’s care, we remain committed to providing every member with the best experience, and we are looking into these concerns.”

The lawyer for the collection agency, Evergreen Professional Recoveries, told me “no comment.”

But Anderson says the collection is still on Vargas’s credit report. And she says it’s preventing her from buying a home.

“I was prequalified but they didn’t let me proceed because they wanted me to take care of that collections - the bills in collection first,” says Vargas. “But I couldn’t do that because it’s ongoing with no answers.”

The collection agency dropped the lawsuit without prejudice.

However, Becky House from the non-profit American Financial Solutions says businesses can wait years before re-filing suit in these cases.

“They have six years to come after you to file that lawsuit,” says House. “That’s a long time.”

House says if something like this appears on your credit report, you can dispute it.

“I’m definitely going to do it through the credit agencies,” says House. “Who can then take the necessary steps to make sure that information is accurate and it should be there, or remove it from my credit report.”

Vargas is moving ahead with her lawsuit against Kaiser and the collection agency. Because she’s demanding answers, and the repair of her financial reputation.

“I personally want closure in all this but I really want whatever it is that caused this to be fixed,” says Vargas.

Kaiser tells me it sends out notices to members when it doesn’t pay, along with an explanation of benefits. But lawyer Jason Anderson obviously tells a different story.

We will keep you up to date with this lawsuit.

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