Marque Medicos Fullerton, LLC v. Hartford Underwriters Insurance Company, 2017 IL App (1st) 160756

Background

Four putative class actions were filed in 2015 by medical providers against multiple workers’ compensation insurers (Zurich, Travelers, Hartford, AIG), alleging insurers failed to pay statutory interest on late payments for work-related medical bills under 820 ILCS 305/8.2(d)(3).
Plaintiffs pleaded four counts in each complaint: (I) insurer breach of policy as intended third-party beneficiaries; (II) implied private right of action to enforce §8.2(d)(3); (III) breach of an implied-in-fact contract; (IV) relief under §155 of the Illinois Insurance Code for vexatious/unreasonable delay.
Defendants moved to dismiss under section 2‑615 (and some §2‑619 challenges), arguing lack of subject‑matter jurisdiction (administrative exclusivity) and failure to state various claims.
The circuit court dismissed all four suits with prejudice, finding plaintiffs were not third‑party beneficiaries, had no implied private right, no enforceable implied‑in‑fact contract, and could not recover under §155 as third parties; the court did not explicitly rule on the Commission‑jurisdiction argument.
On appeal the Illinois Appellate Court (1st Dist.) consolidated the appeals, held the circuit court did have subject‑matter jurisdiction over these common‑law/statutory claims, and affirmed the dismissal with prejudice on the substantive grounds the circuit court gave.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Subject‑matter jurisdiction	Act does not bar circuit court; providers seek enforcement of rights outside Commission’s exclusive domain	Claims arise from Act’s payment/interest rules so Commission has exclusive original jurisdiction	Circuit court has jurisdiction: plaintiffs assert common‑law/statutory claims (not employee benefits); Commission lacks general common‑law power
Third‑party beneficiary status	Standard WC policy language + §8.2 amendments show providers are intended beneficiaries	Policy language is not an express conferral of direct benefits to providers; at best incidental	Plaintiffs are incidental, not intended third‑party beneficiaries; count I dismissed
Implied private right of action under §8.2(d)(3)	§8.2(d)(3) explicitly directs interest to providers, so a private right is implied	The statute’s primary beneficiary is the injured employee; provider benefits are incidental	No implied private right: plaintiffs are not in the class the Act primarily protects; count II dismissed
Implied‑in‑fact contract	Defendants implicitly agreed to pay providers (including interest) in exchange for providers billing insurers directly	Any defendant promise to pay flowed from preexisting statutory and contractual duties — no bargained‑for consideration	No enforceable implied‑in‑fact contract: consideration would be performance of a preexisting legal duty; count III dismissed
Recovery under §155 of Insurance Code	Providers are entitled to §155 penalties/fees because insurers unreasonably withheld interest payable to providers	§155 remedies are limited to insureds and assignees, not third parties	§155 relief does not extend to third‑party providers who are not insureds or assignees; count IV dismissed

Key Cases Cited

Kelsay v. Motorola, Inc., 74 Ill. 2d 172 (discusses Act’s purpose to provide prompt and equitable compensation to employees)
Bayer v. Panduit Corp., 2016 IL 119553 (payment for necessary medical services is included within Act’s compensation)
J&J Ventures Gaming, LLC v. Wild, Inc., 2016 IL 119870 (standards on subject‑matter jurisdiction and statutory interpretation)
Employers Mut. Cos. v. Skilling, 163 Ill. 2d 284 (legislative divestiture of circuit court jurisdiction must be clear; interpret statute as whole)
Martis v. Grinnell Mut. Reinsurance Co., 388 Ill. App. 3d 1017 (medical providers generally are not third‑party beneficiaries of WC policies)
Yassin v. Certified Grocers of Illinois, Inc., 133 Ill. 2d 458 (§155 remedies extend to insureds and assignees, not third parties)