Rupp v. Premier Health Partners
2025 Ohio 985
Ohio Ct. App.2025Background
- Dr. Kenneth Christman, a plastic surgeon, treated patients (the Rupps and the Garretts) for emergency injuries at Miami Valley Hospital (MVH), but did not disclose he was not in-network and practiced "balance billing," resulting in large, unexpected bills.
- The patients had insurance that paid most hospital/medical bills, but Christman billed them for substantial balances not covered by insurance, later pursuing collection efforts.
- Patients filed a class action against Christman and Premier Health Partners alleging violations of consumer protection laws, fraud, negligent misrepresentation, and unjust enrichment; Christman counterclaimed for unpaid medical bills.
- After procedural motions, the trial court granted summary judgment for Christman on most patient claims, denied class certification, and set Christman’s counterclaims for trial.
- At trial, after Christman presented his case, the court directed a verdict for patients, finding the contracts unconscionable and unenforceable, but the appellate court found genuine issues of fact about unconscionability and reversed for retrial on the breach of contract counterclaim only.
Issues
| Issue | Plaintiff’s Argument | Defendant’s Argument | Held |
|---|---|---|---|
| Directed verdict on breach of contract | Christman’s contract should be enforced; patients owe balance due. | Contract is unconscionable/adhesion and unenforceable. | Reversed; factual issues remain as to unconscionability, remanded for retrial. |
| Denial of summary judgment to Christman | Patients signed the contract; Christman is entitled to judgment. | Contract unconscionable; defenses exist. | Affirmed; genuine factual disputes preclude summary judgment. |
| Admission of billing expert testimony | Billing expert’s underlying data unreliable. | Data and methodology are industry standard/reliable. | Affirmed; no abuse of discretion in admitting expert testimony. |
| Bifurcation of patient trials | Separate trials required due to complexity/different facts. | Cases arise from similar facts; bifurcation unnecessary and inefficient. | Affirmed; trial court did not abuse discretion in refusing bifurcation. |
| Assertion of additional defenses / amendment of answer | Patients waived contract-of-adhesion/unconscionability defenses. | Defenses reasonably disclosed; no element of surprise; Christman had notice. | Affirmed; no objection at trial, no plain error. |
| Limitation of attorney fees to counterclaim | Should recover fees from defending class action as well. | Attorney fees should be limited to prosecution of counterclaim. | Affirmed; not ripe as attorney fees issue was bifurcated and not yet tried. |
| Unjust enrichment claim | Entitled to recover on unjust enrichment regardless of contract. | Express contract precludes unjust enrichment claim. | Affirmed; express contract bars unjust enrichment recovery. |
Key Cases Cited
- Taylor Bldg. Corp. of Am. v. Benfield, 117 Ohio St. 3d 352 (Ohio 2008) (defines and applies unconscionability requirements for invalidating contracts)
- Collins v. Click Camera & Video, Inc., 86 Ohio App. 3d 826 (Ohio Ct. App. 2d Dist. 1993) (discusses substantive and procedural unconscionability)
- Ruta v. Breckenridge-Remy Co., 69 Ohio St. 2d 66 (Ohio 1982) (sets standard for directed verdicts)
- Lake Ridge Academy v. Carney, 66 Ohio St. 3d 376 (Ohio 1993) (sets burden of proof for unconscionability, both procedural and substantive)
- Miller v. Bike Athletic Co., 80 Ohio St. 3d 607 (Ohio 1998) (adopts Daubert standard for scientific expert testimony in Ohio)
- Hambleton v. R.G. Barry Corp., 12 Ohio St. 3d 179 (Ohio 1984) (outlines elements required for unjust enrichment in Ohio)