Opinion ID: 1654898
Heading Depth: 2
Heading Rank: 1

Heading: tortious interference with business claim.

Text: ¶ 9. Under Mississippi law, a claim for tortious interference with business relations requires proof of the following four elements: (1) the acts were intentional and willful; (2) the acts were calculated to cause damage to the plaintiffs in their lawful business; (3) the acts were done with the unlawful purpose of causing damage and loss without right or justifiable cause on the part of the defendant (which constitutes malice); and (4) actual loss and damage resulted. MBF Corp. v. Century Business Communications, Inc., 663 So.2d 595, 598 (Miss.1995). PDN asserts that it has offered evidence of each of these elements, while Loring argues that even if PDN's allegations were true, the insurance carrier has the right to choose who will provide home nursing and physical therapy services to an injured employee. On this basis, Loring submits that her acts were not without right or justifiable basis. ¶ 10. Miss.Code Ann. § 71-3-15(1) (Rev.2000) provides that the employee has the right to chose one competent physician and such other specialist to whom he is referred by his physician. In addition, section 71-3-15(1) provides that referrals by the chosen physician shall be limited to one physician within a specialty or sub-specialty. Based on this statute, along with the definitions provided in the Fee Schedule to Miss.Code Ann. § 71-3-15(3), PDN asserts that the injured employee, and subsequently his physician, has the right to choose his medical care provider, not the employer or its carrier. Therefore, PDN contends that since Balius's doctor referred him to PDN, Loring has no authority or right to require that Balius be treated by anyone other than PDN. ¶ 11. The Fee Schedule defines a specialist as: 41. Specialist means a board-certified practitioner, board-eligible practitioner, or a practitioner otherwise considered an expert in a particular field of healthcare service by virtue of education, training, and experience generally accepted by practitioners in that particular field of healthcare service. Miss. Workers' Comp. Comm'n Fee Schedule, Med. Cost Containment Rules C. ¶ 41 (Jan. 1, 1998). Also, the Workers' Compensation Commission defines a practitioner as a person licensed, registered, or certified as an ... nurse ... physical therapist. Id. ¶ 32. ¶ 12. In further support of its argument, PDN cites Dolenga v. Aetna Cas. & Sur. Co., 185 Mich.App. 620, 463 N.W.2d 179 (1990), for its holding that a rehabilitation service provider's intentional interference with business relations claim against a workers' compensation carrier was viable when the carrier refused to authorize services by such provider and insisted that the injured employee receive rehabilitation services from a provider chosen by the carrier. That court stated, since it is the claimant who receives the medical treatment or rehabilitation services, it ought normally to be the claimant who chooses the provider of those services. Id. at 181. ¶ 13. Loring, on the other hand, states that it is common practice for worker compensation insurers, in search of cost savings, to select the provider of such services. Loring contends that Miss.Code Ann. § 71-3-15 does not provide that the injured employee has the right to choose other treatment and nursing services not administered under the direction of a physician. Otherwise, Loring contends, the Legislature would have expressly provided that injured employee could not only choose his doctor, but also his nurse. Also, Loring states that PDN's use of the Fee Schedule, as support for its argument that nurses are specialists, stretches the intent of the Legislature, since it did not define specialist in § 71-3-15 to include physical therapists and nurses. ¶ 14. In Norville v. Commercial Union Ins. Co., 690 F.Supp. 558 (S.D.Miss.1988), aff'd mem. 866 F.2d 1419 (5th Cir.1989), a Mississippi federal court held that the carrier had a right to de-authorize chiropractic treatment which is other attendance or treatment and require the injured worker to switch to a physician. That court held that the insurer was entitled to summary judgment on the chiropractor's claim of tortious interference with business relations. 690 F.Supp. at 561-62. In that case, the court stated that [u]nder Section 71-3-15, the employer-carrier has the right and duty to properly choose and offer medical care and other treatment to the injured employee. We agree with this analysis. ¶ 15. We conclude that PDN's argument that AIG, and its employee, Loring, cannot choose which home nursing services provider to pay for is without merit. The language in section 71-3-15 does not provide that the injured employee has the right to choose his nurse or therapist, unless that nurse or therapist was specifically chosen by a doctor who remained to administer care to the injured employee. The record here does not reveal that the doctor remained to administer care to the patient; he merely referred Balius to a home health care provider. Thus, this issue is without merit.