Perez, Bertha

Lien claimant Monrovia Memorial Hospital provided surgical services to applicant Bertha Perez (back injury, produce packer) and billed $67,497.95; defendant paid $15,857.48 based on bill review. During ongoing litigation of the disputed bill, the hospital allegedly circumvented defendant's claims procedures by submitting the bill to defendant's medical review department, resulting in an erroneous full payment of $51,640.47, then withdrew its lien. The WCJ ordered the hospital to make restitution of $51,640.00 for unjust enrichment and imposed a $2,500 sanction plus costs and fees against the lien claimant and its representative under Labor Code section 5813 and WCAB Rule 10561/10421 for bad faith litigation tactics, including a roughly three-year failure to comply with a discovery order. The Board affirmed, finding the IBR-established reasonable value was the previously paid amount, that the lien claimant engaged in improper conduct supporting equitable restitution under Hurtado, and that its willful noncompliance with the May 6, 2015 order and manipulative payment tactics justified sanctions. The F&O issued November 8, 2019 was affirmed.